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Based on observation, interview and record review the hospital failed to ensure that the facility's patient care area and the dietary department were maintained in a clean and sanitary environment. Two of two emergency carts (ER) were observed to have an accumulation of dust on the top of the carts, plastic trays on 2 of 2 medication carts were observed to be cracked with tape observed on the trays to secure them, dietary department failed document dishwasher water temperature and failed to maintain food off the floor.

Findings:

Review of policy titled "Cleaning and Disinfecting Equipment", Section: Infection Control, Policy Number: IC-05.01 Effective Date: 07/01/2016, Revised Date: 10/01/2016. Reads in Part ... ...Purpose: To define a process for the cleaning and disinfection of equipment and environmental surfaces to prevent the spread of infection ... ....Below is a list of noncritical equipment and surfaces that may be located in the hospital. If other noncritical equipment is identified in the hospital, it will be wiped with a disinfection laden cloth between patient use and when visible soiled. 6. Medicine Carts/Emergency Carts/Isolation carts or Totes (responsible party: Nursing). The inside and outside of all carts will be cleaned and wiped with disinfectant laden cloth when visibly soiled.

Review of policy titled: "Cleaning - IC.4" Effective Date: 8/2016, Dietary, Purpose: To maintain a sanitary working environment Policy and Procedure reads in part ... ... Equipment, work surfaces, walls and floors are maintained in sanitary condition by daily, ongoing procedures. Actions: 3. Dishes and utensils are cleaned by machine with a scrape, pre-rinse wash, final rinse system. Wash temperature is maintained at 150 degrees F. Final rinse is maintained at 180 degrees F. for a minimum of 15 seconds. Sanitation and Safety Policies 8. Procedures for washing and sanitizing dishes, glassware, silverware and patient trays are developed posted and followed. Dish machine washing and rinsing temperatures are recorded daily.

Review of Dietary Manual Policy titled "DM-Storage-01: Storage of Potentially Hazardous Foods" reads in part .... Policy: Potentially hazardous foods shall be stored in a manner that prevents cross contamination and food borne illnesses. Procedure: 4. All foods shall be kept off the floors of the walk-in refrigerators and freezers.

Observation of the intake patient treatment area was observed along with the Director of Nursing, Employee ID #52 at 11:00 a.m. on 05/31/2018. The patient intake area Emergency Cart was observed to have and accumulation of visible dust on the top horizontal shelf along with the suction machine and other supplies stored on the cart.

Interview 05/31/2018 at 11:05 a.m. with DON, Employee ID #52 confirmed that the dust was unacceptable and the equipment should have been cleaned more than once a month if needed.

Observation of an Emergency Cart in the Nursing Station area along with the Infection Control Nurse Employee ID #51 at 1:00 p.m. on 05/31/2018 it was observed to have an accumulation of dust build up on the top horizontal shelf along with the suction machine and other supplies stored on the cart.

Employee ID #51 stated on 05/31/2018 at 1:00 p.m. that the Emergency Carts are on a cleaning schedule of once a month and Employee ID #51 stated it was lasted cleaned on May 5, 2018. Employee ID #51 was asked if once a month was sufficient enough to keep the cart clean, she stated "No, It should be cleaned more frequently that once a month."

Observation of 2 of 2 medication carts along with Employee ID #51 at 2:00 p.m. on 05/31/2018 revealed both medication carts contained plastic trays covering the top shelf of each cart, each plastic tray (2 of 2) was observed to have large cracks and breaks in the plastic. Trays were observed to have pieces of tape adhering to the plastic tray holding them together.

On 05/31/2018 at 2:10 p.m. the Infection Control Nurse Employee ID #51 was asked if this was acceptable to use these trays. Employee ID # 51 stated, "The trays should not be used, they need to be replaced. The trays are cracked and they cannot be properly disinfected."

During a tour of the dietary area along with Infection Control Nurse ID #51 and the Director of Dietary Employee ID #59 at 11:30 a.m. on 05/31/2018 it was observed the temperature log for April 2018 did not have completed dishwasher washing temperature and rinse temperature listed on the following dates: April 27, 28, 29 and 30, 2018.

Further observation of the walk in freezer on 05/31/2018 at 1:30 p.m. along with Employee #51 and #59 observed a case of fish filets on the floor of the freezer.

Interview with the Infection Control Nurse on 05/31//2018 at 1:35 p.m. was ask if it was acceptable for food to be stored on the floor. Employee ID #51 stated, "Food should not be stored on the floor, it should be up on a shelf". Employee ID #51 was then asked if it was appropriate for the dishwasher temperature log not to be completed daily. Employee ID #51 stated, "No, the temperature log should be filled out daily, in the morning and the afternoon."

Interview with the Director of Dietary Employee ID #59 on 05/31//2018 at 1:40 p.m. was ask if it was acceptable for food to be stored on the floor. Employee ID #59 stated, "I just got a delivery and I placed the box on the floor, food should not be on the floor." Employee ID #59 was then asked if it was appropriate for the dishwasher temperature log not to be completed daily. Employee ID #59 stated, "No, the log should be filled out twice a day."