Residents of the The Sequoias, an upscale retirement center, became ill with E. coli O157:H7, beginning October 9, in Portola, California. The Sequoias employees did not prepare food for the residents; the facility had a contract with Sodexo for food preparation and service. Based on the epidemiologic curve, a common source was the likely cause for the infections. A case-control study implicated raw spinach. The spinach was delivered by Lee Ray-Tarantino, a produce wholesaler, and was a "pre-washed" product. Produce was stored in a walk-in refrigerator that contained only produce, salad, and dairy items. The spinach was not washed prior to serving. During the environmental investigation, an inspector noted that the Sequoias kitchen met industry standards and was free from violations. Two days later, however, a follow up investigation noted that several refrigeration units were above 41 degrees Fahrenheit, and that there was a build-up on the ice machine. These violations were corrected by the next inspection.