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 kitchen practices and protocols were in accordance with the Food Sanitation Rules OAR 333-150-000. Findings include, but are not limited to: On 05/12/26, between 11:30 am and 2:00 pm, the facility kitchen was observed, and the following was identified: 1. Sanitation and Equipment: * Chlorine and QT PH test strips were heat and water damaged and/or expired; * Water in dish machine and PH for chemicals do not meet requirements; * Dish machine and gauge have extensive water deposits; and * Disinfectant chemicals are on the counter with food. During an observation on 05/12/26 at approximately 1:00 pm, Staff 1 (PIC/Lead Cook) and Staff 2 (Maintenance Director) demonstrated the dish machine did not meet required temperatures and chemical PH. Staff planned to manually wash dishes using the three-compartment sink method until the repair was made. 2. Food Storage: * Personal ice packs in freezer (MC kitchenette); * Several cooked and uncooked meats in cooler stacked together, not in separate drip pans, and without dates; * Uncovered bowls of sherbet in freezer; * Expired pre-made salad in cooler (discarded); and * Desserts and beverages uncovered in transport to resident rooms. The areas of concern were observed and/or discussed with Staff 1 (PIC/Dietary Manager), Staff 2 (Executive Director), and Staff 3 (Maintenance Director) at approximately 2:00 pm on 05/12/26. Staff acknowledged the findings.

C0240 OAR 411-054-0030 (1) (a) Resident Services Meals, Food Sanitation Rule 1.Actions to be taken to correct the rule violation include: Sanitation and Equipment: * On 5/12/2026 ECO-LAB was contacted for new test strips. ECO-LAB immediately brought in test strips at approximately 2:15 pm. Chemicals were tested immediately with no findings. Chemicals tested in compliance and were in required range. Test strips are now kept in kitchen drawer away from heat, and water. * Eco-lab serviced and tested dish washing machine during this visit. It tested in compliance and paperwork was left with the community. Lead cook will monitor daily with test strips and documented above drawer where strips are kept. * During surveyor visit the maintenance cleaned the hard water deposits while present. This task has been added to the NOC cleaning task sheet for up keep of hard water deposits. * Disinfectant chemicals were immediately removed from area were food is present. It will be kept on dirty dish cart and or under kitchen sink. for safety of cross contamination. Additionally staff will be educated at our next monthly inservice this month. *As noted above ECO-LAB technician tested the dishwashing machine tempurature at this visit and it tested in range paperwork left with community. ECO-LAB technician is out monthly, and if any further issues ECO-LAB will be out when needed. 2. Food Storage *Personal ice packs were removed from the freezer.These ice packs come from Consonus pharmacy. They are used to and from transport of medication. This task will be added to NOC for nightly cleaning and removal of said ice packs with oversight of the Memory care Director for compliance. * Meats have been seperated with pans for cooked and uncooked meet, and they have been labeled with dates. This will be monitored daily by the cooks along with Executive Director oversight. * Cooks have been educated with proper storage of food left over stored in freezer. With any left overs that need to be kept frozen and not in use need to be discarded for cross contamination. This will be monitored by cooks with Executive Director oversight. *Cooks will discard any food after 3 days of non use. This task will be done daily to check dates on out dated food for proper usage and discarding. This will be monitored by cooks and oversight by the Executive Director. * On 5/12/2026 covers were ordered for beverages. Parchment paper is being utilized to cover beverages during transport of meals to rooms as of right now. Cooks and staff have been educated on this process with oversight of the Executive Director. 5/2

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 not limited to: Refer to C240.

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: