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, interview and record review, it was determined the facility failed to maintain the kitchen in good repair and in a sanitary manner, and to ensure meals were served at appropriate textures and were palatable, in accordance with the Food Sanitation Rules, OAR 333-150-000. include, but are not limited to: Observation of the kitchen on 06/27/25 at 11:00 am through 1:30 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: * Flooring under mats with dirt/debris build up * Flooring in corners, edges, between and under equipment * Wall behind ice machine * Ceiling vents * Drains throughout kitchen and in Dining room * Industrial can opener and housing * Juice machine * Industrial mixer and table * Deli refrigerator door * Interior of deli refrigerator * Blender exterior * Walls behind trash can, * Walls at kitchen entry * Walls around dish machine * Stainless steel shelving throughout kitchen * Exterior of ovens (handles/knobs) * Sides of major equipment * Stove top * Freezer floor * Dry storage floor under metal racks * Dinning room floors under tables * Dining room tables * Exterior of trash cans b. The following areas were found in need of repair: * Caulking behind hand washing sink with visible debris build up * Caulking around dishwashing area with large amount of debris build up; * Cabinets under sinks in both dining rooms with water damage *Walk in freezer with ice build up * Deli Cooler not at correct cooling temperature found at 55 degrees Fahrenheit. c. White surface/cutting board on steam table found heavily stained and scored. d. Multiple items observed in deli cooler not dated when opened. A container of salad was also observed not dated and looked old and wilted with areas of browning. e. Sauté pans found heavily scored and non-stick area flaking/scratching off. Hot pad/mitts were observed worn with holes. f. Multiple food items noted in deli fridge were found not at 41 degrees or below. Cottage cheese noted at 52.4 degrees, and diced peaches at 53.4 degrees. Refrigerator temperature logs for deli cooler were reviewed and no documented temperatures were recorded for the previous 4 days. Staff 2 (Dining Services Manager) was informed of the elevated temperatures and acknowledged the food was above safe temperature levels and discarded the items. Staff 2 stated they would contact a repair man to service the unit. e. Cook was observed to serve food items from steam wells with gloved hands that were potentially contaminated by other tasks. There were utensils available, but staff did not use them. f. Multiple kitchen staff preparing and/or serving food did not have hair and/or facial hair effectively restrained as required. g. Lunch items on menus stated “lemon dill fish, baked potato, vegetable”. Facility served fried fish, baked potato with gravy, and a stir fry type vegetable blend. There was no lemon/dill component to the fish. Staff was observed to serve mechanical diets the fried fish and baked potato with skin. Cook left off the vegetables completely and did not offer an alternative vegetable to the mechanical diet residents. Surveyor approached staff 2 about the items that were given to mechanicals that were on the “avoid” list for mechanicals. The list stated items to avoid included, “Fried fish, Potato skins, stir fry vegetables.” Staff 2 indicated the fish was not fried but baked and was “soft.” The food product was fried fish that was baked but still had the breading. The cook was not aware mechanical softs could not have the skins of the potatoes or fried fish. The facility did not ensure res with mechanical diets were offered an alternative vegetable. h. Kitchen staff was observed to puree the stir fry vegetables that included pea pods. Surveyor tested the puree for proper texture and there were noted fibrous and stringy components from the pea pod shells and the vegetable were not smooth or at appropriate textures for diet type. The facility did not have an alternative vegetable prepared. Surveyor had to ensure the incorrect textured vegetable were not served. The facility was instructed to make alternative vegetables that could be pureed to correct textures. i. Plates served to residents did not appear appetizing. The vegetables were overcooked the baked potatoes were sliced in half and placed both halves on the plate and brown gravy poured over the top. One small piece of fish was served. There was no garnish or tartar sauce or any dill component as listed on the posted menu. The gravy was spread over the potato in a hurried manor causing gravy to cover parts of the fish and overcooked vegetables along with the plate. The meal did not look appetizing or palatable. The facility did not follow the posted menu for mechanicals leaving off the vegetable. Surveyor reviewed above areas with Staff 2 (Dining Services Manager) and they acknowledged the identified areas. At 1:30 pm the surveyor reviewed the areas in need of cleaning, repair and poor practices with Staff 1 (Executive Director) who also acknowledged the areas in need of correction.

1. a. Full deep clean of kitchen and dining rooms addressing all areas identified during survey. b. The following areas were found in need of repair: . * Caulking behind hand washing sink with visible debris build-up; Caulking replaced. * Caulking around dishwashing area with large amount of debris build-up; Caulking replaced and debris removed. * Cabinets under sinks in both dining rooms with water damage; Reviewed by AED on 06/26/25. Damage is old, but cabinets are structurally sound with no signs of mold. Verified with Maintenance, damage result of old plumbing issue that was resolved previously. Review completed with surveyor following survey, same day. *Walk in freezer with ice build up; Ice build up result of broken fan in freezer. Maintenance is contacting local vendor to have broken fan replaced. * Deli Cooler not at correct cooling temperature found at 55 degrees Fahrenheit. Deli cooler serviced and repaired. c. White surface/cutting board on steam table and deli case found heavily stained and scored both replaced. d. Multiple items observed in deli cooler not dated when opened. All items removed and disposed of. e. Sauté pans found heavily scored and non-stick area flaking/scratching off. - Three sautee pans discarded. New pans in place, Hot pad/mitts were observed worn with holes. -Worn and holy hot pads have been discarded. Hot pads have been replaced. f. Multiple food items noted in deli fridge were found not at 41 degrees or below all food items removed. Daily temp logs in place and monitored. g. Proper hand washing/hand hygiene immediately addressed and ongoing staff training and observation. h. Hair and beard restairnts immediately addressed; in addition to on going training and observation. i. All menu changes will be posted 24 hours in advance. 100% audit of all diets updated and reviewed training completed in addition to on going training and observation. j. Puree items with appropriate alternatives to items that may not be pureed or leave fibrous components have been posted and will be reviewed with weekly menus in addition to training and observation. k. Immediate training completed with dietary staff on expectations of provididing nutritious, palatable meals with attention to presentation for every plate served. 2. CBC kitchen inspections will be conducted weekly by ED/AED/DSM with reivew to areas needing addressed and will be corrected and training conducted at time of inspection. 3. There will be daily review of all areas noted in 1. b-k, in addition to weekly CBC kitchen inspections. DSM/PIC/ED/AED. 4. The DSM and AED will ensure all areas addressed in the POC are completed with on going monitoring.

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: 142: 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.

Review above, as both tags respond to the same violations.

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: