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: Observation of the facility main kitchen and memory care kitchenette areas on 01/15/26, from 9:45 am through 2:00 pm, found the following: 1. Main Kitchen a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, and/or black matter was visible on or underneath the following: * Flooring under dish machine; * Flooring under three-compartment sink; * Drains under dish machine; * Clean side of dish area; and * Fan blades and cages blowing on clean dishes. b. The following areas were in need of repair: * Steamer drainpipe inside floor drain without required space gap; and * Section of flooring was unsealed concrete, creating an non-smooth surface. 2. Memory Care Kitchenettes a. Care staff were observed working with exposed food during meal service without gloves covering long painted nails, exposing food to potential contamination. b. Dirty dishes were observed stored in both sides of the sink in the kitchenette in Unit B. Staff were observed to wash hands directly over sink full of dishes. Neither sink was dedicated as a hand wash sink as required. c. Both memory care unit kitchenettes had residential-style dishwashers to wash and sanitize dishes for residents. The facility was not able to demonstrate a process that ensured equipment was effectively sanitizing food contact equipment. Surveyors were provided documentation on hot water temperatures that indicated dishwasher temperatures on 01/06/26 were not reaching the minimum required temperatures range for sanitizing dishes (140-160 degrees F). Staff 3 (Maintenance Supervisor) was interviewed at 1:30 pm and acknowledged the facility identified a hot water temperature issue on 01/06/26 of 120 degrees F for the dishwashers. He reported he had not addressed the potential issue because he had been unable to enter the memory care unit due to a COVID-19 outbreak. Staff 2 (Dining Director) and Staff 1 (Memory Care Administrator) both acknowledged they were not informed there was any concern with dishwasher temperatures in the memory care units. Staff 2 stated they had no oversight of the memory care kitchenettes and dish sanitation process for resident meal service dishes. Upon further investigation, Staff 3 indicated that facility maintenance staff had not been checking/monitoring the internal temperatures of the dishwashers to ensure dishes were being effectively sanitized. Staff 1, Staff 2, and Staff 3 were all unable to confirm that resident dishes were being effectively sanitized. The facility was currently in an active COVID-19 outbreak. At approximately 2:00 pm, surveyor reviewed the above areas with Staff 1 and Staff #2. They acknowledged the identified areas.

1A. Cleaning and Monitoring of Areas The identified areas have been cleaned and the identified areas are cleaned twice daily according to a set cleaning schedule. Following each scheduled cleaning, the Supervisor on duty will conduct a verification check to ensure all areas meet regulatory sanitation standards. Compliance will be monitored and documented as part of ongoing quality assurance. 1B. Maintenance and Flooring Corrections A work order has been submitted to correct the steamer drainpipe by installing a proper air gap. The work order is scheduled for completion by 2/6/26, and the Dining Room Director will follow up to ensure timely completion and compliance. Regarding the unsealed flooring, Mennonite Village will contract a licensed flooring company to seal the affected area, ensuring a smooth, cleanable, and sanitary surface in accordance with regulatory requirements.This will be completed by 3/15/2026. 2A. Food Handling Procedure Current staff instructed to start using gloves if you have long or painted nails while handling any food. A procedure will be implemented by 2/6/2026 requiring any staff member handling food who has long or painted nails to wear gloves at all times to prevent potential contamination. Staff have been educated on this requirement, and compliance will be monitored by the supervisor on duty. 2B. Sink Designation and Signage Signage will be placed by 2/6/2026 to clearly designate one side of the sink for handwashing only and the other side for dirty dishwashing. This will ensure proper separation of tasks and reduce the risk of cross-contamination. Staff have been educated on proper sink usage and expectations. AC. Dishwasher Sanitization and Monitoring The hot water temperature has been adjusted to ensure proper sanitization. Manufacturer specifications were obtained and submited confirming that both POD dishwashers are NSF-certified. Temperature readings were taken on both POD dishwashers, confirming an internal temperature of 152°F, which meets sanitization requirements. A monitoring system has been implemented requiring staff to verify that the sanitation indicator light illuminates after each wash cycle, confirming the dishwasher has reached the required 150°F sanitization temperature. If the sanitation light does not activate, staff are instructed to immediately notify the Maintenance Department for evaluation and repair. During this time, all dirty dishes will be transported to the main kitchen for proper washing and sanitization until the POD dishwasher is fully operational. The Dining Director has contacted an outside vendor to explore the option of installing commercial dishwashers in Lydia’s House. Additionally, an internal thermometer has been ordered, and the Maintenance Department will implement by 2/16/2026 a scheduled process for testing and documenting dishwasher temperatures in each POD to ensure ongoing 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 observations and interviews, 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.

Please seee tag 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: