OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule (1) The residential care or assisted living facility must provide a minimum scope of services as follows: (a) Three daily nutritious, palatable meals with snacks available seven days a week, in accordance with the recommended dietary allowances found in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables; (A) Modified special diets that are appropriate to residents' needs and choices. The facility must encourage residents' involvement in developing menus. (B) Menus must be prepared at least one week in advance, and must be made available to all residents. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes. (C) Food must be prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules). This Rule is not met as evidenced by: Based on observation, and interview, it was determined the facility failed to maintain the kitchen in good repair and in a sanitary manner, effectively sanitized dishes and stored food in accordance with the Food Sanitation Rules, OAR 333-150-000. Findings include, but are not limited to: 1. Observation of the ALF kitchen and Memory Care Kitchenette on 05/02/25 at 10:45 am through 2:15 pm revealed the following deficiencies: a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, black matter, and grease was visible on or underneath the following: * Door thresholds on kitchen entry and exit doorways * Floor corners in the threshold of entry and exit doors * Industrial can opener * Industrial mixer * Walk in cooler drain on outside of walk in * Hand washing sink area with splatter * Faucet and area around handwashing sink * Ceiling vent above ice machine * Kitchenette reach in refrigerator and freezer * Kitchenette microwave * Kitchenette oven * Kitchenette drawers/cupboards * Kitchenette wall behind trash can b. The following was observed needing to be repaired. * Caulking around hand washing sink was cracked/missing or had black substance build up. * Dish machine in Memory Care Unit was not registering any concentration of sanitizing agent. c. Dining room silverware was observed to be pre-set upon entry to facility at 10:45 am, Lunch was served at 12:00 pm. Kitchen staff stated lunch tables were set immediately following breakfast meal service. Food contact surfaces of utensils were not wrapped/covered to protect from potential contamination. d. Staff 2 (Cook/Person In Charge designee) was observed preparing and serving food without appropriate facial hair restraints. e. No surface sanitizing buckets were observed upon entry and throughout kitchen inspection to ensure effective sanitation during meal prep and service. Staff 2 was interviewed and acknowledged no buckets were made. f. Ice machine was observed to have drain pipe directly inside of kitchen drain. No air gap was visible to ensure any drain back up would not potentially contaminate the ice machine. A long tube was observed sitting in the drain under the stainless steal prep table where can opener was located. Staff were asked what the tube was for and they indicated it was a water line for a juice machine connection. Staff indicated it was not in use and had not been in use. However, they confirmed it was an active water line. Surveyor instructed the line needed to be up and out of the drain and create at least an inch air gap to prevent potential contamination. g. Staff 2 was designated person in charge and was not able to effectively demonstrate knowledge in potential illnesses that would be excludable and reportable as per food code. h. Facility did not have or could not locate a copy of the Oregon Food Sanitation rules as required. i. Dish machine in Memory Care Unit was a low temperature machine requiring chemical sanitation. There were no test strips in memory care kitchenette for staff to validate effective sanitation of dishes. Staff verified that all plates, cups, utensils were washed/sanitized in the dish machine for resident meal service. Staff available at meal time did not know the sanitizing chemical used nor the effective PPM (parts per million) that would be required. Staff verified that they did not check the machine for effective sanitation. At 1:45 pm Staff 3 (Maintenance Director) indicated an outside vendor comes in to check sanitation levels for the dish machines. Documentation indicated the memory care dishwasher had not been monitored by vendor since 11/6/24. Staff 3 also indicated he did not check the dish machine sanitation levels. j. Multiple food items were found in the memory care unit reach in refrigerator without dates opened or prepared. A bag of cereal was observed in a cupboard open to potential contamination. k. At 12:06 pm, Two plates of breakfast type foods were found sitting on top of the stove in memory care unit. Staff indicated those plates were for residents who did not come to breakfast and who wanted something to eat later. Staff indicated this was a common practice to set aside plates of food and to discard it once lunch was served. Staff acknowledged it was not stored in the refrigerator and was out since 8 am. Staff 2 and Staff 1 were notified of this practice and both acknowledged those food items should have been placed in the refrigerator to be warmed/reheated not left on the counter. l. Memory care staff member was observed to not demonstrate effective knowledge on use of thermometer for checking temperatures prior to food service. Staff was not aware that the thermometer probe needed to be inserted into the food product until instructed by the surveyor. Staff was then observed to not sanitize the thermometer before temping the food nor in between food products potentially contaminating the foods. m. Memory care staff did not have on aprons/effective barriers to protect from potential contamination from care duties during meal service. n. Memory care staff were observed to potentially contaminate gloves during meal service by reaching in drawers/cupboards and not change gloves then touch ready to eat foods with those potentially contaminated gloves. o. Kitchenette area did not have enough effective service utensils for all food types. Staff was observed to attempt to serve out chowder soup using a slotted spatula as no more service ladles/spoons were available. p. A staff member’s lunch box was observed sitting on top of the memory care kitchenette toaster potentially contaminating the surface where ready to eat foods are prepared. Multiple staff drinks were observed that were not of approved style types that did not have lids and/or straws as required per rule. At approximately 1:30 pm surveyor reviewed above with staff 2 who acknowledged areas. At 1:45pm surveyor reviewed identified areas with Staff 1 (Business Office Manager) who acknowledged the concerns.

Areas found to be out of compliance referenced in section 1. will be cleaned, repaired, and corrected as of 5/30/25. Dietary director will use Quality Assurance tools (Food Sanititation Audit, and cleaning checklist) per Prestige policy to do weekly audits per prestige policy and Memory Care director will utilize quality assurance tools and audits to ensure ongoing compliance with OAR 333-150-000. Executive Director will be responsible for continued compliance through weekly meeting with dietary and memory care directors, kitchen walkthroughs and quality assurance audits. Items referenced in section 1.a. in need of cleaning have been added to updated cleaning list as of 5/21/25. Deep clean of all kitchen areas in AL is scheduled for 5/27/25, Memory Care Kitchenette deep clean scheduled for 5/28/25 and will occur on an ongoing quarterly basis. Industrial can opener has been replaced as of 5/21/25. Maintenance director will have caulking around handwashing sink replaced by 5/30/25 to correct item 1.b. Executive director will audit area to verify completion. All dishes are being washed in Assisted Living kitchen until vendor comes to evaluate memory care dish machine and it has been approved for proper use and staff trained. Staff trianing proper dishwasher use scheduled for 6/3/25. All staff received training regarding food safety, sanitation, nutrition and on items referenced in section 1. c, d & e. on 5/20/25 Tubing and pipe referenced in item 1.f have both been repositioned and securedas instructed as of 5/20/25. Section 1.g.-All staff received training on potential illnesses, and reporting requirements on 5/20/25. Section 1.h.-Labeled copy of food sanitation rules have been placed in kitchen for acccess to all staff members as of 5/20/25. Section 1.i.-All dishes will be washed in Assisted Living Kitchen until staff receives training for proper use of dish machine. Training is scheduled for 6/3/25. Section 1.J. All staff received training food safety, storage, labeling on 5/20/25. Memory care director will be auditing weekly using food sanitation tool to ensure ongoing compliance. Section 1.k-All staff received training on Safe Food storage on 5/20/25. Memory care director will be auditing weekly using food sanitation tool to ensure ongoing compliance. Section 1.l. Staff received training on safe food temperatures and checking food temperatures on 5/20/25. Memory care director will be checking food temperature log and proper temping during audits and kitchenette walkthroughs. Section 1.m.-Staff were provided with new apons on 5/14/25. Continuing use of aprons will be audited my memory care director to ensure continued compliance with use. Section 1.n-Staff received training on proper gloves use on 5/20/25. Section 1.o-Kitchen will send service wear with food appropriate for each item being served at each meal as of 5/20/25. Seciont 1.p-Personal items removed from kitchenette area and staff training scheduled for 6/3/25 to review proper storage of personal items, drink types and allowances. Memory care director will ensure ongoing compliance during kitchenette walkthroughs.

OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule (1) The residential care or assisted living facility must provide a minimum scope of services as follows: (a) Three daily nutritious, palatable meals with snacks available seven days a week, in accordance with the recommended dietary allowances found in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables; (A) Modified special diets that are appropriate to residents' needs and choices. The facility must encourage residents' involvement in developing menus. (B) Menus must be prepared at least one week in advance, and must be made available to all residents. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes. (C) Food must be prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules). This Rule is not met as evidenced by:

OAR 411-057-0140(2) Administration Compliance (2) The licensee of a memory care community must comply with both the licensing rules for the facility and Chapter 411, Division 57. This Rule is not met as evidenced by: Based on observations and interviews, it was determined the facility failed to follow licensing rules for Residential Care and Assisted Living Facilities. Findings include, but are not limited to: Refer to C240.

Refer to C240

OAR 411-057-0140(2) Administration Compliance (2) The licensee of a memory care community must comply with both the licensing rules for the facility and Chapter 411, Division 57. This Rule is not met as evidenced by: