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: Rose Schnitzer Manor Based on observation and interview, it was determined the facility failed to ensure the kitchen was clean and in good repair in accordance with the Food Sanitation Rules OAR 333-150-000. Findings include, but are not limited to: Observations of the main facility kitchen on 06/11/26, from 10:45 am through 12:50 pm, revealed the following: 1. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, black matter, rust, and/or grease was visible on or underneath the following: * Floor under/behind sink on “Dairy” cooking line; * Legs of sink on “Dairy” cooking line; * Dustpan in ware washing machine area of “Meat” side of kitchen; * In ware washing machine area of “Dairy” side of kitchen there was an accumulation of black debris where stainless-steel backsplash met wall paneling; * Floor sink in ware washing machine area of “Dairy” side of kitchen; * Fire suppression sprinkler head in ware washing machine area of “Dairy” side of kitchen; * Interior upper recesses of commercial ice machine with significant accumulation of black debris creating opportunity for cross contamination of ice; * Food delivery carts; * Commercial steamer in “Dairy” side of kitchen-front and area where doors met steamer; * Condenser fan covers of “Dairy” walk-in cooler; * Fire suppression sprinkler of “Dairy” walk-in cooler; * Walk in freezer floor; * Chair seats in dining room; and * Base of dining tables. 2. Items in need of maintenance or repair: * Various small wares with damaged handles, rendering them unable to be effectively sanitized; * Both ovens on hot line of “Meat” side of kitchen; * Damaged/missing/improperly installed acoustic ceiling panels; and * Cutting boards with heavy scoring, rendering them unable to be properly sanitized. 3. Sanitation and food handling: * Improper glove use; * Lack of facial hair restraints on multiple cooking staff; * Lack of hand washing between changing gloves; * Damp towels observed on food service areas; * Improper use of sanitation towels/towels not returned to surface sanitation solution bucket after use; * Trash can stored in prep sink of “Dairy” side of kitchen; and * Multiple ware washing racks in “Meat” ware washing area stored directly on the floor, contributing to cross contamination. 4. Food storage: * Multiple opened packaged food items in “Meat” walk-in cooler without open dates; * Multiple prepared food items in “Meat” walk-in cooler had no labels or dates; * Improper hierarchy of raw proteins in “Meat” walk in cooler; and * Multiple prepared food items in “Dairy” walk-in cooler had no labels or dates. 5. Other areas of concern: * No administrative staff able to provide copies of food handler’s cards for cooking staff; * Upon initially entering the facility kitchen there was no designated person in charge; and * The person in charge was unable to state proper temperature for reheating foods or articulate the two-stage cooling process. At approximately 1:00 pm the surveyor met with Staff 1 (Administrator) and Staff 2 (Pastry Chef) to review deficiencies. The findings were acknowledged by Staff 1 and Staff 2.

-The floor beneath the food prep. sink, including legs, and surrounding hard-to-reach areas were cleaned and sanitized thoroughly. Areas beneath and around food prep equipment will be included on routine cleaning schedule and inspected during daily/weekly rounds. -The backsplash seam and adjacent wall surface were cleaned and sanitized throroughly. The area was inspected for damage or gaps that could contribute to bacteria/mold accumulation and maintenance will be asked to replace severely compromised sections. This area will be included in weekly deep-cleaning procedures and inspections. -All floor drains were cleaned, sanitized, and flushed to remove residue and verify proper drainage. Floor drains will be cleaned and inspected weekly and more frequently as needed. -The sprinklerhead will be carefully cleaned to remove dust and debris without compromising the integrity of the fire suppression system. Fire protection components will be visually inspected and cleaned as part of the monthly environmental maintenance program. -The ice machine interior, including upper recessed surfaces, was cleaned and sanitized in accordance with manufacturer specifications. Ice was discarded during the cleaning process. Ice machines will be cleaned, sanitized, and documented according to manufacturers recommended schedule. -All food delivery carts are to be throroughly washed, rinsed, and sanitized, including shelves, handles, undersides, and wheels. Delivery carts will be cleaned after each use and included in routine sanitation audits. -Steamer was thoroughly cleaned inside and out to remove food residue, grease, mineral deposits, and debris. Equipment inspected for maintenance needs. Steamers are to be cleaned daily with periodic deep cleaning performed according to manufacturer recommendations. -Condenser fan guards and accessible fan components are to be cleaned to remove accumulation. Maintenance will verify proper operation. Assemblies will be inspected and cleaned on a scheduled preventive maintenance program. -The freezer floor was cleaned to remove food debris, ice buildup, dirt, and residue. The floor was inspected for damage requiring repair. Freezer Floors will be inspected and cleaned routinely to prevent debris accumulation and identify maintenance needs. -All dining room chairs were thoroughly cleaned and sanitized, including seating surfaces, backs, legs, and undersides. Dining room furniture will be cleaned daily and included in scheduled deep cleaning inspections. -All damaged utensils were immediately removed from service. Utensils with intact handles will replace them. Any future damaged utensils will be discarded upon discovery.Kitchen staff will inspect utensils during daily operating procedures and monthly inventory to identify damaged equipment requiring replacement. -The ovens were intentionally out of service and had been cleaned prior to inspection. The pilot lights were extinguished because the equipment was not being used. Management will verify with the regulatory authority whether additional labeling or documentation is preferred when equipment is intentionally out of service If necessary, ovens will be clearly marked "Out of Service" until returned to operation. Equipment not in use will be identified to avoid confusion during future inspections. -Maintenance inspected all ceiling tiles. Damaged and missing panels will be replaced as soon as possible. Ceiling will be maintained in good repair. Ceiling inspections will be incorporated into monthly rounds. Damaged panels will be replaced promptly. -Excessively worn cutting boards were immediately removed from service. They will be replaced with new NSF-approved cutting boards. Cutting boards will be inspected monthly for excessive wear. Boards with deep scoring will be resurfaced or replaced before they become unsanitary. -Staff members were immediately instructed on proper glove use, including changing gloves whenever contamination occurs and using gloves only as a supplement to proper hand hygiene. Staff observed using gloves improperly will receive immediate coaching. All culinary services staff will complete refresher training on proper glove use. Supervisors will conduct routine observations and document compliance. -Facial hair restraints are provided and all affected employees are required to wear beard guards while engaged in food preparation. Beard restraints will be maintained in adequate supply and compliance will be verified during each shift by supervisory staff. -Staff received immediate re-education emphasizing that changing gloves does not replace required handwashing. Employees were instruced to wash hands before donning new gloves whenever gloves are changed after contamination or task changes. Hand hygiene practices will be monitored through routine supervisory observations and incorporated into ongoing food safety training. -All towels were removed from food surface contact surfaces immediately. Staff was instructed that food contact surfaces must remain clean, dry, and free of cloth towels except during active cleaning and sanitizing procedures. Daily sanitation audits will include verification that food contact surfaces remain free of improperly stored towels. -Employees were instructed to keep wiping cloths submerged in properly prepared sanitizer solution between uses. Sanitizer concentrations were verified and staff retrained on proper wiping cloth storage and use. Supervisors will verify sanitizer bucket concentration and proper towel storage througout each shift. Sanitizer concentrations will continue to be tested and documented. -Trash container was removed immediately from the food prep sink and the sink was thoroughly cleaned and sanitized before further use. Staff were reminded that food prep sinks are to be used exclusively for approved food prep activities. Kitchen opening and closing inspections will include verfification that food prep sinks remain free of non-food items -All warewashing racks were removed from the floor, cleaned, and sanitized. Storage practices will be reviewed with all culinary services staff. Supervisors will verify that all clean equipment and utensils are stored off the floor at least 6'' during daily inspections to minimize cross-contamination risks. -All opened packages of food items not properly dated were immediately discarded. All prepared food items in walk-in cooler not properly labeled and dated were discarded. Staff was re-educated on the importance of maintaining proper label and dating practices. Supervisors will verify proper labeling and dating practices daily when conducting rounds. -Hierarchy of food storage will be revisited with all culinary services staff and re-education will be administered when necessary. All food storage units will be monitored by Chefs and supervisors during routine daily rounds. -All Food Handler's Cards will be immediately collected, verified for validity, and copies will be placed in the Chef's offices and employee personnel files. An electronic tracking log will be established to monitor expiration dates and ensure documentation is readily available for regulatory review. A Food Handler Card tracking system will be maintained with renewal reminders issued prior to expiration. Copies of all current certifications will be kept in an accessible location for inspections. -The culinary services department established a procedure requiring a designated Person in Charge to be present in the kitchen during all hours of operation. Staff were instructed on their responsibility to identify themselves to regulatory officials and assume oversight of food safety operations during inspections. Daily staffing schedules will identify the designated Person in Charge for each shift. Supervisors will ensure coninuous PIC coverage whenever food prep activities are occurring. -The Person in Charge received immediate retraining on critical food safety principles, including reheating previously cooked Time/Temperature Control for Safety(TCS) foods to 165F within two hours and the required two-stage cooling process (135F to 70F within two hours, and 70F to 41F or below within an additional four hours). Food safety reference materials will be posted in the kitchen for quick reference. All individuals designated as PIC will complete competency-based food safety training and demonstrate knowledge of critical cooking, reheating, cooling, hot holding, cold holding, and sanitization requirements. Competency assessments will be conducted quarterly and documented as part of the department's quality assurance program. -ONGOING QUALITY ASSURANCE MEASURES -Mandatory refresher food safety and sanitation training will be conducted for all culinary services employees, with emphasis on hand hygiene, glove use, prevention of cross-contamination, and proper cleaning and sanitizing practices. -We will perform daily opening and closing sanitation inspections using a standardized checklis. Weekly supervisory audits of employee food handling practices will be conducted and we will immediately address any deficiencies through coaching and retraining. -Food safety expectations will be reviewed during monthly department meetings. -We will maintain documentation of staff training, sanitation audits, corrective actions, and competency evaluations for regulatory review. -Accountability will be reinforced by incorporating food safety compliance into employee performance evaluations and ongoing competency assessments. -THIS FACILITY IS COMMITTED TO MAINTAINING COMPLIANCE WITH APPLICABLE FOOD SAFETY REGULATIONS AND PROVIDING A SAFE ENVIRONMENT FOR RESIDENTS THROUGH CONTINUOUS STAFF EDUCATION, ACTIVE SUPERVISION, AND ONGOING QUALITY IMPROVEMENT. -WE WILL DESIGNATE A TRAINED PIC FOR EVERY SHIFT AND DOCUMENT PIC ASSIGNMENTS ON THE DAILY SCHEDULE. -WE WILL MAINTAIN A READILY ACCESSIBLE REGULATORY COMPLIANCE BINDER CONTAINING CURRENT FOOD HANDLER CARDS, FOOD SAFETY CERTIFICATIONS, TEMPERATURE LOGS, SANITATION LOGS, AND TRAINING RECORDS. -QUARTERLY FOOD SAFETY COMPETENCY ASSESSMENTS FOR ALL SUPERVISORYS STAFF WILL BE CONDUCTED TO VERIFY KNOWLEDGE OF CRITICAL FOOD SAFETY REQUIREMENTS. -ROUTINE MOCK HEALTH INSPECTIONS WILL BE PERFORMED TO IDENTIFY AND CORRECT DEFICIENCIES BEFORE REGULATORY INSPECTIONS OCCUR. -INSPECTION FINDINGS AND CORRECTIVE ACTIONS WILL BE REVIEWED DURING DEPARTMENTAL MEETINGS TO REINFORCE EXPECTATIONS AND PROMOTE CONTINUOUS QUALITY IMPROVEMENT.

OAR 411-054-0050(1-5) Infection Prevention & Control (Amended 03/18/2022)(1) Facilities must establish and maintain infection prevention and control protocols to provide a safe, sanitary and comfortable environment. This includes protocols to prevent the development and transmission of communicable diseases.(2) Each facility must designate an individual to be the facility ' s "Infection Control Specialist" responsible for carrying out the infection prevention and control protocols and serving as the primary point of contact for the Department regarding disease outbreaks. The Infection Control Specialist must:(a) Be qualified by education, training and experience or certification; and(b) Complete specialized training in infection prevention and control protocols within three months of being designated under this paragraph, unless the designee has received the specialized training within the 24-month period prior to the time of the designation. The Department will describe trainings that will be acceptable to meet the specialized training requirement in rule, by January 1, 2022.(3) Each facility must establish infection prevention and control protocols and have an Infection Control Specialist, trained as required in this rule, by July 1, 2022.(4) Facilities must comply with masking requirements as prescribed in OAR 333-019-1011 or, if applicable, OAR 437-001-0744, to control the spread of COVID-19.(5) Facilities must comply with vaccination requirements for COVID-19 as prescribed in OAR 333-019-1010.Stat. Auth.: ORS 410.070, 443.004, 443.012, 443.450Stats. Implemented: ORS 443.004, 443.400-443.455, 443.991 This Rule is not met as evidenced by: Based on observation and interview, it was determined that the facility failed to establish and maintain infection prevention and control protocols. Findings include but are not limited to: During kitchen survey on 06/11/26, Staff 3 (Infection Control Specialist) was unable to provide surveyor with written policies for Infection Control Protocols for facility outbreaks/GI illnesses or the policy for Food Worker Illness and Exclusion. Refer to C240

-The facility will develop and implement written Infection Prevention and Control protocols specific to culinary operations during infectious disease outbreaks, including gastrointestinal illness events. Policies will outline employee responsibilities, enhanced cleaning and disinfection procedures, meal service modifications, communication with nursing and administration, and appropriate use of personal protective equipment (PPE). The policies will be incorporated into the Culinary Services Department Policy and Procedure Manual and made readily available for staff and regulatory review. Infection control policies will be reviewed annually and whenever regulatory guidance changes. Dietary staff will receive annual education and competency validation regarding outbreak response procedures and infection prevention practices. The Executive Chef will be responsible along with the Administrator and Infection Preventionist. -A comprehensive Food Worker Illness and Exclusion Policy has been implemented outlining reportable symptoms and diagnoses, employee reporting requirements, exclusion and restriction criteria, return-to-work requirements, and management responsibilities in accordance with applicable food safety regulations. All dietary employees will be educated on the policy and will sign acknowledgements verifying receipt and understanding. The Executive Chef and Human Resources Department will be responsible for this. -TO STRENGTHEN INFECTION PREVENTION PRACTICES WITHIN THE CULINARY SERVICES DEPARTMENT, THE FACILITY WILL IMPLEMENT THE FOLLOWING QUALITY ASSURANCE MEASURES: -MAINTAIN CURRENT INFECTION PREVENTION AND CONTROL POLICIES AND FOOD WORKER ILLNESS AND EXCLUSION POLICIES IN THE DIETARY DEPARTMENT POLICY MANUAL FOR IMMEDIATE ACCESS DURING INSPECTIONS -PROVIDE ANNUAL INFECTION PREVENTION AND FOOD SAFETY EDUCATION TO ALL CULINARY EMPLOYEES, WITH ADDITIONAL TRAINING WHENEVER POLICIES OR REGULATORY REQUIREMENTS ARE UPDATED. -COORDINATE WITH THE FACILITY'S INFECTION PREVENTIONIST AND NURSING LEADERSHIP TO ENSURE CULINARY SERVICES ARE INTEGRATED INTO THE FACILITY'S OUTBREAK RESPONSE PLAN. -CONDUCT ANNUAL REVIEWS OF INFECTION PREVENTION POLICIES AND PERIODIC AUDITS TO VERIFY STAFF COMPLIANCE WITH EMPLOYEE ILLNESS REPORTING, EXCLUSION PRACTICES, HAND HYGIENE, PERSONAL PROTECTIVE EQUUIPMENT, AND ENHANCED SANITATION PROCEDURES. -DOCUMENT ALL STAFF EDUCATION, COMPETENCY ASSESSMENTS, POLICY REVIEWS, AND CORRECTIVE ACTIONS AS PART OF THE FACILITY'S QUALITY ASSURANCE AND PERFORMANCE IMPROVEMENT PLAN (QAPI) PROGRAM. -THE FACILITY IS COMMITTED TO MAINTAINING A COMPREHENSIVE INFECTION PREVENTION AND CONTROL PROGRAM THAT SUPPORTS RESIDENT SAFETY, REGULATORY COMPLIANCE, AND EFFECTIVE COLLABORATION BETWEEN DIETARY SERVICES, NURSING, ADMINISTRATION, AND INFECTION PREVENTION PERSONNEL.