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: Eunsuk Based on observation and interview, it was determined the facility failed to maintain the kitchen in good repair and in a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. Findings include, but are not limited to: 1. On 09/23/25, from 10:13 am thru 11:40 am, the facility main kitchen was observed. a. The following areas needed cleaning: * Juice machine - an accumulation of splatters; * Fire extinguishers – build-up of dust; * An air conditioner – build-up of dust; * Industrial can opener - significant black matter; * The wall behind and the floor around the dishwasher area – an accumulation of dust; * Interior of the microwave – significant rust and black matter; * Wall behind the grill – significant accumulation of dust; * Walls throughout the kitchen – food spills; * Under the sink and the drain area near the dishwasher – significant amount of black matter; * Lower shelf of the food warmer – food debris/spills; and * Exterior of dishwasher – significant accumulation of dust. b. The following areas needed repair: * The window screen was damaged and not secured effectively to prevent the entry of flies or other insects; * Cutting boards with heavy scoring and in need of replacement; * Door frame to the mini dry storage entry area was chipped and gouged; and * A missing cover exposing wires near the landline. 2. On 09/23/25, at 11:45 am, the Building A kitchenette was observed to need cleaning in the following areas: * An air conditioner – build-up of dust; * Wall and ceiling vents – heavy accumulation of dust; * Under the three-compartment sink – food spills and significant amount of black matter; and * Lower stainless steel shelves – food debris/spills. 3. On 09/23/25, at 11:50 am, the Buildings C/D kitchenette was observed. a. The following areas needed cleaning: * An air conditioner – build-up of dust; * Interior of the microwave – significant rust and black matter; * Walls throughout the kitchenette – food spills; * The inside of the handwashing sink – accumulation of brown matter; * A fan, not in use at the time - heavy accumulation of dust; * A ceiling vent next to the commercial hood/range – heavy accumulation of dust; * Drain area under the three-compartment sink – black matter; and * A hot cocoa machine - an accumulation of splatters. b. The following areas needed repair: * The ice maker, in the kitchenette dry storage area, filter was out, and Staff 2 (Dining Services Director) reported it needed to be fixed; and * The kitchenette dry food storage area, the edges of shelves had missing or damaged plastic vinyl, exposing the underlying raw materials. 4. Improper food storage: * The refrigerator, in the main kitchen, temperature displayed outside indicated 56 degrees F. It was re-checked after an hour, and it 47 degrees F. All items were requested to be removed from the refrigerator during the exit interview; and * Refrigerators, in the main kitchen, Building A and Buildings C/D kitchenettes – undated containers of food. 5. Other areas of concern include: * Commercial food mixer and a toaster, in main kitchen, were not covered when not in use; and * Garbage cans, in main kitchen, were uncovered when not in use. The areas of concern were observed and discussed with Staff 2 on 09/23/25 and reviewed with Staff 1 (ED) on 09/23/25 at 12:45 pm. The findings were acknowledged.

1.The kitchen and kitchenettes will receive a deep clean including walls, fixtures, shelves, vents, appliances, etc. Reapirs will be completed for all items listed in the survey results. Refrigerator has been repaired and temperatures will be obtained daily. Covers have been placed on appliances and garbage cans in main kitchen. 2. The Dining Services Staff will receive additional training on cleaning schedule and tasks, refrigerator temperatures and labeling and dating food items. 3. The Dining Services Director will review daily and weekly per the QA - Dining Services Review Schedule. 4. The Executive Director is responsible for ensuring compliance.

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: Based on observation and interview, it was determined the facility failed to follow licensing rules for Residential Care and Assisted Living Facilities. Findings include, but are limited to: Refer to C240

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: