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 a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. Findings include, but are not limited to: Observation of the facility main kitchen and memory care unit kitchenette was completed 07/14/25 from 10:20 am through 11:45 am and the following was identified: a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, grease and/or black matter was visible on or underneath the following: * Juice machine * Hand washing sink edges/corners * Floors under equipment/counters in beverage service area * Interior of ice machine * Edges of flooring in dry storage * Flooring and walls under and around dish machine area * Kitchen drains * Floors under steam table * Flooring under and in between large equipment and behind oven/range/grill * Stainless steel shelving holding clean dishes by service line * Knobs of ranges/ovens/grill and steam table * Flooring in under and around dishwashing area * Walk in freezer floor * Can rack in dry storage * Metal racks storing clean dishes * Stainless steal service area on tray line * Interior of drawers * Interior of Microwave * Wall behind trash can * Thermometers in memory care unit b. The following areas were found in need of repair: * Small gap in ceiling by sprinkler c. Multiple food items found in walk in cooler without proper labels and/or prepared/opened or use by dates as required. Multiple food packages found open in walk in exposing food products to potential contamination. Multiple items found open/uncovered and without proper labels/dates in deli cooler. Multiple items found in walk in cooler that were past 7 days from prepared date and should have been discarded. Multiple items were found not dated when opened in the memory care unit refrigerator. d. Facility did not have test strips to verify/validate surface sanitizing chemicals were at appropriate levels for sanitizing as required. Staff 2 (Dining Services Manger) was not aware of the type of chemical dispensing from the wall for 3 compartment sink and surface sanitizer buckets needed different test strips. The chemical contained lactic acid and the facility had quaternary ammonia strips. The facility did not have a system to regularly test the concentration of that solution to ensure at appropriate sanitizing levels. e. Multiple kitchen staff observed without hair or beard/facial hair restraints. f. Reach in cooler for beverages including items that were potentially hazardous/protein rich did not have a thermometer to ensure items were stored at appropriate temperatures for cold holding. Staff 2 verified they could not locate a thermometer. g. Reach in refrigerator in the memory care unit kitchenette thermometer read 50 degrees Fahrenheit. Food items stored in the refrigerator temped at 45 degrees. Oregon food code rules dictate cold food storage must be at 41 degrees or below. h. The dedicated hand washing sink in the memory care kitchenette was full of dirty dishes. There was no appropriate place for staff to wash their hands as required by code. i. A staff open beverage container was observed stored in the reach in refrigerator designated for resident food storage. The beverage container did not have a lid, or a straw as required to prevent potential contamination. j. Trash can in memory care kitchenette did not have a lid. Visible food waste was observed in the container uncovered. The trash can was not actively in use and was not covered as per rule. Staff 1 and 2 acknowledged that trash can did not have a cover. At 11:30 am the above items were reviewed with Staff 2 who acknowledged areas needing correction. On 07/15/25 at 2:00 pm, identified areas were reviewed with Staff 1 (Executive Director) and Staff 2 who acknowledged the areas of non-compliance.

1. a. accumulation of all food splatter, dirt, and grease has been thoroughly cleaned from literally every surface in the kitchen, floors, fridge, walls, ranges, ovens, and steam table. b. small gap in ceiling by sprinkler has been repaired 7/24. c. ALL food items have been properly covered and dated. Staff have been in-serviced about proper food handling/storage and the importance of labeling with a date to prevent contamination. d. all the correct test strips have been purchased and stored properly. All staff have been trained on how to utilize test strips, when to change out the sanitation bucket, and which strips are used for what purpose. e. all staff have been instructed to restrain their hair and facial hair. f. the reach in cooler now has a working thermometer, and all staff are instructed to inspect and document daily temperatures. g. reach in refrigerator now has a new thermometer and temperature is being monitored and documented daily to ensure proper temp. h. the dedicated hand washing sink is now clear and clean with a sign to remind staff and others that it is for handwashing only. Staff educated of the importance of having a designated hand washing station. i. staff have removed all personal food items from resident fridge. Staff have been re-educated of the rule about keeping personal items separate from the resident's designated food storage space; whether it be cupboards, drawers, or refrigerator. j. the garbage can in memory care kitchenette now has a lid. Making sure garbage can is clean and has a clean lid at all times will be added to the daily cleaning task list. 2. a. detailed daily cleaning task list will be completed, signed, and turned in to the Dietary Manager who will audit for cleanliness and efficiency. b. monthly inspection of sprinkler heads and vents by maintenance and documented. c. Dietary Manager will audit food inventory throughout the day to ensure all food items and beverages are properly covered and dated. This includes, but not limited to walk-in cooler, freezer, reach-in fridge, dry storage, and on the line. d. Dietary Manager will do daily audits of all sanitizing buckets throughout the day to ensure proper use, testing, and changing out the bucket according to schedule. Staff will document each time they refresh the sanitzing buckets. e. if staff show up for their shift without their hair restrained, they will be sent home until their hair is properly restrained. f. a schedule is posted for staff to document daily temperature checks to ensure proper temp and accuracy of thermometer. All staff have been educated about the importance of monitoring and documenting temps. g. a schedule is posted for staff to document daily temperature checks to ensure proper temp and accuracy of thermometer. All staff have been educated about the importance of monitoring and documenting temps. h. all staff re-educated about the important purpose of the designated hand washing sink; There is also a sign posted to remind others that the sink is for hand washing only. i. all staff reviewed and signed the rule regarding no personal belongings (beverages/food) stored in the resident's fridge. Staff have their own designated area to store their belongings. If any staff food/beverage is ever found in the resident's designated food storage area, that employee will receive a written warning, and then final discharge. j. Inspecting the garbage can daily to ensure it has a lid and covered at all times will be added to a daily checklist done by staff on every shift. Staff have been instructed to notify the Dietary Manager if the garbage can or lid need replaced. 3. a, daily, weekly, monthly b. monthly, unless repairs needed before c. daily d.daily e. daily f. daily g. daily h. daily i. daily j. daily 4. a. Dietary Manager, Memory Care Director, Executive Director b. Dietary Manager, Maintenance c. Dietary Manager, Memory Care Director d. Dietary Manager, Head Cook e. Dietary Manager, Memory Care Director f. DIetary Manager, Head Cook, Memory Care Director g. Dietary Manager, Memory Care Director h. Dietary Manager, Memory Care Director i. Dietary Manager, Memory Care Director j. Dietary Manager, Memory Care Director

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 a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. This is a repeat citation. Findings include but are not limited to: Observation of the facility main kitchen was completed on 09/24/25. The following was identified: An accumulation of food spills, splatters, loose food debris, dirt, dust, grease, and/or black residue was observed on and/or underneath the following: * Hand washing sink edges/corners; * Floors under equipment/counters in beverage service areas; * Edges of flooring in dry storage; * Flooring and walls under and around dish machine area; * Floor drains; * Floors under steam table; * Flooring under and in between large equipment and behind oven/range/grill; * Stainless steel shelving holding clean dishes by service line; * Knobs of ranges/ovens/grill and steam table; * Flooring in, under, and around dishwashing area; * Metal racks storing clean dishes; * Stainless steel service area on tray line; * Interior of drawers; and * Wall behind trash can. The need to ensure the kitchen was kept clean was discussed with Staff 1 (Executive Director) and Staff 2 (Dining Services Manager) on 09/24/25. They acknowledged the findings.

1. accumulation of all food splatter, dirt, and grease has been throroughly cleaned which includes, but not limited to: hand washing sink, floors, walls, floor drains, shelving, knobs, dishwashing station, steam tables and wells, all surface areas, fridge, microwave, and garbage cans. 2. detailed daily cleaning task list will be completed, signed, and turned in to the Dietary Manager who will audit for cleanliness and efficiency. Tasks list will be sectioned, and each section will be assigned to staff #1, 2, and 3. This will prevent any confusion about who is responsible for what task, and help management hold staff accountable and/or provide further training opportunities. 3. daily, weekly, monthly 4. Dietary Manager, Memory Care Director, Executive Director area, interior and exterior of all drawers, and garbage cans.

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 a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. This is a repeat citation. Findings include but are not limited to: Observation of the facility main kitchen was completed on 12/31/25 from 10:00 am through 11:15 am. The following was identified: An accumulation of food spills, splatters, loose food debris, dirt, dust, grease, and/or black residue was observed on and/or underneath the following: * Hand washing sink edges/corners in beverage area; * Floors under equipment/counters in beverage service areas; * Flooring and walls under and around dish machine area; * Floor drains in beverage area, under steam table, under dish machine and under back prep sink; * Interior of bottom cabinet under steam table; * Floors under steam table; * Stainless steel shelving holding clean dishes by service line; * Stainless steel shelving above baking prep area; * Knobs hand handles of ranges/ovens/grill and steam table; * Range top spiders and area under; * Removable drip pan under stove top; * Interior and exterior of convection oven; * Flooring in, under, and around dishwashing area; * Metal racks storing clean dishes; and * Interior of drawers holding clean utensils; At 11:00 am, the need to ensure the kitchen was kept clean was discussed with Staff 1 (Executive Director) and Staff 2 (Executive Chef) on 12/31/25. They acknowledged the findings.

1. ALL areas of kitchen, beverage service areas and dishwashing area have been thoroughly deep cleaned of all food splatters, loose food debris, dirt, dust, grease, and/or black residue including but not limited to: hand washing sinks, floors under equipment and counters, all beverage service areas, all drains, floors, walls, steam tables, cabinets, shelving, knobs and handles of range/oven, drip pan, and all metal racks. 2. A detailed cleaning check list has been updated which includes daily, weekly, and monthly duties to ensure cleanliness is being maintained on a consistent basis. ALL kitchen staff have been in-serviced about cleaning expectations and accountibility if not completed. Executive Chef will audit kitchen and cleaning lists daily to ensure compliance is up to par and maintainted. Executive Director and Executive Chef will meet weekly to review task lists, audits, and discuss any changes/modifications needed. 3. Cleaning will be done and audited on a daily basis. 4. Executive Director and Executive Chef will be responsible to see that corrections are being implemented and monitored.

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 411-054-0105 (2-4) Inspections and Investigation: Insp Interval (Amended 12/15/21)(2) The facility shall not interfere with a good faith disclosure of information by an employee or volunteer concerning abuse or other action affecting a resident's safety or welfare, as described in OAR 411-054-0028(4).(3) Staff of the Department shall visit and inspect every facility at least but not limited to once every two years for a full in-person survey to determine whether the facility is maintained and operated in accordance with these rules.(a) For each year during which a facility does not have a full survey, the Department shall conduct an in-person inspection of the kitchen and other areas where food is prepared for residents.(b) Subsection (a) will not go into effect until July 1, 2022.(c) Facilities not in compliance with these rules must submit, within ten days of receipt of the inspection report, a plan of correction that satisfies the Department.(d) The Department may impose sanctions for failure to comply with these rules.(4) Department staff may consult with and advise the facility administrator concerning methods of care, records, housing, equipment, and other areas of operation. This Rule is not met as evidenced by: Based on observation and interview, 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 C240.

1. PLEASE REFER TO C240 2. PLEASE REFER TO C240 3. PLEASE REFER TO C240 4. PLEASE REFER TO C240

OAR 411-054-0105 (2-4) Inspections and Investigation: Insp Interval (Amended 12/15/21)(2) The facility shall not interfere with a good faith disclosure of information by an employee or volunteer concerning abuse or other action affecting a resident's safety or welfare, as described in OAR 411-054-0028(4).(3) Staff of the Department shall visit and inspect every facility at least but not limited to once every two years for a full in-person survey to determine whether the facility is maintained and operated in accordance with these rules.(a) For each year during which a facility does not have a full survey, the Department shall conduct an in-person inspection of the kitchen and other areas where food is prepared for residents.(b) Subsection (a) will not go into effect until July 1, 2022.(c) Facilities not in compliance with these rules must submit, within ten days of receipt of the inspection report, a plan of correction that satisfies the Department.(d) The Department may impose sanctions for failure to comply with these rules.(4) Department staff may consult with and advise the facility administrator concerning methods of care, records, housing, equipment, and other areas of operation. This Rule is not met as evidenced by: Based on interview, observation and review of records, it was determined the facility failed to ensure their kitchen survey plan of correction was implemented and satisfied the Department. This is a repeat citation. Findings include, but are not limited to: Refer to C 240.

Refer to C240

OAR 411-054-0105 (2-4) Inspections and Investigation: Insp Interval (Amended 12/15/21)(2) The facility shall not interfere with a good faith disclosure of information by an employee or volunteer concerning abuse or other action affecting a resident's safety or welfare, as described in OAR 411-054-0028(4).(3) Staff of the Department shall visit and inspect every facility at least but not limited to once every two years for a full in-person survey to determine whether the facility is maintained and operated in accordance with these rules.(a) For each year during which a facility does not have a full survey, the Department shall conduct an in-person inspection of the kitchen and other areas where food is prepared for residents.(b) Subsection (a) will not go into effect until July 1, 2022.(c) Facilities not in compliance with these rules must submit, within ten days of receipt of the inspection report, a plan of correction that satisfies the Department.(d) The Department may impose sanctions for failure to comply with these rules.(4) Department staff may consult with and advise the facility administrator concerning methods of care, records, housing, equipment, and other areas of operation. 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.

1. Please refer to C 240. 2. Please refer to C 240. 3. Please refer to C 240. 4. Please refer to C 240.

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. This is a repeat citation. Findings include, but are not limited to: Refer to C240.

1. PLEASE REFER TO C240 2. PLEASE REFER TO C240 3. PLEASE REFER TO C240 4. PLEASE 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: Based on observations and interviews, it was determined the facility failed to follow licensing rules for Residential Care and Assisted Living Facilities. This is a repeat citation. 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: