Oak View Health and Rehab: Immediate Jeopardy Food Safety - SC
When a cook tested the machine on February 11, 2025, the test strip came back blank. She tried again. Same result. The kitchen manager, who had been brought in from a sister facility to help out, started troubleshooting and confirmed what the strip already showed: there was no sanitizer reaching the dishwasher at all. She checked the three chemical buckets sitting on the floor next to the machine. One held liquid detergent. One held metal-safe detergent. One held rinse aid. None of them was sanitizer. The kitchen manager told inspectors there was no dishwasher sanitizer anywhere in the building, and that she would borrow some from her home facility.
The temperature gauge on the dishwasher's exterior read 94 degrees Fahrenheit. The manufacturer requires a minimum of 120 degrees.
Lunch was already on the steam table. Staff were plating food on regular dishes.
Federal inspectors rated this an immediate jeopardy, the most serious classification available, meaning the deficiency had created a situation likely to cause serious injury, harm, or death to residents if not corrected immediately. Every resident who eats or drinks by mouth, the facility later acknowledged, had the potential to be affected.
The three-compartment sink, which staff use to hand-wash pots and pans, was in no better shape. At 1:15 PM, inspectors observed the wash compartment full of water with a metal pot sticking out of it. The rinse compartment and the sanitizing compartment were both empty and dry. A kitchen crew member who had worked at the facility for seven months told inspectors she had never seen anyone use the sanitizer compartment. Ever. Cook1 said the rinse compartment was stopped up and that some staff use all three compartments and some don't.
The dishwasher had broken down sometime before the inspection and was repaired before inspectors arrived. During the period it was down, the kitchen switched to Styrofoam containers for food, but continued serving residents drinks in regular cups, which were being washed in the three-compartment sink without sanitizer. When the dishwasher came back online, the kitchen switched back to regular plates. By the time inspectors arrived, residents had already eaten at least one lunch and one dinner on plates that had not been properly sanitized.
Multiple nurses and nursing assistants confirmed to inspectors that heated plates were used during both lunch and dinner service that day.
The part-time dietician, who works eight hours a week in what she described as a clinical role, told inspectors she was not involved in day-to-day kitchen operations and was not aware that kitchen staff had not been using sanitizer in either the dishwasher or the three-compartment sink.
The kitchen problems did not stop with the dishwasher. During the initial tour that morning, inspectors found two cases of canned corn stored on the floor. A 9-ounce can had no label and was dented. A Campbell's vegetable soup can was also dented. Two packs of hoagie rolls had no date or label. A pack of Wonder dinner rolls was expired.
The freezer held a box with eight unidentified food items inside, two unlabeled and undated bags of unknown food, a bag of tater tots with no label or date, three bags of an unknown food wrapped in cellophane with no label or date, and a bag of breadsticks with no label or date.
The refrigerator contained a case of sweet potatoes with no label or date, and the surface of the sweet potatoes had a white fuzzy substance on them. A bag of diced onions had no label or date. A pack of sharp cheddar cheese had no date. A honey ham had no label or date.
The acting certified dietary manager confirmed all of it and removed the items from storage.
Temperature logs for the refrigerator and freezer showed missing entries on multiple days the prior month. The log for February 2025 had not been started at all.
The facility's plan to address the immediate jeopardy included installing proper sanitizer in both the dishwasher and the three-compartment sink, rewashing all dishes, pots, pans, and utensils, and placing every resident who eats or drinks by mouth on monitoring for signs of foodborne illness every shift for three days. The medical director was notified the same evening.
The kitchen failures were not the only serious gap inspectors documented.
Oak View has more than 120 beds, a threshold that requires a qualified, full-time social worker on staff. The facility had none. The administrator confirmed it directly during an interview on February 4. The person filling the social services role was the Central Supply Coordinator, a woman with no social work license or certification who had been serving as social services designee, on and off, for most of the previous year. The full-time social worker, she told inspectors, had been let go.
The unit manager assigned to guide the designee said she had been working with her "off and on" and was not familiar with many social work duties. She did not have a social work degree either.
Residents knew. During the Resident Council Meeting on February 5, multiple residents told inspectors the facility had not had a licensed social worker for a period of time.
Inspectors also found a resident, identified in the report as Resident 76, who had a PEG tube and was on enhanced barrier precautions, meaning staff were required to wear gowns and gloves before entering the room for any hands-on care. The precaution was in place because of the feeding tube. On the morning of February 10, two certified nursing assistants entered the room to give the resident a bath. The PPE bin outside the door was empty. Neither aide put on protective equipment before beginning the bath.
One of them, CNA8, said, "I am sorry, I forgot to put on my PPE."
Later that same afternoon, the same resident was assisted with daily care again. CNA7, who had been one of the two aides that morning, was observed coming out of the room. She had not worn PPE that time either. "I keep forgetting to put on the PPE," she told inspectors. "I am sorry."
The Director of Nursing told inspectors that her expectation was for management staff to observe floor staff using proper PPE and that infection control was covered in staff meetings and a yearly skills fair.
The PPE bin outside Resident 76's door was empty both times inspectors watched staff walk past it and into the room.
In the Unit 4 shower room, inspectors found a toilet bowl stained with a dark greenish substance running from the rim down into the bowl. There was no water in the bowl. The room smelled. A white toilet tank lid had been placed over the bowl. The housekeeper responsible for Unit 4 told inspectors she had never cleaned that shower room and did not have the code to get inside. Nobody had given it to her. Nobody had asked her to clean it.
The toilet sat that way through at least two inspection days. When the maintenance supervisor was brought in to look at it on February 6, he called it disgusting and said he would replace it as soon as possible. He had not received a maintenance request for it. Neither the broken toilet nor the dim lighting in the shower room had been reported to his department.
The housekeeping supervisor acknowledged he had no daily cleaning checklist for housekeepers, only a monthly deep-clean checklist for resident rooms. The shower room was not on it.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Oak View Health and Rehabilitation from 2025-02-11 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: July 5, 2026 · Our methodology
Oak View Health And Rehabilitation in Conway, SC was cited for immediate jeopardy violations during a health inspection on February 11, 2025.
When a cook tested the machine on February 11, 2025, the test strip came back blank.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.