Based on facility policy review, observations and interview, the facility failed to maintain a sanitary kitchen environment by storing expired food items and failing to safely store 1 bag of food with the potential to affect all 69 residents. The findings include: Review of the facility's policy titled, Safety & Sanitation Best Practice Guidelines, dated 11/2017, showed .Refrigerated Food Storage Guide .Food .Commercially prepared .egg .covered securely; date when opened and with use by date .Food .Cheese .Milk .Storage Time .Manufacturer's expiration date . During an observation on 9/5/2023 at 11:20 AM, with the Dietary Manager, the following items were found in the main walk-in refrigerator: 1 box containing 116 fluid ounces of individual creamers, approximately 1/3 full, expired on 4/9/2023. 2- 5 pound (lb) packages of pasteurized processed Swiss cheese (unopened), expired on 7/12/2023. 1- 1 gallon container of Vitamin D milk, approximately 1/4 full, expired on 8/31/2023. During an observation on 9/5/2023 at 11:30 AM, with the Dietary Manager, the following item was found in the main walk-in freezer: 1 opened, unsealed, unlabeled bag of commercially prepared eggs containing 19 servings. During an interview on 9/5/2023 at 11:35 AM, the Dietary Manager stated food items should be sealed and labeled with opened date or discarded if expired, and he confirmed the expired and unsealed food items were available for resident use. During an observation and interview on 9/6/2023 at 8:27 AM, the Regional Dietician in the dry storage room, the following items were found: 3- 1.5 lb unopened bags of the facility's supplier's brand of Fried Crispy Onions, expired on 3/18/2023. The Regional Dietician confirmed the crispy onions were expired and available for resident consumption.

Based on facility policy review, observation and interview the facility failed to ensure staff wore protective beard covering while preparing food for 1 of 2 staff observed; failed to wear appropriate hair covering during meal service for 1 of 2 staff observed and failed to ensure staff disinfected hands after glove removal during meal service for 1 of 2 staff observed. The findings include: Review of the facility policy, Hygiene & Safety Practices, revised 11/2017 revealed .partners shall wear hair restraints such as hats, hair coverings, or nets, beard restraints .that are designed and worn to effectively keep their hair from contacting exposed food; clean equipment, utensils, and linens; and unwrapped single-service and single-use articles . Review of the facility policy Safety & Sanitation Best Practice Guidelines .Glove Use, revised 11/2017 revealed .Always wash hands using correct hand washing procedures before putting on gloves. Putting on gloves with contaminated hands will contaminate the outside of the glove .Remove used gloves by pulling downward from wrist covering soiled portion of gloves, discard, and wash hands . Observation in the kitchen on 12/16/18 at 9:42 AM, revealed [NAME] #1 preparing cheese cake. Continued observation revealed [NAME] #1had a beard and was not wearing a protective covering over his beard. Interview with [NAME] #1 and the Chef on 12/16/18 at 10:00 AM, in the kitchen, confirmed they did not usually wear protective coverings over beards. Observation in the kitchen on 12/16/18 at 11:40 AM, revealed [NAME] #1 assisting the Chef to check food temperatures in the food prep area. Continued observation revealed [NAME] #1 did not have a protective covering over his beard. Observation of the lunch meal in the East Bistro on 12/16/18 from 12:05 PM - 1:15 PM revealed the Chef served a hot plate of food; donned a glove on the left hand; retrieved a container from the cooler without removing the glove or sanitizing the hands and prepared a sandwich. Continued observation revealed after preparing the sandwich the Chef removed and discarded the glove and continued to serve hot foods without disinfecting the hands. Further observation revealed the Chef donned a glove on the left hand, retrieved a container from the cooler without removing the glove and sanitizing the hands and prepared another sandwich. Continued observation revealed the Chef removed and discarded the glove, without disinfecting the hands, and proceeded to serve hot foods. Observation of the lunch meal on 12/17/18 at 12:20 PM, at the [NAME] Bistro revealed [NAME] #2 was wearing a baseball type cap with a long pony tail hanging out the back of the cap while preparing/plating food. Interview with the Dietary Manager on 12/17/18 at 2:30 PM, in the conference room, confirmed staff are expected to follow the facility policy and wear protective covering over beards and disinfect their hands after glove removal.