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MERCY MEDICAL CENTER 1320 MERCY DRIVE NW CANTON, OH 44708 Aug. 1, 2012
VIOLATION: DIRECTOR OF DIETARY SERVICES Tag No: A0620
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on observations, interview and review of facility policy, the director of the dietary department failed to ensure temperatures of cold food items was safely maintained and failed to ensure food or drink items were not expired. This had the potential to affect all patients, staff or visitors. The current census was 287.

Findings include:

A tour of the kitchen area resumed on 07/31/12 at 1:45 PM. A random selection of coolers and freezers were observed for temperature readings. At that time, cooler KIT544 was observed to have two 1-quart cartons of expired non-dairy creamer inside. One had expired on [DATE] and the other on 07/26/12. Staff C was then made aware and immediately disposed of the cartons.

At approximately 10:18 AM Staff C brought the requested temperature logs for equipment and food. Review of those logs revealed that temperatures for hot food items, freezers, coolers, pot sink and dishwashing machines were being recorded beginning the week of 06/24/12. Staff C stated that all logs prior to that time were now missing and he/she believed that the prior company staff disposed of the logs. Review of the cold food item temperature logs, however, revealed that the first date staff began recording temperatures was 07/26/12. Policies related to infection control in food and nutrition services, temperature monitoring and recording were reviewed. Facility policy 317, Temperature Audit Program, revealed temperatures were to be recorded and documented twice daily.

Staff A and C confirmed this finding at 1:58 PM on 08/01/12, stating "that was all there was" and they were not aware the logs were missing until it was brought to their attention today. Facility policy 317, Temperature Audit Program, revealed temperatures were to be recorded and documented twice daily.

These findings substantiate complaint #OH 035.
VIOLATION: MAINTENANCE OF PHYSICAL PLANT Tag No: A0701
Based on observations and interview, the facility failed to ensure carts utilized for storing and/or transporting clean dishware were kept clean and free of debris. This affected all utility carts observed within the automated dishwashing room with the potential to affect all utility carts within the department utilized for clean storage of dishware and all patients, staff and visitors served food on those dishes. The current census was 287.

Findings include:

On 07/31/12 at 10:44 AM tour of the automated dishwashing area was conducted with Staff B and C. The cart utilized to transport clean tray bases was observed to be dirty, with particles of food present on it. The storage cart with clean dinner plates was also noted to be dirty, with food particles present on it. Staff C confirmed both carts were dirty and stated they were cleaned nightly with a disinfecting solution or soap and water and should also be spot cleaned as needed.

Observations of the tray line were begun on 07/31/12 beginning at 10:55 AM. Staff was observed washing hands at a sink located directly next to a cart with dinner plates on it. Staff C confirmed the cart contained clean plates and the cart was in fact dirty with loose food particles present on it. Staff C further stated the cart of clean plates would be moved away from the hand washing sink so there would be no risk of splash contaminating the plates. Staff C then proceeded to move the plates in question and informed tray line staff not to store them at that location in the future.

Tour of the kitchen was begun again on 08/01/12 at 8:45 AM. Storage carts within the automated dishwashing area were observed again. The bottom of the carts used to store clean small serving bowls, dinner plates and salad/soup bowels were noted to be dirty with food particles and white residue present. Staff C confirmed this finding at that time.

These findings substantiate complaint #OH 035.