§483.60(i) Food safety requirements. The facility must -
§483.60(i)(1) - Procure food from sources approved or considered satisfactory by federal, state or local authorities. (i) This may include food items obtained directly from local producers, subject to applicable State and local laws or regulations. (ii) This provision does not prohibit or prevent facilities from using produce grown in facility gardens, subject to compliance with applicable safe growing and food-handling practices. (iii) This provision does not preclude residents from consuming foods not procured by the facility.
§483.60(i)(2) - Store, prepare, distribute and serve food in accordance with professional standards for food service safety.
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Observations:
Based on review of manufacturer's guidelines, facility records, observations, and staff interviews, it was determined the facility failed to maintain safe storage of ice for residents for one of one ice machines located in the kitchen.
Findings include:
Review of the manufacturer's guidelines for the "Kold-Draft GT & GB Models" (ice machine) revealed that "Individual drains must never be directly connected to a common manifold, drain, or standpipe. If individual drains are to be discharged into a common manifold, drain, or standpipe, a minimum one and half-inch air gap must be provided at each connection. This is to prevent any backflow or back-siphoning of drain water into the ice maker or ice bin."
Review of ice machine maintenance records provided by the facility on 12/12/23, indicated that the ice machine was last serviced and cleaned on 9/25/23.
Observation on 12/11/23, at 11:14 a.m. revealed a black, slimy substance on the outside of the white plastic drainpipe from the bottom of the ice bin. The bottom edge of the pipe was resting against the top edge of the drainpipe to the floor, and there was black, slimy substance on the inside edge of the drainpipe to the floor, and there was no one and half-inch air gap.
During an interview on 12/11/23, at 11:14 a.m. the Dietary Manager confirmed the presence of the black, slimy substance on both pipes and that the pipes were resting together.
During an interview on 12/12/23, at 1:30 p.m. the Nursing Home Administrator confirmed the presence of the black, slimy substance; the edges of the pipes were touching; the ice machine was last cleaned on 9/25/23; and that the ice machine piping was dirty and should have been cleaned and measures taken to prevent the development of the black, slimy substance.
28 Pa. Code 201.14(a) Responsibility of licensee
| | Plan of Correction - To be completed: 01/15/2024
The ice machine discharge hose will be cut to achieve the 1.5" air gap required. The open air drain cup itself is sanitized as part of the ice machine preventive maintenance process but in order to improve the appearance of the inside and outside of the drain cup the drain cup will be cleaned and sanitized with an appropriate cleaning solution. The existing preventive maintenance process form will be modified to insure that the 1.5"air gap is part of the preventive maintenance inspection procedure and is maintained at 1.5". The cleaning of the open air drain cup will part of the ice machine review process and cleaned as needed.
The director of facilities engineering or VP ancillary services will conduct facility inspections looking for Safety, Life Safety, Infection Control and aesthetic issues that need to be addressed and resolved. Ice machine open air gaps and drain cup appearance will be part of their inspection process. Additionally our Infection Prevention Team and the NHA have included the drain inspection as part of their monthly kitchen inspections beginning 12/19/2023. The inspection will be included on the inspection documentation that is reviewed at quartlerly Infection Prevention Committee meetings and quarterly QAPI meetings through 2024.
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