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 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. Observations of the main kitchen were made on 11/25/25 at 10:15 am through 12:00 pm. a. The following areas were in need of cleaning: ? There was dust on all ceiling vent covers in the kitchen and dry food storage room, as well as walls and ceiling around the vents; ? There was black matter, dust, and objects on flooring beneath and behind the industrial ice machine, upright freezer and two upright refrigerators; ? There was black matter and dust under racks in dry food storage room; ? There was dust on the water heater vent pipes in the dry food storage room; and ? There was black matter on floors, walls and ceiling in the janitor’s closet. b. The following areas were in need of repair: ? Multiple base cabinet doors were loose or detached from hinges; and ? One drawer on the prep island was detached from its track. c. Additional observations: ? Direct care staff were observed entering the kitchen to retrieve aprons, gloves, and serving utensils, exposing kitchen surfaces to potential contamination. 2. Observations of the MCC kitchenette were made on 11/25/25 at 12:00 pm through 12:30 pm. a. The following areas were in need of repair: ? All dining chairs had splits in the fabric on the seats, and the fabric on the armrests was worn through to the underlayment, making them uncleanable; and ? There were scrapes and gouges in the walls between the windows and doorways. b. Additional observations: ? Direct care staff were observed serving residents in the MCC dining room and delivering plates to residents’ rooms without donning a protective barrier over potentially contaminated clothing. The above findings were reviewed with the Administrator (Staff 1) and the Maintenance Director (Staff 2) on 11/25/25 at 12:30 pm. They acknowledged the areas in need of correction.

C0240 OAR 411-054-0030 (1)(a) Resident Services Meals, Food sanitation Rule 1. Actions to be taken to correct the rule violation include: a.*The cleaning schedule has been updated and implemented to weekly to reflect cleaning areas of the dry food storage room, walls and ceilings around vents to keep free from dust. NOC Staff will utilize task sheet for cleanings initial and turn in to the Director daily when cleaning has been completed for the night. The cleaning of the dry food storage, walls and ceilings have since been cleaned on 11/28/2025. Weekly inspections along with daily task sheet initialed by staff will be used as guide for the cleaning inspection. Executive Director will be responsible assuring corrections are completed and monitored. * The cleaning schedule has been updated and implemented for monthly cleaning of the floors beneath and behind ice machine, freezer and upright refrigerators to keep free of black matter and dust. NOC staff will utilize task sheet for cleanings initial and turn in to the Director daily when cleaning has been completed for the night. The cleaning of the flooring behind and under ice machine, upright freezer, and two refrigerators have since been cleaned on 11/30/2025. Monthly inspections along with daily task sheet initialed by staff will be used as a guide for the cleaning inspection.Executive Director will be responsible assuring corrections are completed and monitored. *The cleaning schedule has been updated and inplemented for daily cleaning under the dry food racks in storage room to keep it free of black matter and dust. Noc staff will utilize task sheet for cleanings initial and turn in to Director daily when cleaning has been completed for the night.The cleaning under the food storage racks have since been cleaned on 11/26/2025. Daily inspections along with daily task sheet initialed by staff will be used as a guide for the cleaning inspection. Executive Director will be responsible for assuring corrections are completed and monitored. *The cleaning schedule for maintenance has been updated for the cleaning of heater vent pipes in the dry food storage room. The dust from the heater vent pipes in dry food storage room has since been cleaned on 11/26/25. This has been added to the maintenance cleaning schedule as a bi-weekly required task. The Executive Director will be responsible for making sure this task is monitored and completed as scheduled. * The cleaning schedule for maintenance has been updated and implemented for the cleaning of janitors closet. The black matter, floors and walls and celing have been cleaned on 12/8/2025. This is not a janitor's closet. It is our fire system room. The door is kept open for air flow. This room is utilized by our vendors for monitoring of the fire system. The Director along with maintenance will monitor room for any storage and or cleaning after vendors if needed. b. Staff will utilize work orders for Maintenance for repairs. Maintenance Director will monitor orders daily for any needed repairs. * Kirby Nagelhout contractors were contacted for drawer detached from its track on prep island and base cabinet drawers. Contractors came out on 12/5/2025. Awaiting bid for detached drawer from track as well as lower cabinets. However it was founded that it was the weight of the silverware was causing the drawer to have to much weight for drawer to open and close correctly. Silverware has since been moved. A LER will be in place for quarter 1 2026 budget for work to be completed. Staff will utilize work orders for Maintenance for repairs. Maintenance Director will monitor daily for any needed repairs. c. Additional Observations: *Direct care staff observed retrieving aprons, gloves, and serving utensils exposing kitchen surfaces to potential contamination. The aprons were moved to drawers next to washing station along with gloves as they come into kitchen. This is to limit contact, and or contaminate surfaces in kitchen this was corrrected on 11/25/2025. The Executive Director will be responsible for monitoring and making sure this corrective action will be followed diligently. 2. Actions to be taken to correct the rule violation include: * Contacted vendor Direct Supply for a bid for new dining room chairs for Memory Care on December 1, 2025. bid received and approved. A LER will be in place for quarter 1 2026 budget for chairs to be purchased. Staff will sanitize appropiately and utilize maintenance work orders for upkeep of dining chairs. Maintenance Director will review daily along with visual observations of chairs monthly. * The scrapes and gouges were fixed with in a couple days on 12/1/25 & 12/2/25 with a completion of 12/12/2025. This gives ample time for drying and final touches. Staff will utilize maintenance work orders for any future repairs. This will be checked daily by Maintenance Director. b. Actions to be taken to correct the rule violation include: * Staff in Memory care were given aprons to be used in Memory care for donning and doffing on 11/25/2025 when providing meals. New aprons have been purchased and set up in dining room for staff to use when delivering plates out to the residents. The Executive Director will be responsible for monitoring of aprons being worn daily when serving meals.

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, interview and record review, 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.

Z0142 OAR 411-057-0140(2) Administration Compliance Actions to be taken to correct rule violation include: 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: