Based on facility policy review, facility documentation review, and interview, the facility failed to maintain a grievance log for the required period of 3 years.The findings include: Review of the facility's policy titled, Grievances, dated 7/1/2009, revealed .Grievance Log will be kept for a period of three (3) years. The log shall contain evidence of the resolution and grievances . Review of the facility's Concern log revealed the facility had record of grievances from July 2024 - August 2025. There was no log available for grievances prior to July 2024. During an interview on 9/3/2025 at 11:44 AM, the Administrator confirmed no grievance log was available in the facility prior to July 2024. The facility changed administration and ownership in June 2024. The Administrator confirmed the grievance log was to be kept and available for review in the facility for a period of 3 years. During an interview on 9/3/2025 at 11:48 AM, the Case Manager stated she was the current grievance official at the facility. The Case Manager had been the grievance official since the facility changed ownership in June 2024. The Case Manager stated she was unaware where the grievance log was prior to July 2024. The Case Manager confirmed there was no grievance log available prior to July 2024 and that grievance logs were to be kept for a period of 3 years. The Case Manager stated she had reached out to the former grievance official who no longer worked at the facility who was unaware where the grievance logs were located.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, facility reported state intake information, medical record review, and interview, the facility failed to ensure allegations of abuse were reported to the appropriate authorities for 2 Residents (Residents #3 and #8) of 5 resident abuse investigations reviewed.The findings include: Review of the facility's undated policy titled, Abuse, Neglect, and Misappropriation of Residents Property, revealed .All alleged abuse and all substantiated incidents will be reported to the Bureau of Quality Assurance of Health Care Facilities and any other agencies as required . Review of the medical record revealed Resident #3 was admitted to the facility on [DATE] with diagnoses including Diverticulitis of Large Intestine, Dysphagia, Repeated Falls, and Dementia. Review of Resident #3's undated comprehensive care plan revealed .potential for impaired thought processes r/t [related to] dementia .Impaired thought processes .r/t cognitive loss .No male caregivers . Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #3 scored a 3 on the Brief Interview for Mental Status (BIMS) assessment which indicated the resident had severe cognitive impairment. Resident #3 had moderately impaired vision with corrective lenses and exhibited no behavioral symptoms. The resident required a wheelchair for mobility and substantial/maximal assistance for toileting hygiene, shower/bathe self and personal hygiene. Review of the state agency facility reported incident intake information revealed the facility reported an allegation of sexual abuse for Resident #3 on 4/16/2024 by the former Director of Nursing (DON). The alleged incident occurred on 4/16/2024 at 2:25 PM. It was noted .It was noted, .Reporting out of an abundance of caution .[Resident #3] .had a Nurse approach her and she [Resident #3] stated 'Do Not let your daughter go to the bathroom alone.' She continued with 'There is 2 men .and they fingered me to death and I fell for the trap'. The resident also told the nurse. 'It was 2 old men' .investigation initiated Medical provider notified. Daughter notified . Continued review revealed .[Resident #3] .Resident was in the dining room, in her geri-chair watching television. Resident motion for nurse to approach her. The resident told the nurse 'Do not let your daughter go to the bathroom alone'. Nurse asked why? Resident stated, 'There is two men down there and they fingered me to death, I fell for the trap'. Nurse tried to comfort resident and notified social services of the situation. Social service notified the Director of Nursing (DON) .Investigation was initiated. Tearful .Physician notified .Social Service was notified .Resident exam with not injury noted .Conclusion .Not verified .No visitors or unknown people in the area. Resident was in sight of staff at all times .DX of dementia and when exam by staff RN [Registered Nurse], there was no harm or injury noted .Corrective Action .Have asked for no male caregivers for resident . During an observation and interview on 9/2/2025 at 3:07 PM, Resident #3 was lying in bed watching television. Resident #3 stated she had been at the facility for 2 weeks and the year was 3021. Resident #3 denied anyone hurting her or touching her inappropriately at the facility and stated .I'm bigger than everybody . During an interview on 9/3/2025 at 2:40 PM, the DON stated she was not employed by the facility at the time of Resident #3's allegation and did not participate in the investigation. The DON stated there was no documentation available in the facility related to the investigation of Resident #3's allegation of sexual abuse. The DON confirmed the only information she had related to the allegation of sexual abuse for Resident #3 was from the 5 day follow up report she was able to pull out of the facility reported incident computer system. The DON confirmed there was no other documentation available related to the allegation. The DON confirmed investigation documentation was to include what notifications were made. The DON confirmed she was unaware if law enforcement and Adult Protective Services (APS) were notified of Resident #3's sexual abuse allegation and stated there was no notification to law enforcement, Adult Protective Services (APS) .that I have located . Notifications to law enforcement and APS were to be documented and included in the facility investigation documentation. During a telephone interview on 9/4/2025 at 10:28 AM, the former DON stated she did not recall the allegation of sexual abuse for Resident #3. The former DON stated she would have been responsible for abuse investigations, and it would have included notifications to the family, physician, state agency, Adult Protective Services (APS) and police. The former DON stated all investigations were left in her desk drawer when she left the facility. During an interview on 9/3/2025 at 4:45 PM, the DON stated she was unaware if the former administration had notified law enforcement or Adult Protective Services (APS) of Resident #3's sexual abuse allegation. The DON stated she called the local police department on 9/3/2025 and there was no police report related to Resident #3. The DON stated the facility had contacted APS on 9/3/2025 and left a message to determine if they had been notified of the allegation. The DON confirmed there was no documentation available at the facility to indicate law enforcement or APS had been notified of the allegation and confirmed both agencies should have been notified of the allegation and there should be evidence of the notification. During a telephone interview on 9/4/2025 at 1:11 PM, the local police department stated they were unable to locate a report for Resident #3. During a telephone interview on 9/4/2025 at 1:28 PM, the APS intake counselor stated she was unable to locate any reports related to Resident #3. During a telephone interview on 9/4/2025 at 1:47 PM, the APS Supervisor stated she had checked the state and county records and there had been no reports to APS regarding Resident #3. Medical record review revealed Resident #8 was admitted to the facility on [DATE] with diagnoses including Dementia, Major Depressive Disorder, Adjustment Disorder and Delusion Disorder. Medical record review of Resident #8's current comprehensive care plan dated 5/30/2022 revealed .Verbally abusive behavior .Converse with others without swearing or berating .is experiencing alteration in mood AEB (as evidence by) .c/o (complaint of) people coming into room and stealing . Each problem identified by the facility had appropriate pharmacological and non-pharmacological interventions implemented. Review of a Psychiatric Nurse's note for Resident #8 dated 7/13/2023, revealed the resident was seen for psychiatric evaluation for .irritability, dementia, frustration previous gpsych (geri-psychiatric) admits 071323 (7/13/2023) Administration requests consult r/t (related to) ongoing lability . Review of a quarterly Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #8 scored a 3 on the Brief Interview for Mental Status (BIMS) assessment which indicated the resident had severe cognitive impairment. The resident required assistance from 1 or more staff members for activities of daily living (ADL's). During an interview on 9/4/2025 at 3:16 PM, the Administrator and DON confirmed there was no investigation documentation for allegations of abuse reported to the state agency or APS for Residents #3 and #8. The Administrator and DON were unaware what the investigations for Residents #3 and #8 included because no documentation of the investigation was retained by the previous administration. The Administrator stated all allegations of abuse were to be reported to the state agency, law enforcement, and APS within 2 hours of allegation. The Administrator confirmed she was unaware if the allegations had been reported because no documentation was available from the previous administration.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, medical record review, facility reported state intake information, the facility failed to maintain evidence that an allegation of abuse was thoroughly investigated for 2 residents (Residents #3 and #8) of 5 resident abuse investigations reviewed. The findings include: Review of the facility's undated policy titled, Abuse, Neglect, and Misappropriation of Residents Property, revealed .All unusual occurrences to residents are to be reported to the immediate supervisor and document on the accident/incident Report Record for follow-up, investigation and monitoring of events, occurrences and patterns which may constitute abuse or neglect .All alleged violations will be thoroughly investigated, and precautions will be taken to prevent further chance of abuse while the investigation is in process . Review of the medical record revealed Resident #3 was admitted to the facility on [DATE] with diagnoses including Diverticulitis of Large Intestine, Dysphagia, Repeated Falls, and Dementia. Review of Resident #3's undated comprehensive care plan revealed .potential for impaired thought processes r/t [related to] dementia .Impaired thought processes .r/t cognitive loss .No male caregivers . Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #3 scored a 3 on the Brief Interview for Mental Status assessment which indicated the resident had severe cognitive impairment. Resident #3 had moderately impaired vision with corrective lenses and exhibited no behavioral symptoms. The resident required a wheelchair for mobility and substantial/maximal assistance for toileting hygiene, shower/bathe self and personal hygiene. Resident #3 was always incontinent of urine and bowel and received antidepressants, anticoagulants, and antibiotic medications during the 7 day look back period with indications noted. Review of the state agency facility reported incident intake information revealed the facility reported an allegation of sexual abuse for Resident #3 on 4/16/2024. It was noted, .Date of Occurrence: 4/16/2024 .Time: 2:25 pm .Patient .Age .89 .Sexual Abuse of Patient/Resident .Reporting out of an abundance of caution .[Resident #3] .had a Nurse approach her and she [Resident #3] stated 'Do Not let your daughter go to the bathroom alone.' She continued with 'There is 2 men .and they fingered me to death and I fell for the trap'. The resident also told the nurse. 'It was 2 old men' investigation initiated Medical provider notified. Daughter notified .Dx: [Diagnosis] unspecified Dementia, unspecified severity without Behaviors, other specified Anxiety disorders, Major Depressive disorder, HTN [Hypertension], constipation, unspecified Diverticulitis, UTI [Urinary Tract Infection], Fe [Iron] def [deficiency] anemia, nonrheumatic valve disorder, osteoporosis .Personal Hx [history] of TIA [Transient Ischemic Attack] .Bims [BIMS] 3 .Report Date: 4/16/2024 .Continued review revealed .[Resident #3] .Resident was in the dining room, in her geri-chair watching television. Resident motion for nurse to approach her. The resident told the nurse 'Do not let your daughter go to the bathroom alone'. Nurse asked why? Resident stated, 'There is two men down there and they fingered me to death, I fell for the trap'. Nurse tried to comfort resident and notified social services of the situation. Social service notified the Director of Nursing (DON) .Investigation was initiated. Tearful. assessment of the alleged victim with no medical treatment necessary. Physician notified .Social Service was notified .Resident exam with not injury noted. Remained in Dining Room in her Geri-Chair watching television. No witness to any incident .spoke with all staff working in the area .daughter .stated [Resident #3] had been raped by her uncle when she was between the ages of 6-8 .She didn't know any details. Daughter feels that her mom is just progressing in her dementia and that she is relieving things from her childhood. She requested that Psych [Psychitric] nurse practitioner see her. social worker arrange this as well as inform staff so we can comfort resident as needed .All staff reports that resident has been up in chair in the dining room .ate good lunch with no visitors this day .have been able to see her at all times. no distress was noted .Conclusion .Not verified .No visitors or unknown people in the area. Resident was in sight of staff at all times .DX of dementia and when exam by staff RN [Registered Nurse], there was no harm or injury noted .Corrective Action .Have asked for no male caregivers for resident . During an observation and interview on 9/2/2025 at 3:07 PM, Resident #3 was lying in bed watching television. Resident #3 stated she had been at the facility for 2 weeks and the year was 3021. Resident #3 denied anyone hurting her or touching her inappropriately at the facility and stated .I'm bigger than everybody . During an interview on 9/3/2025 at 11:53 AM, the Case Manager stated she had served as the Case Manager/social services since July 2024. The Case Manager did not participate in the investigation for Resident #3's abuse allegation, was unaware of the details, and unable to locate any social service documentation related to the allegation/investigation. Attempted telephone interview on 9/3/2025 at 3:21 PM with the Former Administrator that was in place at the time of the allegation. During an interview on 9/3/2025 at 2:40 PM, the DON stated she was not employed by the facility at the time of the allegation and did not participate in the investigation. The DON stated there was no documentation available in the facility related to Resident #3's allegation of sexual abuse. The DON confirmed the only information she had related to the allegation of sexual abuse for Resident #3 was from the 5 day follow up report she was able to pull out of the facility reported incident computer system. The DON confirmed there was no other documentation available related to the allegation. An abuse investigation was to include witness statements, physical assessments, notifications to physician, resident interviews and skin assessments to determine if any other residents were affected, and incident report. The DON was unable to determine what the allegation was, when it occurred, who the witnesses were, what steps were taken afterward to investigate and protect the resident, what assessments were performed, and what notifications were made. The DON confirmed there were no witness statements, social worker notes, incident report, resident physical assessment, resident interviews and skin assessments .that I have located . The DON stated there was no entry into Resident #3's medical record related to the allegation. The DON stated the facility had tried to reach out to the former administrator and DON regarding complaint investigations without success. During a telephone interview on 9/4/2025 at 10:28 AM, the former DON stated she did not recall the allegation of sexual abuse for Resident #3. The former DON stated she would have been responsible for abuse investigations, and it would have included notifications to the family, physician, state agency, Adult Protective Services (APS) and police, physical assessment of the resident, resident interview, other resident interviews and skin assessments, incident report, and witness statements for all potential witnesses. The former DON stated all investigations were left in her desk drawer when she left the facility. Medical record review revealed Resident #8 was admitted to the facility on [DATE] with diagnoses including Dementia, Major Depressive Disorder, Adjustment Disorder and Delusion Disorder. Medical record review of Resident #8's current comprehensive care plan dated 5/30/2022 revealed .Verbally abusive behavior .Converse with others without swearing or berating .is experiencing alteration in mood AEB (as evidence by) .c/o (complaint of) people coming into room and stealing . Each problem identified by the facility had appropriate pharmacological and non-pharmacological interventions implemented. Review of a Psychiatric Nurse's note for Resident #8 dated 7/13/2023, revealed the resident was seen for psychiatric evaluation for .irritability, dementia, frustration previous gpsych (geri-psychiatric) admits 071323 (7/13/2023) Administration requests consult r/t (related to) ongoing lability . Review of a quarterly Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #8 scored a 3 on the Brief Interview for Mental Status (BIMS) assessment which indicated the resident had severe cognitive impairment. The resident required assistance from 1 or more staff members for activities of daily living (ADL's). During an interview on 9/4/2025 at 3:16 PM, the Administrator and DON confirmed there was no investigation documentation for allegations of abuse reported to the state agency for Residents #3 and #8. The Administrator confirmed a thorough investigation was to be completed for all abuse allegations/state reportable incidents and should include resident interview related to the allegation, witness statements, other resident interviews/skin assessments, physical assessments, physician notification, family notification, and notifications to other agencies. The Administrator and DON were unaware what the investigations for Residents #3 and #8 included because no documentation of the investigation was retained by the previous administration. The Administrator confirmed abuse investigations were to be documented and retained in the facility. The Administrator confirmed they were unable to determine if a thorough investigation was completed because there was no investigation documentation available for Residents #3 and #8.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, medical record review and interview the facility failed to complete a discharge summary for 1 resident (#30) of 3 residents reviewed for transfer/discharge requirements. The findings include: Review of the facility policy titled, Discharge Policy, undated showed .Residents will be discharged with a plan of care .When a Resident is discharged documentation will include a brief summary of significant findings, and events of the residents stay in the nursing home, his condition on discharge and the recommendation and arrangements for future care .Discharge Summary will be completed when discharged .Discharge Instruction Sheet will be completed .a copy of these instructions will be given to the Resident and or family/significant other/designated Resident Representative . Medical record review showed Resident #30 was admitted to the facility on [DATE] with diagnoses including Hypertension, Dementia, Retention of Urine, Heart Failure and Difficulty in Walking. Medical record review of Resident #30's Discharge summary dated [DATE] showed .discharged to assisted living . The Discharge Summary did not include a final summary of the resident's status at the time of discharge, a recapitulation (summary) of the resident's medications, or a post-discharge plan of care for Resident #30. During an interview on 7/7/2022 at 7:10 PM, Registered Nurse (RN) #1 confirmed a discharge summary is to be completed for all residents transferred from this facility. RN#1 stated Resident #30 was discharged on 5/4/2022 and returned to the Assisted Living side of the facility. RN #1 stated she completed the discharge summary for Resident #30 but it did not include a discharge instruction sheet, a discharge plan of care, a summary of the resident's stay or a list of Resident #30's medications. During an interview on 7/7/2022 at 7:20 PM, the Social Services Director stated Resident #30 decided she wanted to return to the Assisted Living facility. The Social Services Director stated the facility did not have adequate time to complete the required discharge summary.

Based on facility policy review, observation, and interview the facility failed to maintain sanitary kitchen equipment in 1 of 1 kitchen observed. The findings include: Review of the facility policy titled, Cleaning & Sanitation dated 9/2/2020 showed, .The Director of Food and Nutrition Services will develop, implement, and monitor schedules for cleaning, sanitizing .To ensure the food service department is maintained .as well as a clean, sanitary, and safe environment .Food service employees are trained on how to properly use, clean and maintain all equipment .Cleaning schedules designate cleaning tasks for each position and are posted in an accessible area . During an observation on 7/5/2022 at 9:52 AM, with the Dietary Manager (DM) #1 showed the can opener mounted on a stainless steel food preparation table was found with dry brown food debris build up behind the can opener blade. The can opener was observed with dried brown food residue on the shaft of the can opener from liquid content as a can was opened by the blade. During an interview on 7/5/2022 at 10:12 AM, DM #1 confirmed the can opener was in unsanitary condition and was available for use to prepare food for the 30 residents in the facility. DM #1 stated the equipment cleaning schedule did not include the task of sanitizing the can opener. There was no documentation the can opener had been cleaned before it was used by the facility.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, medical record review, and interview the facility failed to complete falls risk assessments for 1 residents (#38) of 3 residents reviewed for accidents of 13 sampled residents. The findings include: Review of the facility policy, Fall Management Policy and Procedure, revised 6/2018, revealed .Fall Risk Assessments are to be completed with the MDS [Minimum Data Set] quarterly, annually .by the MDS nurse .Residents who score 15 or above on the Fall Risk Assessment will be identified as a high fall risk . Medical record review revealed Resident #38 was admitted to the facility on [DATE] with diagnoses including Dementia, Atrial Fibrillation, and Difficulty Walking. Medical record review revealed a Fall Risk Assessment had been completed on 9/1/18 with score of 24 (a score of 15 or higher indicated a resident was at risk for falls). Continued review revealed no further fall risk assessments had been completed on 5/9/19 and 8/6/19. Medical record review of the Annual Minimum Data Set, dated [DATE] revealed the resident was severely cognitively impaired and never or rarely understood. Continued review revealed the resident required total assistance for bed mobility, transfer, toileting and hygiene. Medical record review of the facility falls investigation dated 2/21/19 revealed Resident #38 had a fall on 2/21/19 and sustained a laceration to the forehead with a new intervention implemented of a personal safety alarm (PSA) to the chair. Medical record review of the facility falls investigation dated 3/31/19 revealed Resident #38 had a fall without injury on 3/31/19 with a new intervention implemented of pool noodles to the mattress. Medical record review of the facility falls investigation dated 5/9/19 revealed Resident #38 had a fall on 5/9/19 and sustained an abrasion to the forehead with a new intervention implemented of a PSA to the bed. Interview with the Director of Nursing on 8/21/19 at 3:30 PM, in the conference room, confirmed residents falls risk was assessed by completing a fall risk assessment form. Continued interview confirmed fall risk assessments are to be completed by the MDS nurse on admission and quarterly. Further interview confirmed the facility failed to complete fall risk assessments timely for Resident #38 and failed to follow their facility policy.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and interview the facility failed to implement a care plan for 1 resident (#1) of 5 residents reviewed for fluid management of 22 sampled residents. The findings include: Medical record review revealed the resident was admitted to the facility on [DATE], with diagnoses including Dementia without Behavioral Disturbance, Hypertension and Encephalopathy. Medical record review of the care plan revised 8/21/18 revealed .Resident is on a regular no added salt diet .2000 ml [milliliters] fluid restriction .2 plus edema .Fluid Shifts .Will maintain adequate nutrition as evidenced by stable weight .7/6/18 .weights Mon, Weds, Fri . Review of the weights for Resident #1 dated 7/6/18-9/24/18 revealed 5 of 35 weights were not documented. Interview with the Director of Nursing on 9/26/18 at 4:00 PM, in the conference room confirmed the facility failed follow the care plan to weigh the resident every Monday, Wednesday and Friday.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and interview the facility failed to follow a Physicians order to obtain weights for 1 resident (#1) of 3 residents reviewed for fluid management of 22 sampled residents. The findings include: Medical record review revealed the resident was admitted to the facility on [DATE] with diagnoses including Dementia without Behavioral Disturbance, Hypertension and Encephalopathy. Medical record review of a Physicians Order dated 7/6/18 revealed .Obtain wt [weight] 3 times a wk [week] on M,W,F [Monday, Wednesday, Friday]. Medical record review of a Dietician note dated 8/17/18 revealed .wt continues trending up with sign [significant] wt [weight] gain 8.5% x 90 days. Wt gain likely r/t [related to] fluid shifts w [with] /edema . Medical record review of the weights for Resident #1 dated 7/6/18-9/24/18 revealed 5 of 35 weights were not documented. Interview with the Director of Nursing on 9/26/18 at 4:00 PM, in the conference room confirmed the facility failed to weigh the resident 3 times per week as ordered by the Physician.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, observation and interview the facility failed to ensure an accurate reconciled account for controlled medications for 1 of 3 medications carts observed. The findings include: Review of the facility policy, Narcotic Count, undated, revealed .2 .To assure controlled drugs are handled, stored, and disposed of properly .3 .To assure proper record keeping for controlled drugs .Procedure .5 .After the supply is counted and justified, each nurse must record and date and his/her signature verifying that the count is correct .6 .Discrepancies found at any time, change of shift or other, are to be immediately reported to the director of Nursing Service. Medical record review revealed Resident #34 was admitted to the facility on [DATE], with diagnoses including Diabetes, Dementia, Depression and Anxiety. Observation and interview on 9/26/18 at 5:00 PM, with Licensed Practical Nurse (LPN) #1 in the 1st skilled medication room, revealed the narcotic log for Resident #34's Xanax (medication to treat anxiety) 0.25 milligram (mg) was incorrect. Continued observation revealed the narcotic log for 9/25/18 at 9:00 PM showed (3) Xanax 0.25 mg remained. Further observation revealed (2) Xanax 0.25 mg tablets were available. Interview with LPN #1 confirmed she does not know why the count is wrong. Interview with the Director of Nursing on 9/26/18 at 6:30 PM, in the conference room confirmed the narcotic count for Resident #34's Xanax 0.25 mg was incorrect and 1 tablet was missing. Further interview confirmed the facility failed to ensure an accurate reconciled account for a controlled medication.

Based on review of the facility Inservice Proper Dish Washing and Sanitizing documentation, review of the facility dish washer temperature log, and interview, the facility failed to maintain the dish machine to ensure proper sanitation of dishes for 1 of 1 high temperature dish machines, potentially affecting all residents in the facility. The findings include: Review of the facility Inservice Proper Dish Washing and Sanitizing, dated 8/9/18 revealed .very important that the dish machine is functioning properly at all times .sanitizing temp should be 180 [degrees] . Observation and interview with the Dietary Manager on 9/24/18 at 8:45 AM, in the kitchen revealed the following dates breakfast, lunch, and dinner dish machine temperatures had been below 180 degrees: 7/29/18 - 7/30/18, 8/9/18 - 8/18/18, 9/1/18, 9/3/18 - 9/4/18, and 9/9/18-9/16/18. Interview with the Dietary Manager confirmed facility policy was to maintain the dish machine rinse temperature at 180 degrees or higher. Further interview confirmed he was not aware of the lower than required temperatures that occurred in 6/2018, 8/2018, and 9/2018. Further interview confirmed the facility failed to maintain the dish machine to ensure proper sanitation of dishes.