The findings of the kitchen inspection, conducted 05/14/24, are documented in this report. The survey was conducted to determine compliance with the OARs 411-054-0030 for Residential Care and Assisted Living Facilities for Resident Services- Meals, and Oregon Health Service Food Sanitation Rules OARs 333-150-0000.

The findings of the first revisit to the kitchen inspection of 05/14/24, conducted 07/18/24, are documented in this report. The survey was conducted to determine compliance with the OARs 411-054-0030 for Residential Care and Assisted Living Facilities for Resident Services - Meals and Oregon Health Service Food Sanitation Rules OARs 333-150-0000.

The findings of the second revisit to the kitchen inspection of 05/14/24, conducted 09/19/24, are documented in this report. It was determined the facility was in substantial compliance with the OARs 411-054-0030 for Residential Care and Assisted Living Facilities for Resident Services- Meals, and Oregon Health Service Food Sanitation Rules OARs 333-150-0000.

Based on observation and interview, it was determined the facility failed to maintain the kitchen in good repair and in a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. Findings include, but are not limited to:

Observation of the facility kitchen reviewed on 05/14/24 from 10:15 am through 2:20 pm revealed the following:

a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, and/or black matter and grease was visible on or underneath the following:

* Interior of reach in and walk in fridge/freezer;

* Interior of ovens, exterior of grill, and sides of equipment;

* Deep fryer with large grease buildup and visible food debris;

* Interior and exterior of dishwasher with scale buildup;

* Fan cages and blades in main kitchen area and in walk in cooler;

* Kitchen walls near/behind trash cans, misc. areas;

* Interior of ice machine;

* Stainless steel shelving;

* Metal racks storing clean dishes/equipment;

* Metal racks in walk in cooler/freezer;

* Can opener blade and casing;

* Industrial mixer;

* Ceiling vents;

* Interior and exterior of microwave;

* Interior of reach in coolers;

* Wells in steam table;

* Line fridge with white/gray fuzzy substance on metal shelving;

* Floors throughout kitchen areas and walk in refrigerator and freezer, under/between equipment/shelves; and

* Interior and exterior of toaster.

b. The following areas needed repair:

* Exposed areas of corners with protective covering which was cracked, chipped and/or missing;

* Metal racks in freezer with rusted areas;

* Visible mineral/scale build-up on interior and exterior of ware washing machine;

* Floors with cracks, non smooth surfaces;

* Caulking in dirty side of ware washing area with black debris; and

* Reach in cooler with rusted shelving where protective coating had worn off.

c. Dishwasher was observed not reaching 180 degrees for sanitation. Multiple observations revealed final rinse temperatures to be 127, 124, 125, 128 and 127 degrees F.  Review of dishwasher temperature logs documented all rinse temperatures for May, 2024 below 180 degrees. Staff 1 acknowledged the dish machine was malfunctioning and not reaching desired temperatures for rinse. Staff 1 stated that a new machine had been purchased; however, had not arrived yet. Kitchen staff acknowledged rinse temperatures had been "a bit lower" for about a month. Staff 1 when interviewed indicated she believed the temperature of rinse they were looking for was 150 degrees not 180 as required. Staff were instructed by survey team to use alternative sanitation methods until new dish machine was in place.

d. Cutting boards including tray line board was found heavy scored and/or stained.

e. Vegetable soup in reach-in fridge was dated 04/06/24, not within 7-day storage per food code. Staff 2 (Cook/designated Person In Charge) acknowledged it should have been discarded.

f. Multiple bowls and food containers in kitchen noted to not be stored covered or inverted;

g. Silverware in dining room was stored with food contact area facing up and exposed to potential contamination.

h. Disposable utensils, Styrofoam containers and coffee filters were stored uncovered and exposed to potential contamination.

i. Boxes in walk in freezer were observed stored not sealed and/or damaged.

j. Sliced meat in walk in refrigerator was observed not sealed or dated.

k. Multiple food items noted without an open date or use by date in cold and dry storage.

l. Table ware in dining room was preset without being covered or inverted per code.

m. Staff 2 (Cook/designated person in charge) was not able to demonstrate knowledge in the following areas based on interview and observations: unable to list foodborne illnesses, symptoms and how to prevent spread, proper reheating and cooling processes, proper hand hygiene and glove changes when serving food.

n. Staff 2 was noted to not have facial hair restrained as required.

o. Desserts and beverages served to residents in their rooms were not covered and protected from potential contamination during transport as required.

At approximately 2:00 pm, surveyors reviewed the above areas with Staff 1 (Administrator), who acknowledged the identified areas.

A:  Food Sanitation Rule, OAR 333-150-000

Kitchen Manager has set up cleaning schedule for entire Kitchen to be deep cleaned.  Kitchen Manager and Executive Director had a Mandatory training/in-service on 6/5/24 with all Kitchen staff addressing Sanitation and reviewed cleaning schedules with all Kitchen Staff.  Cleaning schedules will be completed daily by Cook and Dish Aid.

Kitchen staff, Executive Director, & Maintenance Cleaned Walk-in Cooler and Freezer.  Removed old racks and replaced with new racks in Walk-in Cooler.  Executive Director addressed at 6/5/24 Mandatory meeting/training regarding all coolers, sandwich bar, walk-in cooler and freezer must be cleaning and all items must be closed, covered, & dated.  Cleaning schedules are in place. Cook and Dish Aid are responsible for daily schedule.

B:  Areas needing repairs:  Kaufman Home Maintenance came out and repaired corners on walls and cracks.  Kaufman Home Maintenance will be repairing Floors with cracks.  Maintenance and Executive Director replaced shelving in Freezer and Cooler.  Kitchen Manager will report and repair needs to Maintenance daily or as needed.

C: Dishwasher not reaching 180 degrees.  Waxie converted to a low temp and brought out chemical on 5/14/24 for low temp dishwasher until new equipment arrives. Executive Director and Kitchen Manager addressed Temps in mandatory meeting/in-service on 6/5/24 with all Kitchen staff, if dishwasher is not meeing temps staff must notify Administration, and if issue is not resolved staff will emplement 3 conpartment sink, wash, rinse, & sanitize.  Dish Aid is reponsible for ensuring correct temperatures are reached during each shift.

D:  Cutting boards on tray line: Maintencance removed cutting baords and replaced with new ones.  Executive Director and Kitchen Manager addressed at mandatory meeting/in-service with all kitchen staff.  Staff will report to kitchen manager when cutting boards need to be replaced.  Kitchen manager will check all working equipement and replace as needed, monthly.

E:  Vegtable soup out dated:  Executive Director and Kitchen Manager address with all kitchen staff at 6/5/24 meeting/in-service food items must be dated, covered, and discared after 7 days.  Each shift will check food items ensuring items are discarded that are out of date.  Cooks will monitor daily/each shift.

F:  Executive Director and Kitchen Mananer addressed at meeting/in-servicve with all kitchen staff bowls and any food containers must be covered.  Staff will take items out of cases and then reclose the box.  Each shift is responsible for ensuring all food continers are covered.

G: & L: Executive Director and Kitchen Manger addressed with all kitchen staff on 6/5/24 all silverware if dining hall is being preset staff will wrap silverware at each place setting & coffee cup will be inverted, Dish Aid is responsible for task.  Dish Aid is responsible during each shift.

H:  Executive Director and Kitchen Manager addressed all disposible utensils, styrofoam containers and coffee filters must be closed up after opening and removing for use.  Cooks and Dish Aid are repsonsible for ensuring items are closed back up.  Addressed with all kitchen staff at 6/5/24 meeting/in-service.

I:  Executive Director and Kitchen Manager addressed all boxes can not have any damage and must be sealed.  Cooks are responsible when removing or putting cases away, any damage cooks will remove.  

J:  Executive Director and Kitchen Manager addressed food items must be sealed, covered, & dated, discussed at mandatory 6/5/24 meeting/in-service.  Cooks are repsonsilbe for montorying daily during shifts.  Kitchen Manager will do weekly walk throughs.

K:  Executive Director and Kitchen Manager addressed at mandatory training/in-service on 6/5/24 that all food items in dry or cold storage must have and open date or use date.  Kitchen Manager will monitor weekly and daily.  

M:  Executive Director and Kitchen Manager addressed foodbourne illnesses, symptoms and how to prevent spread, proper reheating and cooling processes, proper hand hygiene and glove changes when serving food at mandatory training/in-servie on 6/5/24.  Staff will report to Administration if they are feeling ill and if one of the following illnesses are diganosed; Noro, Hepatitis, Shigells, Enterohemorrhagic or Shiga E.coli, and Salmonella Administration will notiffy the county health dept.

N:  Executive Director and Kitchen Manager addressed wearing hair nets and beard nets.  And hair must be restrained.  Cooks and Dish Aids are aware and will use during there shift.  

O:  Executive Director and Kitchen Manager addressed desserts and beverages must be covered, training/in-service.  During transportation staff will cover drinks and desserts when taking to resident apartments.  

Monthly training/in-services are scheduled through the year with executive director and kitchen manager for all kitchen staff.   

Based on observation, interview, and record review, it was determined the facility failed to maintain the kitchen in good repair and in a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. Findings include, but are not limited to:

Observation of the facility kitchen on 07/18/24 revealed the following:

a. An accumulation of debris, dirt, dust, and grease was visible on or underneath the following:

* Metal racks storing clean dishes/equipment; and

* Ceiling vents.

b. The following area needed repair:

* A ceiling light fixture above the steam table was broken.

c. The dishwasher was observed not reaching 180 degrees Fahrenheit for sanitation. Multiple observations revealed final rinse temperatures to be between 116 and 124 degrees F.  Review of dishwasher temperature logs documented all rinse temperatures for July 1 through July 18, 2024, below 180 degrees F. Staff 4 (Kitchen Manager) reported a new dish machine was purchased; however, it had not yet arrived. She stated the facility was using a chemical sanitizer (Chlor Plus), and there was no minimum rinse temperature needed. The facility contacted the distributor to provide survey with documented information and instructions for use of the chemical sanitizer.

The email from the distributor confirmed there was "no minimum temperature requirement for the product used. Standard testing for the product would be to use a chlorine test strip during the rinse cycle. It should read 100-130 ppm for standard range." Kitchen staff were unaware of the testing requirement. On request of survey, Staff 5 (Dish Aide) used chlorine strips and checked the rinse cycle water from the dishwasher multiple times. The ppm was 10, not reaching the required minimum 100 ppm. Staff 4 was notified and acknowledged the chemical sanitizer was not functioning properly to sanitize and the rinse cycle water temperatures did not reach 180 degrees F. Staff were instructed by survey to use alternative sanitation methods until new dish machine was in place.

d. A large fan located on the floor, just past the ice machine, was on and blowing on and around the ice machine, which posed risk of contamination of the ice when the machine was accessed.

e. Two ceiling lights had debris and/or bugs inside.

f. A male employee was noted to not have facial hair restrained as required.

At approximately 11:45 am, surveyor reviewed the above areas with Staff 4, and then Staff 3 (Administrative Assistant), who acknowledged the identified areas.

A, B, & E -  Metal rack was replaced with a new rack on7/19/24.  Kitchen Manager added on weekly cleaning log all racks in kitchen area, cooler, freezer, ceiling vents, & light will be cleaned and inspected weekly.  Any damaged racks will be reported to Administrator.  Kitchen Manager will follow up bi-weekly to ensure all cleaning logs are current and completed.

C.   Dishwasher - New dishwasher arrived on 7/30/24 and will be installed on 7/31/24.  

D.  In-Service with all Kitchen staff regarding fans blowing on ice machine.  Discussed the risk of contamination of the ice.  Kitchen Manager removed fan so that it would know longer blow on or near ice machine.  

E.  Kitchen employee had stubble shorter than an eye lash.  Informed kitchen staff that if they have any facial hair they must use beard/hair net.  In-serviced staff on 7/18/24.  Kitchen Manager will report to Administrator if any kitchen staff is not following restraint requirement.    

Based on interview, observation, and record review, it was determined the facility failed to ensure their kitchen survey plan of correction was implemented and satisfied the Department. Findings include, but are not limited to:

Refer to C 240.

Refer to C 240