The findings of the kitchen inspection, conducted 05/10/23, 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 re-licensure survey of 05/10/23, conducted on 07/13/23, are documented in this report. It was determined the facility was in substantial compliance with the OARs 411 Division 54 for Residential Care and Assisted Living Facilities, OARs 411 Division 57 for Memory Care Communities and Home and Community Based Services Regulations OARs 411 Division 004.

Based on observation and interview, it was determined the facility failed to ensure the kitchen was clean, food was stored appropriately and glove use was in accordance with the Food Sanitation Rules  OAR 333-150-0000.

Findings include, but are not limited to:

On 05/10/23 at 10:55 am the following areas of concern were observed:

* In the walk in refrigerator:

  - Multiple containers of leftovers without labels and/or dates;

  - Carton of eggnog past "best by" date; and

  - Roll in cart with food items uncovered including: cake with whipped topping, tarter sauce and guacamole.

* In walk in freezer:

  - Three stacks of boxes on floor;

  - Open frozen food items without dates; and

  - Package of breaded fish open to the air.

* Dry storage:

  - Cardboard boxes on the floor included: ice cream cones, cake mixes, cups, bowls, bag of couscous, popcorn, juice;

  - Bag of whole grain red quinoa open to air;

 - Open bag of pudding; and

  - Scoop in bin of oats.

* Bag of onions on floor under handwashing sink.

* Roll in cart next to reach in refrigerator with uncovered pies and burritos.

* In food prep area: uncovered slices of pie on trays.

* Handle of scoop in ice bin (not hanging on hook).

* Areas in need of cleaning:

  - Vents above grill/stove with dust/grease;

  - Grease drippings on stove hood;

  - Wall behind stove and steamer (grease and splatters)

  - Wall and ceiling above juice machine and coffee station (dusty);

  - Vent above cereal containers/clock/coffee station (heavy dust build up);

  - Light covering above food prep area next to stove (dusty/splatters);

  - Roll in cart near reach in refrigerator with food debris/crumbs on shelving holder slates;

  - Two blender bases with food drippings/splatters;

  - Hood above dishwasher rusty; and

  - Bottom shelf holding steamer and cutting boards -  finish worn off (uncleanable).

* Garbage cans uncovered when not in use:

   - One near stove with open container of shredded cheese and tortilla wraps;

  - One near the two compartment sinks;

  - Open can holding food scraps by hand washing sink; and

  - One near uncovered slices of pie.  

* Multiple observations of serving staff changing gloves without washing hands before donning clean gloves. Staff were observed conducting multiple food preparation activities without changing gloves or washing hands between activities.

The areas of concern were observed and discussed with Staff 1 (Dietary Manager) and Staff 2 (Executive Director) on 05/10/23. The findings were acknowledged.

C240

5/11/23 a deep clean began in the kitchen including the walk in refrigerator, the roll in carts, vents, stove hood, blender, walls, ceiling vents and light coverings all cleaned and are dust/ spatter free. Finish on the cutting board storage is to be refinished. All uncovered food as well as containers of leftover food without labels and/or dates was disposed of.

Garbage cans with lids are on order All deliveries of food were put away on shelves up off the floor.

2. When deliveries are made, cardboard boxes will be placed on milk cartons to keep items off the floors, deliveries will then be put away on shelves by end of day.

Routine Daily and Monthly cleaning schedules put into place.

Education completed for glove useage, food storage, and cleaning procedures to be done annually and as needed as evidenced by internal audits.

3. Kitchen Manager or designee will monitor and assure the cleaning procedures and schedules are adheared to on a daily, weekly, monthly basis. Kitchen Manager will monitor that all deliveries are put away and properly stored, leftovers are properly stored and dated, and monitor glove use on a weekly basis.

4. Kitchen Manager, Executive Director

Based on observation and interview, it was determined the facility failed to follow licensing rules of Residential Care and Assisted Living Facilities.

Finding include, but are not limited to:

Refer to C240.

Z142

Refer to CBC Plan of Correction for C240

Refer to CBC Plan of Correction for C240

Refer to CBC Plan of Correction for C240

Refer to CBC Plan of Correction for C240