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 and ensure food was prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules). Findings include, but are not limited to: On 07/24/25, interviews with staff and observations of the facility kitchen, food storage areas, food preparation, and food service were conducted. The following was identified: a. An accumulation of food spills, splatters, dirt, dust, black matter, and grease was visible on or underneath the following: * Walls throughout the kitchen; * Interior of the ice machine; * Industrial can opener; * White wire shelving throughout the kitchen; * The exit screen door; * Multiple electrical outlet plates; and * Small screened in area open to the exterior of the building to the right of the prep sink. b. The following areas were noted in need of repair: * The “prep sink” was noted to have a leak and a bucket was observed under the sink piping; * Several flooring tiles in-between the ovens and prep table were noted to be cracked and/or chipped; * Three ceiling light covers were noted to be cracked and/or broken; * The bottom left corner of the back door’s frame and baseboard were missing material; * The tabletop mixer had a coated flat beater with multiple chips in the coating; and * Multiple electrical outlet plates were found broken, chipped, and/or cracked. c. Raw meat in the refrigerator was not stored in a way to limit the potential of cross-contamination. d. An unsupervised cart of uncovered plated meals was observed in a resident use corridor and exposed to contamination. e. Direct-care staff were observed to serve residents meals without the use of a protective barrier. f. The garbage can was observed uncovered throughout meal preparation and service. On 07/24/25 at 2:06 pm, Staff 3 (Cook) and Staff 4 (Cook) toured the facility kitchen and food storage areas with this surveyor and acknowledged areas identified above. The need to ensure the kitchen was maintained in a sanitary manner and food was prepared and served in accordance with Food Sanitation Rules was discussed with Staff 1 (Executive Director) and Staff 2 (Assistant Executive Director) on 07/24/25 at 2:24 pm. They acknowledged the findings.

a On July 31st, 2025, the Executive Director held a meeting with the Food and Beverage team and our maintenance staff go over on how a plan of correction that we will be implemented based on the report we received. The walls throughout the kitchen have been thoroughly clean and have been created a schedule every Thursday for a deep cleaning day. The Executive Director will have a a weekly meeting with the kitchen staff to go over the schedule cleaning list to make sure this task is being completed, if the Executive Director is not available, the Asisstant Manager will be conducting this meeting and inspection. The ice machine interior has been perfectly cleaned and disinfected and scheduled to be emptied every week and cleaned thoroughly by the kitchen staff. This task has been implemented in the to do list for the kitchen crew and to be monitored by the Executive Director to make sure it's being done with a weekly inspection, if the Executive Director is not present, this inspection will done by the Assistant Manager. The industrial can opener is to be properly washed in the dishwasher every time it is used. A written reminder and mandatory protocol have been posted in a visible area for the kitchen crew. The exective Director or Assistant Manager will monitor this task is being done. All the white wire shelving in the kitchen has been sanitized and cleaned. Moving forward kitchen shelves will be wiped down at least weekly with a damp cloth or mild cleaning solution to remove dust, grease, and splatters. A more thorough cleaning, involving emptying the shelves and cleaning both the interior and exterior, will be done monthly.A schedule for cleaning task has been created and has been posted in the kitchen for the kitchen crew and the Executive Director and Assistant Manager will follow up with the schedule to make sure this task is being done with frequent supervision . The exit screen door has been washed properly and is to be washed monthly. This task has been added to the schedule for the kitchen crew and the Executive Director or Assistant Manager will make sure this task is completed. On Monday July 28th all electrical plates have been replaced. Monthly building inspection by our maintnance Director has been scheduled to avoid this type of issues in the future and a step by step training has been implemeted to the kitchen crew to create a work order for the maintnance director. Small screened in area has been sealed from the outside on 7/27/25 b The prep sink has been repaired by Rescue Rooter 7/27/25 The flooring tiles have been replaced on 7/27/25. A new mixer flat bearer was purchased on 7/28/25 All electrical outlets’ broken plates have been replaced July 28th, 2025. c New Laxon with lids has been purchased on 7/29/25 to safely store and separate raw meat to avoid cross contamination.Executive Director will do frequent monitoring to make sure all this policies and protocols are being met, If Executive Director is absent, Assistant Manager will do this inspection. d Plate covers have been ordered on 7/28/25, and all staff have been educated and instructed on plate covers must be use while delivering room service to residents to avoid any type of contamination.Exectutive Director has created a new policy on how to properly serve food ready to eat. Executive Director and Assistant Manager will monitor this important task is being done correctly. e All Direct-care staff have been educated on the importance of using a protective barrier while serving meals. To ensure all direct care fully understand step by step this requirement a food handlers’ card has been a mandatory requirement if involved serving meals. Executive Director and Assistant Manager will keep track employee records for expiration dates on the food handlers card. f A new garbage can was ordered to replaced the broken one on 7/28/25. Kitchen crew is to report to Executive Director on the needs of all kitchen equipment and has been added to our weekly meeting.

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: