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Based on observation, interview, and record review, the facility failed to provide the dietary services in a sanitary environment, placing patients at risk of abdominal pain, and diarrhea from food born illnesses, and possibly death from bacterial growths.

Findings include:

Observations during a tour on the afternoon of 8/2/22, of the facility's dietary department, revealed the following:

- The kitchen floor had dried food and grease debris stuck in the grout lines throughout.
- Three cake sheet pans, with caked on food and grease debris, were available for use.
- The drying rack had copious amounts dried food debris stuck to the metal rails and plastic shelf.
- The food production table and manual can opener had dried food debris on it's sides and down the opener's holster.
- The dishwashing walls had dark green growth on the walls, and cracked peeling paint, which could fall onto the cleaned dishes.
- The air vents, throughout the kitchen, had copious amounts of dust and debris hanging from the ceiling over the food production areas.
- The wall behind the grill and fryer, had grease running down about 12 inches, and a pipe was covered in black grease.
- The fryer had old food debris floating in and around the grease, placing it at risk of being served to patients.
- The dry food storage had food debris on the shelves, and there was an opened box of rice and biscuit mix, which would allow pests access.
- Dented cans were available for use, placing patients at risk of Botulism growth through small openings in the seams.
- The facility was storing unpasteurized eggs over produce, creating an environment for Salmonella cross contamination.
- The walls around the walk-in refrigerator were rusting and unable to be cleaned.

In an interview, during a tour of the facility's dietary department, Staff #10, Registered Dietitian, confirmed the findings and stated, "I manage the department ...We have the floors power washed twice a year, we mop them daily ...We've been trying to scrub the walls ...I guess it's time to get some new pans."

Review of the facility provided policy Industry Procedure, dated 11/01/2016, reflected, "PAM Health, LLC supports the use of industry-based procedures to provide guidelines for safe food production.

Dietary Director/Dietitian is responsible for ensuring that a copy of the reference is obtained for the Dietary Department ...Dietary staff will refer to this publication for guidance.

https://www.servsafe.com/ServSafe/media/ServSafe/Documents/NFSEM_wk3_Actvy-Clean-Sanitize.pdf revealed, "No matter how carefully food is cooked, without a clean and sanitized environment, pathogens can be quickly transferred to both cooked and uncooked food. To prevent cross-contamination from surfaces the correct cleaning and sanitizing procedures must be followed ..."