Based on observation, interview, record review, the facility failed to ensure the Certified Dietary Manager (CDM) fulfilled her job responsibilities of daily kitchen oversight when: 1. The CDM failed to monitor daily kitchen operations to ensure a) food safety guidelines and standards of practice were followed; b) effective supervision of kitchen employees was conducted; c) proper preparation of pureed items; d) meal palatability and food was prepared to conserve nutrients; e) resident food preferences and intolerances were followed, and f) kitchen equipment was in safe working order (Cross reference to F812, F802, F803, F804, F806, and F908). 2. The CDM delegated daily departmental oversight responsibilities to [NAME] 1, who was not trained or qualified to perform the duties of a CDM. [NAME] 1 performed the CDM's job duties 40 hours weekly which included but not limited to; ordering food, visitation of residents for food preferences, attending care plan meetings, and providing instruction and guidance to food service employees. 3. [NAME] 2, who was responsible for preparing two meals a day, five days a week, was not competent in adequate hand washing, preventing cross contamination of food, cleaning, sanitizing and storage of food preparation equipment, manual washing of cookware used for resident food preparation, proper testing of the kitchen sanitizing solution, preparing puree food items according to the recipe, ensuring the resident food was prepared in a manner which maintained the nutritional value of resident meals and resident meals were palatable (Cross reference to F802, F803, F804, and F812). 4. The Registered Dietitian (RD) did not provide effective oversight of the kitchen operations. 5. The facility Administrator was not aware that an unqualified, untrained employee was performing CDM's managerial duties on a fulltime basis and the CDM was not fulfilling her job responsibilities. These failures to ensure the CDM fulfilled her job responsibilities resulted in exposing 76 of 76 residents (17 sampled residents and 59 non-sampled residents), who received food prepared in the kitchen, to practices with the potential to result in food borne illness, bacterial cross contamination, poor meal quality, decreased meal satisfaction and compromised resident nutritional status including but not limited to weight loss. Due to the lack of daily oversight and monitoring of the food service operations by qualified personnel that could cause serious potential harm of food borne illnesses, an Immediate Jeopardy (IJ- a situation in which the facility's noncompliance with one or more requirements of participation has caused or is likely to cause serious injury, harm, impairment, or death to a resident) situation was called on 8/25/22 at 5:24 p.m., under Code of Federal Regulations (CFR) §483.60 Staffing (F801) with the Administrator, (ADM) the Director of Nursing (DON), Assistant DON (ADON), Infection Preventionist (IP), Certified Dietary Manager (CDM), and the Staffing and Recourse Nurse in attendance. The IJ template was provided to the ADM. The facility submitted an acceptable IJ Plan of Removal (Version 3) on 8/26/22, at 5:42 p.m. The IJ Plan of Removal included but was not limited to the following: 1) As of 8/26/2022 the current CDM will resume her role as outlined in the job description to include, but not limited to: planning, controlling, coordinating, directing, and evaluating all aspects of food service, along with data collection for clinical charting, MDS (Minimum Data Set - a comprehensive assessment used for screening, clinical and functional status elements for nursing home residents) participation, and care planning, as well as begin routine monitoring of the kitchen operations to ensure food safety guidelines are met. - Directing the food service operation following the facility and Dietary Policy and Procedure Manuals, - Developing and writing schedules for dietary staff, supervising the preparation of food and food service for the resident meals according to established menus and standardized recipes, ensuring food is prepared by methods that conserve nutritional value and is palatable and attractive to residents, purchasing food and supplies according to the facility menu and remains within the budgetary guidelines established by the facility and maintains all cost records as required by administration, - Participating in planning and conducting departmental meetings and in-service education, - Ensuring sanitation and safety standards are maintained according to State, Federal, and local regulations, maintains all dietary records, i.e.: temperature records, tray cards, profiles, nutritional assessments, MDS, care plans, etc., - Coordinates and gathers the information required by the Registered Dietitian i.e.: resident weights, skin report, facility admissions, dietary consults, enteral feedings, etc., - Participates in charting responsibilities as requested by facility and Registered Dietitian, - Ensures residents receive the proper food items to meet their dietary need and that food is served at the appropriate temperature for safety and palatability, - Participates in IDT (Interdisciplinary Team) meetings and conferences as requested by the facility, - Communicates with Registered Dietitian regularly and as requested by the Administrator or Director of Nursing, - Performs other duties assigned by the Administrator. The CDM will conduct daily Food Service Sanitation (FSS) Kitchen checks using the California Association of Healthcare Facilities (CAHF) Daily Supervisor Rounds Checklist and will include staff interviews which will be reviewed with the Administrator daily (Monday-Friday) to begin on 8/26/2022 for 30 days. If any line item(s) are not met, item(s) will be reviewed, and corrective action implemented for continued monitoring. At the completion of 30 days, if threshold of 90% is not met, additional daily FSS Kitchen checks will continue for 30 days and then be re-evaluated. A Performance Evaluation of the CDM utilizing the facility form will be conducted by the Regional Administrator, on 8/30/2022 and at the completion of the 30 days referenced above to include duties as written in the job description (Threshold: Meets Standards). The Registered Dietitian will conduct a bi-monthly sanitation inspection and review with the Administrator. The Administrator will conduct a bi-monthly Administrator Kitchen Inspection Checklist and review findings with the Registered Dietitian. The Registered Dietitian using the Competency Checklist for Food Service Workers, will complete competencies of all kitchen staff beginning today, 8/26/22, through 8/31/22. Any areas identified requiring improvement will result in 1:1 in-service with staff member with return demonstration to ensure competency is met. By September 30, 2022, all food service workers will be reevaluated by the Registered Dietitian using the Competency Checklist for Food Service Workers. The findings from the daily FSS Kitchen checks and the bi-weekly Dietary Manager Kitchen Inspection Checklist will be discussed at the monthly QA meeting for three months or until substantial compliance is met (Threshold: 90%). 2) As of 8/26/2022 [NAME] 2 was replaced with a qualified dietary cook (Cook 1). [NAME] 1 will prepare breakfast and lunch 5 days per week. [NAME] 1 was an experienced cook when hired on 3/18/2010. [NAME] 1's last competency evaluation was 8/26/2022. 3) The fulltime a.m. [NAME] (Cook 2) was removed from her duties effective immediately and did not cook breakfast on 8/26/22022. [NAME] 2 verbally resigned from her position on 8/26/2022 at 11:00 am. 4) Upon investigation, it was determined that [NAME] 1's recent duties had evolved over several years, but her job description was not updated to reflect changes or additions to her role. The Administrator reviewed the Dietary Department Job Descriptions/Duties, and it has been determined that the assigned role of [NAME] 1 was never reclassified to reflect her recent duties. As of 8/26/2022, the [NAME] 1 has resumed her designated role as cook. All duties defined in her job description upon hire have been reviewed and acknowledged. Systemic problems that occurred resulting in the employment of a cook who did not perform to sanitary standards/expectations are as follows: COVID-19 Pandemic, staffing shortages, failure of Dietary Manager to conduct timely competencies, and failure of the Dietary Manager to provide direct oversight/supervision. The components of the IJ Plan of Removal were validated through observations, interviews, and record review. The IJ was removed on 8/26/22 at 5:53 p.m. with the ADM in attendance. Findings: During a review of the professional reference obtained from https://www.foodsafety.gov/food-poisoning, downloaded 9/1/22, indicated, food poisoning or foodborne illnesses can affect anyone who eats food contaminated by bacteria, viruses, parasites, toxins, or other substances. During a review of the professional reference obtained from https://www.foodsafety.gov/people-at-risk/older-adults downloaded 9/1/22, indicated certain groups of people are more susceptible to foodborne illness. This means they are more likely to get sick from contaminated food and, if they do get sick, the effects are much more serious. Older adults residing in nursing homes are ten times more likely to die from bacterial gastroenteritis than the general population. This increased risk of foodborne illness is because organs and body systems go through changes during aging. These changes include: the gastrointestinal tract holds on to food for a longer period, allowing bacteria to grow; the liver and kidneys may not properly rid bodies of foreign bacteria and toxins; the stomach may not produce enough acid. The acidity helps to reduce the number of bacteria in our intestinal tract. Without proper amounts of acid, there is an increased risk of bacterial growth; underlying chronic conditions, such as diabetes and cancer, may also increase a person's risk of foodborne illnesses. 1. During the tour of the kitchen between 8/23/22 at 8:22 a.m. and 8/25/22 at 4:24 p.m. the following was observed: a. Proper hand washing was not performed by [NAME] 2 after a trash can was touched, b. Cross contamination was not prevented when a measuring scoop was stored inside a food bin, c. Expired food items (three bags of cabbage and five bags of corn tortillas) were available for use and not discarded, d. Leftover potatoes were observed in the walk-in refrigerator and not cooled down safely, e. More than five steam table pans, two small and one large frying pans had thick dark brown residue on the insides of the pans, four cutting boards were heavily marred, the can opener blade was brown and worn, f. The meat slicer, mixer, can opener and a weighing scale were visibly dirty and not clean, g. Three food items in plastic bins were not labeled and did not have open dates, h. Milk was stored in crates on the floor of the walk-in refrigerator, i. [NAME] 2 stored more than five steam table pans wet and not inverted, j. The walk-in refrigerator door, knife rack and a plastic container with clean divided plates were visibly dirty and not clean, k. Two kitchen brooms were stored on the floor, l. A beverage that belonged to an employee was stored in the walk-in freezer, m. Puree recipes were not followed, n. Kitchen equipment was not in safe working order when the walk-in freezer had excessive ice build-up, the walk-in refrigerator door was not flush with the door jamb exposing a gap, and the temperatures on the oven dial were worn off and not legible, o. Resident 80's food preferences and intolerances were not followed, and p. Resident food was not prepared to provide palatability and conserve nutritive value. a. During an observation on 8/24/22, at 8:25 a.m., in the kitchen, [NAME] 2 was washing steamtable pans and placing them in the rinse sink. [NAME] 2 touched the trash can then grabbed a rag out of the sanitation bucket and started sanitizing the counter tops. [NAME] 2 then returned to the rinse sink and started removing the steam trays from the rinse sink. During an interview on 8/24/22, at 8:38 a.m., with [NAME] 2, [NAME] 2 stated, touching the trash can and then sanitizing counters was not the facility's process. [NAME] 2 stated, You need to wash your hands after touching the trash can. During an interview on 8/25/22, at 4:29 p.m., with Certified Dietary Manager (CDM), CDM stated, that if kitchen staff touched a trash can, they would need to wash their hands after. CDM stated, staff must wash hands anytime the hands become contaminated (having been made impure by exposure to something) to prevent cross contamination (the process by which bacteria or other microorganisms are unintentionally transferred from one thing to another with harmful effect). CDM stated her last in-service on handwashing was in 2021. CDM stated, she did not have an in-service on handwashing for 2022. During a review of the facility's Policy and Procedure (P&P) titled, SANITATION AND INFECTION CONTROL SUBJECT: DISHWASHING PROCEDURES (DISHMACHINE), dated 2018, the P&P indicated, . the employee must wash hands thoroughly before handling clean dishes, trays and carts . During a review of the professional reference titled, USFDA [United States Food and Drug Administration] Food Code, dated 2017, the USFDA Food Code indicated, . Section 2-301 . When to Wash, food employees shall clean their hands . after engaging in other activities that contaminate the hands . b. During an interview on 8/23/22, at 8:24 a.m., with CDM, CDM stated, it was the facility's practice to not store scoops inside bins. During an observation on 8/24/22, at 10:19 a.m., in the kitchen, [NAME] 2 was preparing to puree (a smooth creamy substance made of liquidized food) food items for the lunch meal on top of a cart. [NAME] 2 had a plastic bin that contained thickener (a substance added to a liquid to make it firmer) on the top of the cart. [NAME] 2 used a metal measuring scoop stored inside the plastic bin to scoop up the thickener. [NAME] 2 added thickener to the food multiple times. [NAME] 2 placed the measuring scoop on the top of the cart more than two times before placing it back into the plastic bin. During a concurrent observation and interview on 8/24/22, at 3:10 p.m., with [NAME] 3, in the kitchen, there was a plastic bin containing thickener and a measuring scoop stored inside of it. [NAME] 3 stated, measuring cups should not be stored inside of the plastic bin. During a review of the facility's policy and procedure (P&P) titled, SANITATION AND INFECTION CONTROL SUBJECT: CLEANING SMALL APPLIANCES/EQUIPMENT, dated 2018, the P&P indicated, . Food Storage Bins . The scoop should be stored outside the bins in a designated area . c. During an observation on 8/23/22, at 8:24 a.m., in the kitchen, the walk-in refrigerator and the dry storage room were observed. The walk-in refrigerator had three bags of cabbage with expiration dates of 8/15/22. The dry storage room was 82 degrees Fahrenheit (F) and had five bags of corn tortillas with manufactures date of 5/23/22. The tortillas had no received date or expiration date on them. During an interview on 8/23/22, at 8:24 a.m., with CDM, CDM stated, she did not know when the tortillas were received. During an interview on 8/23/22, at 10:27 a.m., with CDM, CDM stated, the cabbage should have been discarded. During a concurrent observation and interview on 8/24/22, at 9:35 a.m., with [NAME] 1, in the dry storage room, the five bags of tortillas were stored with a verified received date sticker of 8/17/22. [NAME] 1 stated, the process at the facility was food needed to be dated if it was removed from the original box it came in. [NAME] 1 stated, five bags of tortillas had received date of 8/17/22. [NAME] 1 stated, if tortillas were not dated, she would look at the facility's shelf-life (the length of time for which an item remains fit for consumption) list. [NAME] 1 stated, tortillas were not listed on the facility's shelf-life list. During an interview on 8/24/22, at 10:44 a.m., with CDM, CDM stated, the shelf life for corn tortillas was 45 days from the manufactures date per [brand name] website. CDM stated that the tortillas were expired. d. During a concurrent observation and interview on 8/23/22, at 8:22 a.m., with CDM, in the walk-in refrigerator, there was a zip lock bag with sliced potatoes with a date that was not legible. CDM stated, the zip lock bag contained leftover cooked potatoes from 8/22/22. CDM stated, a resident requested cooked potatoes twice a day. During an interview on 8/24/22, at 3:10 p.m., with [NAME] 3, [NAME] 3 stated, the facility did not save leftovers. [NAME] 3 stated, the facility's process was not to re-heat food for safety reasons. During an interview on 8/25/22, at 9:36 a.m., with [NAME] 1, [NAME] 1 stated, the facility's practice was to prepare food same day the resident was eating it and not keep leftovers. [NAME] 1 stated, if facility was to keep leftovers a record of that food should be documented on the facility's cooling log. During an interview on 8/25/22, at 1:04 p.m., with CDM, CDM stated, the cook made a batch of potatoes for three days. The leftover portion of potatoes would be refrigerated and used for the next meal. The CDM stated she has not kept a record of pre-made potatoes on the cooling log. During an interview on 8/25/22, at 2:15 p.m., with Registered Dietician (RD) 1, RD 1 stated, she had not seen any leftovers kept at the facility. RD 1 stated, she was not aware facility was keeping leftovers. RD 1 stated, if facility was keeping leftovers the leftovers would need to be cool downed properly. During a review of the facility's COOLING/CHILLING TEMPERATURE CONTROL LOG, dated 6/17/22 through 8/24/22, the COOLING/CHILLING TEMPERATURE CONTROL LOG indicated, no record of sliced potatoes. During a review of the facility's (P&P) titled, FOOD PREPARATION SUBJECT: FOOD PREPARATION, dated 2018, the P&P indicated, . Leftovers must be refrigerated immediately utilizing cool down log, covered labeled and dated . e. During a concurrent observation and interview on 8/23/22, at 8:22 a.m., with CDM, there were more than five steam table pans with thick dark brown residue (amount of something that remains after the main part has gone or been used) on the inside and outside of the pans. Two small and one large frying pans had thick dark brown residue on the insides of the pans. Four cutting boards were heavily marred. The can opener blade was brown and worn. CDM stated, the pans with the dark brown residue were not acceptable to cook with and should be replaced. CDM stated, the cutting boards needed to be replaced. CDM stated, the can opener blade was worn. During a concurrent observation and interview on 8/23/22, at 10:35 a.m., with CDM, in the kitchen, there was one rubber spatula with a chip in the rubber area. CDM stated, the spatulas needed to be discarded. During a review of the professional reference titled, USFDA Food Code, dated 2017, the USFDA Food Code indicated, . 4-202.11 Food-Contact Surfaces. (A) Multiuse FOOD- shall be: CONTACT SURFACES (1) SMOOTH; (2) Free of breaks, open seams, cracks, chips, inclusions, pits, and similar imperfections . During a review of the professional reference titled, USFDA Food Code, dated 2017, the USFDA Food Code indicated, . Section 4-501.12 Cutting Surfaces, surfaces such as cutting blocks that are subject to scratching and scoring [cut or scratch] shall be resurfaced if they can no longer be effectively cleaned and sanitized, or discarded if they are not capable of being resurfaced . f. During a concurrent observation and interview on 8/23/22, at 8:24 a.m., with CDM, in the kitchen, the meat slicer was covered with a plastic bag. CDM stated, if equipment was clean then it would be covered with a plastic bag. The bag covering the meat slicer was removed. The meat slicers' blade and grip had a brown sticky substance. CDM stated, the brown substance should not be on the meat slicer. CDM stated, the meat slicer was not cleaned appropriately. CDM stated, the meat slicer should be disassembled and sanitized. During a concurrent observation and interview on 8/23/22, at 8:24 a.m., with CDM, in the kitchen, the can opener blade was worn and brown. The can opener and can opener base had a brown sticky residue that transferred to the hand when touched. CDM stated, the can opener and can opener base was not clean. During a review of August 2022 DAILY CLEANING SCHEDULE SAMPLE FORM dated 8/1/22 through 8/14/22, the August 2022 DAILY CLEANING SCHEDULE SAMPLE FORM indicated, . ITEM . Slicer . RESPONSIBLE PARTY . Cooks . INITIALS AND DATE . Form was dated and signed off (documentation by staff that something was completed) for days 8/1/22 through 8/14/22. During a review of the facility's P&P titled, CONTROL SUBJECT: SANITIZING EQUIPMENT, FOOD AND UTILITY CARTS, dated 2018, the P&P indicated, . All kitchen equipment and surfaces, which come in contact with food, will be cleaned and sanitized after each use . During a review of the professional reference titled, USFDA 2017 Food Code, dated 2017, the USDA Food Code indicated, Section 4-601.11 Equipment, Food-Contact Surfaces, Nonfood Contact Surfaces, and Utensils (A): Equipment food-contact surfaces and utensils shall be clean to sight and touch. During a concurrent observation and interview on 8/23/22, at 8:55 a.m., with CDM, in the kitchen, the mixer was on the counter with a plastic bag covering it. CDM stated, clean equipment was covered with a plastic bag. The plastic bag was removed. The mixer had a white flakey residue on it. CDM stated the mixer was not clean. During a review of August 2022 DAILY CLEANING SCHEDULE SAMPLE FORM dated 8/1/22 through 8/14/22, the August 2022 DAILY CLEANING SCHEDULE SAMPLE FORM indicated, . ITEM . Mixer . RESPONSIBLE PARTY . Cooks . INITIALS AND DATE . Form was dated and signed off for days 8/1/22 through 8/14/22. During a review of the facility's P&P titled, SANITATION AND INFECTION CONTROL SUBJECT: CLEANING SMALL APPLIANCES/EQUIPMENT, dated 2018, indicated, . Mixers will be cleaned and sanitized after each use . During a concurrent observation and interview on 8/23/22, at 10:15 a.m., with CDM, in the kitchen, a rubber spatula with food residue was seen with a melted handle. The CDM stated the rubber spatula was dirty and handle not cleanable and would be discarded. During a review of the professional reference titled, USFDA 2017 Food Code, dated 2017, the USFDA Food Code indicated, Section 4-601.11 Equipment, Food-Contact Surfaces, Nonfood Contact Surfaces, and Utensils (A): Equipment food-contact surfaces and utensils shall be clean to sight and touch. During a concurrent observation and interview on 8/24/22, at 8:34 a.m., with Dietary Aid (DA) 2, in the kitchen, a plate was seen on the plate warmer with an orange residue. DA 2 stated, the plate warmer was an area for clean plates. DA 2 stated, the plate with the orange residue was not clean and removed it from the plate warmer. During an interview on 8/25/22, at 4:29 p.m., with CDM, CDM stated, dishware with food debris would not be clean and should be washed again. CDM stated, dirty dishware should not be placed with clean dishware. During a review of the facility's P&P titled, SANITATION AND INFECTION CONTROL SUBJECT DISHWASHING PROCEDURES (DISHMACHINE), dated 2018, indicated, . All the dishes should be inspected after coming out of dish-machine and if the dishes are not clean then they should be washed again in the dish-machine . During a concurrent observation and interview on 8/23/22, at 10:15 a.m., with [NAME] 2, in the kitchen, [NAME] 2 was slicing meat on the meat slicer. [NAME] 2 then weighed the slice of meat on a scale. [NAME] 2 stated that she was slicing turkey for the lunch meal. During a concurrent observation and interview on 8/24/22, at 9:33 a.m., with [NAME] 2, in the kitchen, [NAME] 2 opened a drawer attached to the counter. [NAME] 2 stated, the drawer contained the scale she used the day before to weigh meat. The weigh scale in the drawer had a sticky residue. During a concurrent observation and interview on 8/24/22, at 9:35 a.m., with [NAME] 1, in the kitchen, a weigh scale had sticky residue on it. [NAME] 1 stated, when the scale is stored in the drawer it should be stored clean. [NAME] 1 stated, the scale was not clean and was sticky. [NAME] 1 removed the weigh scale from the drawer and started cleaning it. During a review of the facility's P&P titled, FOOD PREPARATION SUBJECT: FOOD PREPARATION, dated 2018, the P&P indicated, . utensils and equipment will be cleaned and sanitized after each use . During a review of the professional reference titled, USFDA Food Code, dated 2017, the USFDA Food Code indicated, . Section 4-601.11 Equipment, Food-Contact Surfaces, Nonfood Contact Surfaces, and Utensils (A): Equipment food-contact surfaces and utensils shall be clean to sight and touch . During a review of the professional reference titled, USFDA Food Code, dated 2017, the USFDA Food Code indicated, . 4-602.13 Non-FOOD CONTACT SURFACES of EQUIPMENT shall be cleaned at a frequency necessary to preclude accumulation of soil residues . g. During a concurrent observation and interview on 8/23/22, at 8:22 a.m., with CDM, in the dry storeroom, a plastic bin of brown rice was not labeled or date listed. A plastic bin of dried potato was not labeled or dated. CDM stated she was unable to find a label or date for the brown rice or dried potato. During a concurrent observation and interview on 8/23/22, at 10:37 a.m., with CDM, in the kitchen, a clear plastic bin was seen with a white substance inside. The bin had no label or date on it. CDM stated, the white substance inside the bin was thickener. CDM stated, the bin should have been labeled and dated. During a review of the professional reference titled, USFDA Food code, dated 2017, the USFDA Food Code indicated, . Commercially processed food . Marking the date or day the original container is opened in a FOOD ESTABLISHMENT, with a procedure to discard the FOOD on or before the last date or day by which the FOOD must be consumed on the premises, sold, or discarded . h. During a concurrent observation and interview on 8/23/22, at 8:24 a.m., with CDM, in the walk-in refrigerator, crates used to store milk were on the floor. CDM stated, it was the facility's practice to store the milk in crates on the floor. During a review of the professional reference titled, USDA Food Code, dated 2017, the USDA Food Code indicated, . Section 3-305.11, Foods should be stored six inches above the floor . i. During an observation on 8/24/22, at 8:25 a.m., in the kitchen, [NAME] 2 was washing steam table pans and placing them in the rinse side of the sink. During a concurrent observation and interview on 8/24/22, at 8:57 a.m., with [NAME] 2, in the kitchen, [NAME] 2 placed a stack of washed stacked steam table pans on a clean rack. The seven steam table pans were wet, stacked together and not inverted. One of the seven pans had food debris. [NAME] 2 stated, the practice was to air dry the steam table pans and store them inverted once they were dry. [NAME] 2 stated, the steam table pans were not stored correctly. [NAME] 2 stated, she usually stored them inverted. [NAME] 2 stated, one of the steam table pans was not clean. [NAME] 2 removed the seven pans from the clean rack. During a review of the facility's P&P titled, SANITATION AND INFECTION CONTROL SUBJECT: DISHWASHING PROCEDURES (DISHMACHINE), dated 2018, indicated, . All dishes should be inspected after coming out of the dish-machine and if the dishes are not clean then they should be washed again in the dish-machine. Allow racks of dishes . to air dry . Do not rack and stack wet dishes . allow dishes to drain thoroughly and air dry after washing . During a review of the professional reference titled, USFDA Food Code, dated 2017, the USFDA Food Code indicated, . Section 4-601.11 Equipment, Food- Contact Surfaces, Nonfood Contact Surface, and Utensils, the food- contact surfaces of cooking equipment and pans shall be kept free of encrusted grease deposits and other soil accumulations; Nonfood- contact surface of equipment shall be kept free of an accumulation of dust, dirt, food residue, and other debris . During a review of the professional reference titled, USFDA Food Code, dated 2017, the USFDA Food Code indicated, . Section 4-901.11, Equipment and Utensils, Air Drying Required, after cleaning and sanitizing, equipment and utensils: (A) Shall be air-dried . j. During a concurrent observation and interview on 8/23/22, at 8:24 a.m., with CDM, in the kitchen, there was a black sticky substance on the walk-in refrigerator door. The black sticky substance obscured (keep from being seen) the color and texture of the door. The black sticky substance when touched with a hand would transfer onto the hand. CDM stated, the walk-in door was not clean. CDM state,d the walk-in door should be cleaned. The walk-in refrigerator had food debris, a package of (brand name) snacks and food wrappers on the floor under the racks. CDM stated, the floor should be free of trash and food. During a concurrent observation and interview on 8/24/22, at 8:36 a.m., with DA 1, in the kitchen, a plastic container containing clean divided plates had food debris and white/yellowish dried substance at the bottom of the container. DA 1 stated, the container was used to store clean divided plates. DA 1 stated, the container was not clean. DA 1, stated the facility's practice was to clean the plastic container every couple of days. DA 1 removed the plastic container. During a concurrent observation and interview on 8/24/22, at 9:33 a.m., with [NAME] 1, in the kitchen, the knife rack had white, beige and brown particles on the top of it. Knives were stored on the rack. [NAME] 1 stated, the knife rack was used to store clean knives. [NAME] 1 stated, the rack was not clean. [NAME] 1 stated, it should have been wiped and sanitized. During an interview on 8/25/22, at 4:29 p.m., with the CDM, the CDM stated, dishware with food debris was not be clean and should have been washed again. CDM stated, dirty items should not be placed with clean dishware. During a review the professional reference titled, USDA Food Code, dated 2017, the USDA food Code indicated, . 4-602.13 Non-FOOD CONTACT SURFACES of EQUIPMENT shall be cleaned at a frequency necessary to preclude accumulation of soil residues . k. During a concurrent observation and interview on 8/23/22, at 8:22 a.m., with CDM, in the sanitation closet, two brooms were touching the floor. CDM stated, the brooms should not be on the floor. CDM stated, the brooms should be hung up so they do not touch the floor. During a review of the professional reference titled, USFDA Food Code, dated 2017, the USFDA Food Code indicated, . 501.113 Storing Maintenance Tools . Maintenance tools such as brooms, mops, vacuum cleaners, and similar items shall be: (A)Stored so they do not contaminate FOOD, EQUIPMENT,UTENSILS, LINENS, and SINGLE-SERVICE and SINGLE-USE ARTICLES; and (B) Stored in an