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 ensure the kitchen was clean and in good repair in accordance with the Food Sanitation Rules OAR 333-150-0000. Findings include, but are not limited to: On 08/06/25 from 11:10 am until 12:20 pm, observations of the facility's kitchen identified the following: a. Food spills, splatters, debris, dirt, and/or black matter was observed on or underneath the following: * Walls throughout the kitchen; * Interior and exterior of the cabinets in the dining service area; and * Interior of the microwave. b. Food Storage: multiple items in dry storage were opened and not dated. c. Food Service: alcohol wipes were not available to staff for sanitizing the probe thermometer after use. d. Cleaning and Repair * The Hobart mixer was not covered when not it use; * There was a build-up of ice along the black pipe on the right hand ceiling of the walk-in freezer; * There was a chip in the corner of the wall by the Hobart mixer; * There was a worn area on the exit door with exposed wood, rendering the surface uncleanable; and * There were two cracked ceiling light covers above the stove and one cracked ceiling light cover in the dry storage area. e. Infection Control and Cleanliness: * Beard restraints were not available for staff use; * Tables in the dining area were set with cutlery with food surface contact areas exposed to potential contamination; and * Tables in the dining area were set with drinking glasses not stored in an inverted position. The kitchen was toured, and the above areas were discussed with Staff 1 (ED) and Staff 2 (Culinary Services Director) on 08/06/25 at 12:20 pm. The findings were acknowledged.

PROVIDER'S PLAN OF CORRECTION 1. The following actions will be taken to correct the violations. a. Food spills, splatters, debris, dirt and /or black matter was observed on or underneath the following: -Walls throughout the kitchen; - Interior and exterior of the cabinets in the dining service area; - interior of the microwave. The Chef Manager and the dining staff will be cleaning all the surfaces identified and the microwave. b. Food storage: multiple items in the dry storage were open and not dated. Chef manager will retrain all kitchen staff with food handling with regards to food handling with regards to food labeling and food storage. c. Food Service: Alcohol wipes were not available to staff for sanitizing the probe thermometer after use. The Chef manager has ordered alcohol wipes used for sanitizing probe thermometers. d. Cleaning and Repair: - The Hobart mixer was not covered when not in use. Chef Manager covered the Hobart mixer with a plastic bag when not in used. - There was a chip in the corner of the wall by the Hobart mixer. Maintenance manager will repair the chipped wall. - There was a worn area on the exit door with exposed wood, rendering the surface uncleanable. The maintenance manager will repair and paint the exit door with exposed wood to be a cleanable/wipeable surface. - There were 2 cracked ceiling lights cover above the stove and once cracked ceiling light cover in the Dry storage area. The Maintenance manager replaced both cracked ceiling lights. e. Infection Control and cleanliness. - Beard restraints were not available for staff use. The Chef manager purchased beard nets for staff use. - Tables in the dining area were set with cutlery with food surface contact areas exposed to potential contamination. The Chef Manager will train servers on properly covering cutlery to prevent contamination and ensure compliance with infection control standards - Tables in the dining room area were set with drinking glasses not stored in an inverted position. The Chef manager will provide training to the servers on properly setting drinking glasses inverted to prevent contamination and ensure compliance with infection control standards. 2. How will the system be corrected so this violation will not happen again. a. Chef Manager updated the cleaning checklist, including daily, weekly, and monthly scheduled tasks, to ensure that sanitation and food is prepared and served in accordance with the Oregon Food Sanitation Rules. b. Chef Manager will do an in service of proper food handling - labeling and dating opened items. Chef manager to do twice a week audit to ensure food is dated appropriately. c. Chef Manager will include alcohol wipes for monthly orders. d. Chef Manager and Cooks will make sure to cover the appliances, Hobart mixer when not in use. Chef Manager and Maintenance Manager will complete a visual check of the kitchen for potential needs quarterly or as needed. 3. How often will the area needing correction evaluated? The systems to ensure that food is prepared and served in accordance with the Oregon Food Sanitation Rules including repairs, cleaning, proper safe food handling practices will be evaluated by the Executive Director monthly during the monthly Management meeting. 4. Who will be responsible to see that the corrections are completed/monitored? The Executive Director will be responsible for overseeing that the above systems are in place and continuously 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: Based on observation and interview it was determined the facility failed to ensure the kitchen was clean and in good repair in accordance with the Food Sanitation Rules OAR 333-150-0000. This is a repeat citation. Findings include, but are not limited to: On 10/21/25, from 10:15 am until 10:35 am, observations of the facility's kitchen identified the following: a. Food spills and splatters were observed on the walls surrounding the stove and on the walls throughout the kitchen; b. Food Storage: multiple items in dry storage were opened and not dated. The kitchen was toured, and the above areas were discussed with Staff 1 (ED) on 10/21/25 at 10:35 am. The findings were acknowledged.

1. The following actions has been taken to correct the violations: a. The chef (Kitchen Manager) and cook has cleaned the food spills and splatter walls surrounding the stove and on the walls throughout the kitchen. b. All food items opened will be labeled with the date opened. 2. How will the system be corrected so this violation will not happen again? a. Staff in-servicing regarding cleaning of kitchen surfaces and sanitation rules. Cleaning schedule created and posted with daily task sheets for the staff to maintain compliance. b. Inservice staff on dates for all food items opened and provide labels for containers. Signs are put up in the dry storage, fridge door, and prep areas to remind them that date food items if they are opened. 3. The Chef (kitchen manager) observes the kitchen for cleanliness daily. Task sheets and kitchen logs will be reviewed daily until compliance is met and then weekly. 4. The Chef and Executive Director will be responsible for overseeing that the above system is in place and continuously 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, interview and record review, it was determined the facility failed to ensure their re-licensure survey plan of correction was implemented and satisfied the Department. Findings include but are not limited to: Refer to C240.

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: