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 ensure kitchen practices and protocols were in accordance with the Food Sanitation Rules OARs 333-150-0000. Findings include, but are not limited to: On 08/21/25 at 10:50 am, the facility kitchen was observed to need cleaning in the following areas: * Large stand mixer – food splatters on splash guard; * Commercial can opener – blade finish worn/build up of black matter; * Countertop mixer exterior – food splatter; * Hood vents above cooking equipment – dusty/greasy; * Floor drain between convection oven and tilted skillet – build up of black/brown matter; * Stainless steel shelves in front of service line – debris/spills/drips; * Wall and caulking above splash guard and behind spray hose sink in dishwashing area – build up of black matter; * Interior of microwave next to cooking equipment – food splatters; * Wall behind cooking equipment – significant build up of grease drips/splatters; * Exterior of hood above cooking equipment – dusty build up above vents; * Shelves below flat grill – drips/debris/spills; * Refrigerator on service line – interior and exterior spills/debris/drips; * Walls below handwashing sinks – black/brown matter build up; * Interior of ice maker – pink matter build up; and * Two door refrigerator on service line – exterior doors with smears/drips/splatter. Other areas of concern included: * Clean slicer uncovered; * Colored cutting boards worn and heavily scored; * Garbage cans without lids on service line; * Food items in two door refrigerator – not covered/labeled and/or dated; * Open meat items in walk in freezer – not dated; and * Walk in freezer – boxes on floor. The areas of concern were discussed with Staff 1 (Culinary Services Coordinator) and Staff 2 (Senor Executive Director on 08/21/25. The findings were acknowledged.

C0240 Resident Services Meals, Food Sanitation 1) Large stand mixer will be cleaned to remove and food splatters on the splash guard. Commercial can opener blade will be cleaned to remove discoloration and build up of black matter. Countertop mixer exterior will be cleaned to remove food splatter. Hood vents above cooking equipment will be cleaned to remove dust and grease. Floor drain between convection oven and tilted skillet will be cleaned to remove build-up of black/brown matter. Stainless steel shelves in front of service line will be cleaned to remove debris/spills/drips. Wall and cauling above the splash guard and behind the spray hose sink in the dish washing area will be cleaned and recaulked to remove build up of black matter. Interior of microwave next to cooking equipment will be cleaned to remove food splatters. Wall behind cooking equipment will be cleaned to remove build up of grease drips/splatters. Exterior of hood above cooking equipment will be cleaned to remove dust build-up above vents. Shelves below flat grill will be cleaned to remove drips/debris/spills. Refrigerator on service line interior and exterior will be cleaned to remove spills/debris/drips. Walls below handwashing skings will be cleaned to remove black/brown matter build-up. Interior of ice maker will be cleaned to remove pink matter build up. Exterior doors of two-door refrigerator on service line will be cleaned to remove smears/drips/splatter. Clean slicer will be covered in between uses to maintain santitation. Colored cutting boards will be replaced. All garbage cans in kitchen will have lids as required. All food items in two-door refrigerator will be covered/labeled/dated as required. Open meat items items in walk-in freezer will be dated as required. Food items in walk-in freezer will be placed on shelving, not on the floor. 2) The system will be corrected by providing an inservice to kitchen staff on the following topics: Facility cleaning schedules and frequency of cleanings required. Proper cleaning of mixers and other equipment. Proper cleaning of floor drains. Proper cleaning of microwave. Proper cleaning of commercial can opener. Proper cleaning of refrigerators/freezers. Proper hood cleaning. Proper wall and shelving cleaning. Proper ice maker cleaning. How to maintain sanitation once equipment is cleaned. Policy review for covering/labeling/dating food items. 3) How often will the area needing correction be evaluated? *Frequency will be identifed on the kitchen cleaning schedule. *Cleaning quality will be audited weekly by Executive Chef. *Monthly kitchen inspection will be completed by Executive Chef (or designee) to ensure ongoing compliance of areas identifed above. Copy of inspection report will be submitted to Assisted Living Executive Director and Senior Executive Director mothly for review. *Quarterly equipment review will be completed by Executive Chef (or designee) to determine need for replacement or repair. 4) Who will be responsible to see that corrections are completed/monitored: Executive Chef Culinary Director Executive 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:

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: This is a repeat citation. This Rule is not met as evidenced by: On 10/27/25 at 9:50 am, the facility kitchen was toured with with Staff 1 (Culinary Services Coordinator) and Staff 2 (Senior Executive Director) and observed to need cleaning in the following areas: * Air intake vent above the prep line with dust buildup; * Stainless steel shelves in front of service line – debris/spills/drips; * Wall behind cooking equipment – significant build up of grease drips/splatters; * Clean slicer uncovered; * Food items in two door refrigerator – not covered/labeled and/or dated; * Open meat items in walk in freezer – not dated; and * Walk in freezer – boxes on floor, door not closing fully, and excessive frost build up on food. The areas of concern were discussed with Staff 1 (Culinary Services Coordinator), Staff 2 (Executive Director), and Staff 3 (Assisted Living Administrator) on 10/27/25. The findings were acknowledged.

C0240 Resident Services Meals, Food Sanitation 1) Air intake vent above the prep line will be cleaned of dust build up. Stainless steel shelves in front of service line will be cleaned to remove debris/spills/drips. Wall behind cooking equipment will be cleaned to remove build up of grease drips/splatters. Exterior of hood above cooking equipment will be cleaned to remove dust build-up above vents. Clean slicer will be covered in between uses to maintain santitation. All food items in two-door refrigerator will be covered/labeled/dated as required. Open meat items items in walk-in freezer will be dated as required. Food items in walk-in freezer will be placed on shelving, not on the floor. 2)The system will be corrected by: Change of leadership in the kitchen. Providing an inservice to kitchen staff on the following topics: Facility cleaning schedules and frequency of cleanings required. Proper cleaning of equipment, walls, and vents. Proper wall and shelving cleaning. How to maintain sanitation once equipment is cleaned. Policy review for covering/labeling/dating food items. 3) How often will the area needing correction be evaluated? *Frequency will be identifed on the kitchen cleaning schedule. *Cleaning quality will be audited weekly by Culinary Director. *Monthly kitchen inspection will be completed by Culinary Director (or designee) to ensure ongoing compliance of areas identifed above. Copy of inspection report will be submitted to Assisted Living Executive Director and Senior Executive Director mothly for review. *Quarterly equipment review will be completed by Culinary Director (or designee) to determine need for replacement or repair. 4) Who will be responsible to see that corrections are completed/monitored: Culinary Director Executive Director Senior Executive 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:

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: The findings of the revisit # to the kitchen inspection of DATE, conducted DATE, 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.

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: Refer to C 240

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: 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. Findings include, but are not limited to: Refer to C 240.

See C 240

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: