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 clean, 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 main kitchen and dining room area on 03/30/26 from 10:30 am through 12:30 pm noted the following: a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, black matter and grease was visible on or underneath the following: * Interior of right oven; * Interior of ice machine; * Kitchen drains; * Removable hood vents above stove; * Ceiling vent above prep area; * Windowsill above prep area; and * Multiple table bases in dining room. b. The following was observed in need of repair: * Multiple drain down spouts were observed inside floor drains creating potential cross contamination concerns and did not yield a potential air gap if drains overflowed; * Metal racks next to the clean side of the dish machine storing clean dishes and supplies were observed with corrosion or rusted areas and were in need of repair or replacement; *Piercing part of industrial can opener was noted in need of replacement as protective coating was worn off and/or pealing; and * Light strip inside reach in freezer was broken/hanging down unattached touching packages of food products. c. Multiple potentially hazardous food items were observed stored in reach in coolers that were not dated when opened or prepared. d. A package of deli sliced ham was observed with an open date of 3/20/26. The product was dated as opened for eleven days. Staff 2 confirmed the product should not be used and discarded the product. A container of coleslaw was observed with a prepared date of 3/23/26. This was eight days since prepared and should have been discarded by day seven. e. A large stock pot was noted to be damaged and in need of replacement. A sauté pan was noted to have nonstick coating worn or scratched off and in need of replacement. f. Staff 2 was observed touching tray tickets, grill utensils, and a wet sanitizer rag, then touched ready to eat food (RTE) like garlic toast, bacon bits, shredded cheese, and onions. The cook in training was observed to leave the line area and handle potentially contaminated items (door to reach in cooler) and not change gloves prior to making RTE sandwiches and handling garlic toast. g. The cook in training was observed to remove a thermometer from his/her pocket and checked the temperature of a food product without sanitizing the probe. The cook was then observed to wipe the thermometer with a wet rag that was sitting on the counter visibly soiled with food debris. The sanitizer rag was not stored in sanitizer solution as required for effective sanitizing. h. Multiple dishwashing racks were observed stored on the floor. i. Kitchen staff were serving meals directly on the insulated dome base and not on a plate. Dome bases are not designed for plating food directly on as they are designed to hold a plate warmer metal pellet or a heated plate. Staff 2 toured the kitchen with the surveyor and acknowledged the areas identified. At approximately 12:30 pm, the surveyor and Staff 1 (Executive Director) reviewed areas of concern. Staff 1 acknowledged the identified areas needing correction.

CO240: 1. Interior of right oven has been cleaned and has been added to the weekly cleaning list and daily wipe down 2. Interior has been clean and disinfected and a new ice machine wand has been ordered this will help with the filtering system and is on the daily cleaning task 3. Kitchen Drains have been scrubbed and clean and has been added to the dailycleaning list 4. Removable hood vents have been cleaned and is on the weekly taks list 5. Ceiling Vent above vent was wipe down and cleaned 6. Celing Vent above prep area will be painted 7. Window sill above the prep area has been cleaned and will be painted 8.All table bases haved been cleaned and is on the daily task list. 9. ESD will shorten all drain down spouts 10. Metal Racks will be ordered to replace the rusted ones 11. Piercing Part and or New can Opener will be replaced 12. Light strip inside the reach in freezer has been repaired 13 All Dietary employees will be inserviced on putting dates on all opened and amy prepared food 14. DSM will audit the dates daily and will be added to the daily checklist 15.Large stock pots have been ordered to replace old one 16. Dietary Staff Training on the proper handwashing and changing of gloves DSM to observe staff to ensure they are followning proper technique 17 Dietary Staff Training on proper way of disinfecting the thermometer by DSM to observe cooks to ensur they will use the proper sanitizing technique 18. Sanitizing and or alcohol has been provded to staff 19. Dietary Training on sanitizer rag to be kjept in the sanitizer solution 20. All dishwashing racks have been moved and now stored 21. All Dining Staff have been inserviced on not serving food directly on the dome of insulated dome base all food will be placed on a plate 22 New food storage containers have been ordered and will immediately use. DSM ahs been provided a daily and weekly audit to be filled out and turned in at the end of each week ED and DSM are responsible for all correction ED and DSM will monitor all above to maintain a clean and in good repair in a sanitary enviorment

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 a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. This is a repeat citation. Findings include, but are not limited to: Observation of the main kitchen on 05/15/26 from 11:30 am through 12:20 pm noted the following: a. Multiple potentially hazardous food items were observed stored in the reach-in coolers with month/day dates ranging from 10/4 through 4/23. Staff 5 (PIC, Server) reported she did not know if the dates indicated when the items were transferred from the original containers, when the items were prepared, or if they indicated the item pull dates. Staff 7 (Cook) stated one item in a plastic tub, dated 5/7/26, should have been pulled after four days. b. An open package of salami was not dated by the facility and had a store clearance label dated 01/13/26. c. During plating at lunch, Staff 6 (Cook) was observed picking up chicken strips and potato wedges with gloved hands, while intermittently touching potentially contaminated items, such as food tickets, handles of cooking utensils, and his apron. Staff 5 toured the kitchen with the surveyor and acknowledged the areas identified. At 12:20 pm these areas of concern were reviewed with Staff 3 (Health & Wellness Director), who acknowledged the identified areas needing correction.

O240 06/2/2026 1. DSM will do audit 2 x a week to check for out dated items 2. DSM observe each cook weekly and retrain them as needed 3. ED has assign the following Relais training for all Dietary staff 1. Proper Cooler Storage 2. The basics of Nutriton Food Safety

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 interview and record review, it was determined the facility failed to ensure their kitchen inspection plan of correction was implemented and satisfied the Department. Findings include, but are not limited to: Refer to C240.

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: