CLEAR CREEK NURSING & REHABILITATION CENTER

6-301.12 Provide paper towels or approved alternative for hand drying at each handsink. -Pf. Observed no paper towels or hand drying device at handsink in serving kitchen 500. CDI, PIC supplied paper towels to handsink. All other sinks throughout serving kitchens and sinks in main kitchen were properly supplied. Points not escalated.

3-501.16(A)(2) Maintain TCS foods in cold holding at 41F or less. -P. Observed cut melons cold holding at 45F in refrigerator of serving kitchen 200. CDI, TCS food item placed back in walk in cooler to rapidly chill. Observed ham and cheese sandwich cold holding at 43F in refrigerator of serving kitchen 800. CDI, TCS food item voluntarily discarded. Slight improvement from previous inspection report, points not escalated. For more information, please visit: www.mecknc.gov/foodsafety or view our training videos at the following weblinks: What are TCS Foods https://www.youtube.com/watch?v=q0iLZb7v0UM and Safe Food Temperatures https://youtu.be/tXP09IK-1TQ .

6-501.111 Keep the premises free of insects, rodents, and other pests. Observed a few flies in dish machine area. -General comment.

6-501.11 Floors, walls, and ceilings including the attachments such as soap and towel dispensers; light fixtures; and heat/ac vents shall be maintained in good repair. Observed approximately 4 floor tiles missing near dish machine.

6-301.12 Provide paper towels or approved alternative for hand drying at each handsink. -Pf. Observed no paper towels at front handsink upon EHS arrival to complete inspection. CDI, paper towels supplied to handsink.

4-602.11 (E )Clean the equipment and utensils used with nonTCS foods as required to avoid contamination. Observed minor pink build up on ice machine chute. Clean. -General comment.

3-501.14(A) Quickly cool cooked foods within 2 hours from 135F to 70F; and within a total of 6 hours from 135F to 41F. -P. Observed sliced cheese 4 turkey chubs cooling from day previous in walk in cooler holding at 56F. CDI, TCS food items voluntarily discarded. For more information please visit: www.mecknc.gov/foodsafety or view our training videos at the following weblinks: What are TCS Foods https://www.youtube.com/watch?v=q0iLZb7v0UM and Cooling Food Safely https://youtu.be/P6x8b1ZVOxU .

3-501.16(A)(2) Maintain TCS foods in cold holding at 41F or less. -P. Observed sliced cheese and deli meats cold holding at 50F in front reach in cooler. CDI, TCS food items placed in walk in cooler to rapidly chill. (Per conversation with PIC, reach in cooler is used frequently for prep and food employees recently finished prepping items and was going in and out of unit frequently). For more information, please visit: www.mecknc.gov/foodsafety or view our training videos at the following weblinks: What are TCS Foods https://www.youtube.com/watch?v=q0iLZb7v0UM and Safe Food Temperatures https://youtu.be/tXP09IK-1TQ .

7-102.11 Label working containers of toxic materials such as cleaners and sanitizers.-Pf. Observed sc-200 chemical cleaner stored in unlabeled bottle near 3 compartment sink. CDI, bottle labeled.

3-501.15 Quickly cool foods. Use methods such as open/vented shallow pans, large ice baths and active stirring. Cold air must flow around product to remove the heat. -Pf. Observed purée eggs cooling in walk in cooler tightly covered. CDI, plastic vented to allow rapid rapid flow and purée eggs placed in ice bath by PIC on shelving in walk in cooler. Observed 4 turkey chubs cooked from day previous cooling in walk in cooler tightly wrapped in foil. CDI, EHS educated PIC on proper cooling methods, TCS food items voluntarily discarded. -General comment. For more information, please visit: https://health.mecknc.gov/envhealth/food-and-facilities-sanitation or view our training videos at the following weblinks: What are TCS Foods https://youtu.be/bRvqAETDjQU and Cooling Food Safely https://youtu.be/P6x8b1ZVOxU .

3-305.11 Store food in a clean, dry location, not exposed to contamination. Keep at least 6 inches above the floor. Observed box of tortilla chips stored on floor in dry storage area. CDI, chips placed on shelving. -General comment.

6-501.12 Floors, walls, ceilings including the attachments such as soap, towel dispensers; light fixtures; and heat/ac vent covers shall be clean. Caution should be used to minimize food exposure. Observed detailed cleaning needed to flooring throughout kitchen to include under cooking equipment, flooring of walk in cooler and walk in freezer, and in dry storage area. Clean.

4-601.11(A) Equipment food contact surfaces and utensils shall be clean to sight and touch. -Pf- Observed metal stem of food thermometer with build-up. Corrected during the inspection (CDI) - thermometer was cleaned.

3-501.16(A)(1) Maintain TCS foods in hot holding at 135F or above. -P- Observed beans and meat sauce below 135F in the warmer (see temperature chart). Corrected during the inspection (CDI) - reheated.

3-501.16(A)(2) Maintain TCS foods in cold holding at 41F or less. -P- Observed ham, mashed potatoes and egg salad above 41F in tall reach-in cooler (see temperature chart). CDI - voluntarily discarded.

3-305.11 Store food in a clean, dry location, not exposed to contamination. Keep at least 6 inches above the floor. - Observed box of strawberries on the floor in the walk-in freezer. Observed boxes of water on the floor in dry storage. CDI - placed on shelf

4-903.11(A)(C) Store single-use and single-service articles in a clean, dry location; where they are not exposed to splash, dust, or other contamination; and at least 6 inches above the floor. - Observed boxes of cups stored on the floor in the dry storage area. CDI - placed on shelving

3-501.16(A)(1) Maintain TCS foods in hot holding at 135F or above. -P- Observed puréed squash and chicken below 135F. Corrected during the inspection (CDI) - Items were reheated. (See temperature log)

4-501.11 Maintain equipment in good repair. - Observed torn gaskets on tall reach-in cooler. Needs to be repaired.

4-601.11(C ) Keep non food contact surfaces of equipment clean to avoid build up of dust, food residue or debris.4-602.13 Non food contact surfaces of equipment shall be cleaned frequently to preclude accumulation of soil residues. - Observed interior of microwave in need of cleaning. CDI - Microwave was cleaned during the inspection.

5-205.11 (A) A handwashing sink shall be maintained so that it is accessible at all times for employee use Pf. Observed mop bucket being stored in front of hand sink in dish wash area preventing accessibility. 5-205.11 (B) A handwashing sink may not be used for purposes other than handwashing Pf. Observed sponges being stored in hand sink in dish wash area. CDI: Mop bucket and sponges were removed.

4-501.114 Maintain sanitizer at correct concentrations when being used to sanitize. -P For more information please visit: http://meck.co/FoodSafety or view our training videos at the following weblinks: Sanitizing Solutions - https://youtu.be/ykP2mr9CtRg and How to Test Sanitizer https://youtu.be/y0SjmnabFaY Observed sanitizer being used in 3 compartment sink with a low concentration level. CDI: PIC added sanitizer solution to sink to bring level up to appropriate level. 4-601.11(A) Equipment food contact surfaces and utensils shall be clean to sight and touch. -Pf. For more information please visit: http://meck.co/FoodSafety or view our training videos at the following weblinks: Sanitizing Solutions - https://youtu.be/ykP2mr9CtRg , How to Test Sanitizer https://youtu.be/y0SjmnabFaY , and Cleaning and Sanitizing Food Contact Surfaces https://youtu.be/av1Rbh-lh08 . Observed several utensils with build up of food debris or soil being stored as clean. CDI: PIC removed items from storage and returned for W/R/S.

3-501.14(A) Quickly cool cooked foods within 2 hours from 135F to 70F; and within a total of 6 hours from 135F to 41F. -P. For more information please visit: http://meck.co/FoodSafety or view our training videos at the following weblinks: What are TCS Foods https://youtu.be/bRvqAETDjQU and Cooling Food Safely https://youtu.be/P6x8b1ZVOxU . Observed ground beef and puree cooling in WIC at an insufficient rate. See temp chart. CDI: PIC adjusted cooling method, EHS satisfied change in method would allow items to reach cooling parameters.

3-501.18 Discard the food requiring date labels once time/temperature window has expired, if it is not been labeled, or if the label is incorrect. -P For more information please visit: http://meck.co/FoodSafety or view our training videos at the following weblinks: What are TCS Foods https://youtu.be/bRvqAETDjQU and Date Marking Food Safely https://youtu.be/BOPsSNUajYs . Observed milk, and a container of puree with incorrect dates marked. CDI: PIC ensured EHS that milk was opened today and puree was prepared on 20Nov. Date marks were corrected.

7-102.11 Label working containers of toxic materials such as cleaners and sanitizers.-Pf Observed a spray bottle of detergent without a label in the dish wash area. CDI: PIC labeled bottle.

3-501.15 Quickly cool foods. Use methods such as open/vented shallow pans, large ice baths and active stirring. Cold air must flow around product to remove the heat. -Pf For more information please visit: http://meck.co/FoodSafety or view our training videos at the following weblinks: What are TCS Foods https://youtu.be/bRvqAETDjQU and Cooling Food Safely https://youtu.be/P6x8b1ZVOxU . Observed ground beef and puree covered in WIC cooling at an insufficient rate to meet cooling time requirement. CDI: PIC removed covers from items and placed pans in an ice bath in WIC to ensure cooling time requirement was met.

3-501.13 (A), (B), (C ) Use approved thawing methods. Pf Observed 4 whole chickens laying directly in prep sink thawing under running water. CDI: PIC placed chickens in a pot to ensure the chickens were fully submerged and water could overflow from pot.

5-205.15 Maintain a plumbing system in good repair. Observed leaking pipe at prep sink.

5-501.17 Provide a covered waste bin in female restrooms. Employee restroom did not have covered trash can available.

3-403.11 Reheating for Hot Holding - P Ham tempt at 109F while reheating. Reheating process just started. Reheating paused due to CO alarm alert. PIC changed from hot foods to cold sandwiches and discontinued with hot food preparation. Ham will not be served. No points taken due to the interruption in cook time.

3-501.16(A)(2) Maintain TCS foods in cold holding at 41F or less. -P Observed lettuce, shredded lettuce, & cabbage temperature at 42F-43F. CDC Suggested to PIC to moved to walk in freezer to chill down to 41F and below then moving back to walk in refrigerator. Re-tempt at 39F. PIC had walk in refrigerator checked by Hinson Electrical.

4-901.11(A) Air dry equipment and utensils after cleaning and sanitizing. Observed wet pans stored and stacked on shelf. Allow pans to air dry before stacking.

4-202.18 Ventilation Hood Systems, Filters - C Observed Ventilation Hood System not venting air out of the kitchen. Ask food employee if it was turned on. Food service employee stated that it was on. CO monitor alerted during inspection, Hinson Electrical came to repair. CDI

2-102.12 PIC shall demonstrate knowledge by being a certified food protection manager. Observed PIC during time of inspection with no certified food protection manager certification.

4-602.11 Clean the equipment and utensils used with nonTCS foods as required to avoid contamination. Observed minor black build up on the inside of ice machine. Points not escalated due to improvement from previous inspection report.

3-501.16(A)(1) Maintain TCS foods in hot holding at 135F or above. -P. Observed puree veggie hot holding in hot box at 128F. CDI, puree veggies were placed in steamer and were reheated to above 165F.

3-501.15 Quickly cool foods. Use methods such as open/vented shallow pans, large ice baths and active stirring. Cold air must flow around product to remove the heat. -Pf. Observed chef salads cooling in walk in cooler tightly covered with plastic wrap. CDI, EHS educated PIC on cooling methods, plastic wrap was vented to allow salad to rapidly cool.

4-903.11(A) Store single-use and single-service articles to prevent contamination and at least 6 inches off the floor. Observed a box of styrofoam cups stored on the floor in dry storage area. Observed plastic lids stored on the floor near walk in cooler.

4-302.14 Provide a test kit that accurately measures sanitizer concentrations. -Pf. Observed facility with the cholorine test papers to test a Qac based sanitizer. CDI, EHS let facility some Qac based test strips.

2-102.12 Certified Food Protection Manager - C Observed no CFPM on-site.

3-202.15 Food packaging has be in good condition, intact and protect the food inside. Observed 3 heavily dented cans on wire racks in walk-in and in storage room.

3-302.11(A) Separate the different types of raw animal foods. -P Observed frozen raw chicken stored above raw frozen beef, raw frozen shrimp, and RTE pepperoni. CDI-Moved pepperoni to other shelf, PIC will move items later. Low risk due to items being frozen.

4-602.11 Clean the equipment and utensils used with nonTCS foods as required to avoid contamination. Observed ice machine with pink build-up on the inside. Informed food employee to clean with alcohol wipes until the next time they burn the ice. Observed can opener being used and soiled. CDI-Took can opener to 3-comp sink to be washed

3-403.11 Reheating for Hot Holding - P Observed food employee reheating steak, had to reheat 3 times for proper reheat temp (165F). Said item was ready to serve, food employee temped and some items were 165 but failed to recongize all portions of food need to be 165F. Check thickest portions, inside, outside edges of a container of food due to hot spots before serving.

3-501.14(B) Quickly cool TCS foods that are prepared from room temperature ingredients. Food must be to 41F within 4 hours. -P Observed cole slaw in walk-in at 52F at 9:56 made 1.5hrs previously. Product cooled 2F/30mins at a cooling rate .06F/min, needs to be .12F. CDI-PIC moved product and was spread thin and moved to sheet trays to freezer and cooled to 40F in 1.5hrs.

3-501.16(A)(1) Maintain TCS foods in hot holding at 135F or above. -P Observed a hot box across from grill holding items below 135F, pulled chicken 123F, 3 trays of communited steak 118F. CDI-Items were put back in steamer to reach 165F for reheat to Hot hold temp. Steak was reheated 3 times to reach 165F, chicken reached 170F.

7-102.11 Label working containers of toxic materials such as cleaners and sanitizers.-Pf Observed a bottle of degreaser in the dish pit, in a bottle with no name of product. Was told it is a food degreaser. CDI-Food employee labeled.

3-501.15 Quickly cool foods. Use methods such as open/vented shallow pans, large ice baths and active stirring. Cold air must flow around product to remove the heat. -Pf Observed 3 thick metal pans of coleslaw in a reach-in by the grill, item was at 52F at 9:56am made 1.5hrs previously. Coleslaw was covered in plastic wrap and put in the reach in to cool. Observed tomatoes, cheese in walk-in covered in plastic not allowing air flow. CDI-Food employee uncovered and moved coleslaw to a sheet tray to cool in freezer. Items reached 41F.

4-903.11(A) Store single-use and single-service articles to prevent contamination and at least 6 inches off the floor. Observed sanitizer wipes stored above plastic silverware. CDI-Moved to bottom shelf.

4-501.11 Good Repair and Proper Adjustment-Equipment - C Observed a steamer not in working order, the top steamer works but with some complications. Thermometer on hot box broken. Keep items in good repair.

5-501.115 Discard items and litter stored in the waste areas and enclosures as they are not necessary to operation and maintenance. Observed a bag of trash sitting next to compactor and several chairs. Keep dumpster free of unecessary clutter.

No Points Deducted: Observed an uncovered employee drink sitting on the prep area of the cook line. CDI- Discarded. 2-401.11 Cover and store employee drinks to prevent contamination of food or utensils.

No Points Deducted: Observed the dish machine rinse temp at 161F. CDI- Turned off and removed a utensil that was stuck in the magnet. Rinse temp is now 186F and above. 4-501.112(A)(2) Provide a minimum of 180F rinse water for sanitization when using the dish machine. -Pf **SUGGESTION: Have an in-service with all staff about using the dish machine properly.

Observed opened bags of lettuce in the walkin cooler and deli meats in the reachin cooler all without dates. CDI- Discarded. 3-501.18 Discard the food requiring date labels once time/temperature window has expired, if it is not been labeled, or if the label is incorrect. -P

No Points Deducted: Observed 2 containers of lettuce tightly covered at 50F. CDI- Vented the plastic and educated the employee of proper cooling methods. 3-501.15 Quickly cool foods. Use methods such as open/vented shallow pans, large ice baths and active stirring. Cold air must flow around product to remove the heat. -Pf

Observed two probe thermometers present. One was not working (showing all "Ls" when turned on", and both did not have a thin probe to temp thin foods like lettuce, sliced tomatoes, etc. Provide a thin probe stem thermometer. **Verification will be within 10 days.

Observed several wet clothes sitting on the counter tops. CDI- An employee removed them. 3-304.14(B) Hold in-use wiping cloths in sanitizer between uses.

-Observed buildup on the inside the top of microwaves in the satellite kitchens. Clean. -Observed splash buildup under the drink machines on in the satellite kitchens. Clean. -Observed brown residue under the steam well cabinets in the satellite kitchens.- Possible (past) leak. Clean. -Observed pink buildup around the outside of the ice machine chute on the 500 hall. Clean. -Observed a soiled resident's personal cup stored in the cabinet on the 500 hall satellite kitchen. CDI- Took to the kitchen to be cleaned. 4-601.11(C )/4-602.13 Keep the equipment clean to avoid build up of dust, food residue or debris.

No Points Deducted: Observed an employee's purse and coat stored on food shelves. Upon inspection, she did not know where to relocate her personal items. CDI- Informed the employee to store all personal items away from food and prep areas. Another employee informed her to place it in the break room. 6-305.11/6-501.110 Designate and use an area for the orderly storage of employees' clothing and possessions. *NOTE: 100/200 Hall Satellite Kitchen is closed & not in use. Bryan present during the inspection.

4-501.112(A)(2) Provide a minimum of 180F rinse water for sanitization when using the dish machine. -Pf- Observed dish machine rinse temperature only reaching 171F and then not peaking 155F. CDI- Three compartment sink will be utilized until dish machine can be fixed. VERIFICATION REQUIRED. 4-601.11(A) Equipment food contact surfaces and utensils shall be clean to sight and touch. -Pf- Observed slicer stored as clean with food debris on underside of blade. Observed juice nozzles with build-up. CDI- Nozzles were cleaned during inspection. -1.5pts-

7-201.11 Store toxic materials to avoid contamination. -P- Observed aerosol can of oven cleaner and disinfectant wipes stored with food items in satellite kitchen. CDI- Items were removed. -0pts-

4-501.11 Maintain equipment in good repair. - Observed torn gaskets on warming unit. Needs to be repaired. -0pts-

6-301.12 Provide paper towels or approved alternative for hand drying at each handsink. -Pf Observed one hand washing area with inaccesssible paper towles; dispenser was not functioning. **Ensure paper towels are accessible at each hand washing area. CDI- Paper towels were made accessible -No Point Deduction

4-601.11(A) Equipment food contact surfaces and utensils shall be clean to sight and touch. -Pf Observed the ice shoots with pink residue in 3 satelite kitchens. Clean and sanitize all ice machine CDI- Ice shoots were cleaned.

7-102.11 Common Name-Working Containers - PF Observed sanitizer in buckets labled "detergent" and detergent in buckets labled "sanitizer. **Ensure all chemicals transfered into containers are properly labled. CDI - Buckets were properly labled. -No Point Deduction

3-304.14(B) Hold in-use wiping cloths in sanitizer between uses. Observed some wipeing clothes were stored in detergent buckets and not sanitizer. **Ensure all in-use wiping clothes are stored in sanitizer 200-400ppm quat concentration.

2-102.12 PIC demonstrates knowledge by being a certified food protection manager. Observed serve safe certification expired December 8th, 2015. PIC scheduled for serve safe class 2/23/16.

4-601.11(A) Equipment food contact surfaces and utensils shall be clean to sight and touch. -Pf. Observed food debris collecting on inside of scoop utensil, sticker tape residue on clean pitchers and lids. Corrected during inspection -Items were pulled from service and placed in 3 compartment sink for washing.

. 3-501.18 Discard the food requiring date labels once time/temperature window has expired, if it is not been labeled, or if the label is incorrect. -P Observed shredded carrots passed window date. Corrected during inspection -shredded carrots were voluntarily discarded.

4-501.11 Maintain equipment in good repair. Observed 3 compartment sink with leak coming from release lever valve. Corrected during inspection -maintenance tightened release valve to prevent water from leaking. Water collecting in left corner near 3 compartment sink in need of removal.

3-305.11 Food Storage-Preventing Contamination from the Premises - CObserved an unsealed bag of food thickener was stored near a prep sink. **Store all food in sealed food grade containers or bags to prevent contamination.