Park Terrace Village
Inspection Findings
F-Tag F0812
F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Based on observation, interview, and record review, the facility failed to ensure food was served in a sanitary manner for 2 of 2 kitchen observations. (Kitchen) Finding includes: On 11/18/25 at 8:57 a.m., an
observation was made of the kitchen. The following was observed:Dirt and debris on the floor, behind the stove, fryer, convection oven, and steamer.Dirt and debris under stainless steel tables and under racks.
Debris and grease on top of the stove, sides of the stove, and sides of the fryer.Dirt and debris behind the ice machine, steam table, and plate warmer debris observed on surfaces. Dirt and debris on the floor and under the racks in the dry pantry. On 11/18/25 at 11:11 a.m., the same was observed. On 11/18/25 at 11:13 a.m., the Dietary Manager indicated the kitchen is cleaned daily, floors are usually cleaned at night, but did not get done last night due to being short-staffed. The staff follow a cleaning schedule. On 11/18/25 at 11:29 a.m., the Administrator provided the current policy on kitchen cleanliness with an original date of 06/25. The policy included, but was not limited to: A clean, sanitary, and safe kitchen environment will be maintained at all times to ensure the health and well-being of our residents, staff, and visitors. All kitchen areas, including food preparation surfaces, equipment, storage areas, walls, and floors, must be cleaned regularly and kept free of debris, spills, and potential contaminants. This citation relates to Intake 2669490. 3.1-21(i)(2)3.1-21(i)(3)
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
PARK TERRACE VILLAGE in EVANSVILLE, IN inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in EVANSVILLE, IN, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from PARK TERRACE VILLAGE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.