The findings of the kitchen inspection, conducted 02/13/24, are documented in this report. The survey was conducted to determine compliance with the OARs 411-054-0030 for Residential Care and Assisted Living Facilities for Resident Services - Meals and Oregon Health Service Food Sanitation Rules OARs 333-150-0000.

The findings of the re-visit to the kitchen inspection of 02/13/24, conducted on 05/22/24, are documented in this report. The facility was found in substantial compliance with the OARs 411-054-0030 for Residential Care and Assisted Living Facilities for Resident Services- Meals, and Oregon Health Service Food Sanitation Rules OARs 333-150-0000.

Based on observation, record review, 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. The facility also failed to provide residents with nutritious and balanced meals. Findings include, but are not limited to:

Observation of the facility kitchen were made on 02/13/24 from 10:45 am through 1:45 pm. The following was noted:

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:

* Reach- in coolers and freezers;

* Cupboards and drawers;

* Underneath sink;

* Drain under sink;

* Interior of microwave;

* Small appliances;

* Interior of ovens; and

* Light fixture above stoves.

b. The following areas were found to be in need of repair:

* Multiple cupboards or drawers with damaged/non-smooth surfaces; and

* Area of missing caulking near sink with crack in countertop.

c. Multiple food items found in dry storage that were open or not securely closed, as well as not dated when opened.

d. Multiple items were observed in reach-in refrigerator that were not dated when opened. One item was found 2 days past its manufacturer's use by date.

e. Items in reach-in freezer were not stored to promote adequate air flow. One item was found uncovered/open to possible contamination. A large container full of ice was observed with visible contaminate (hair/bugs). This tub was used to store food items when freezer was being repaired.

f. Facility did not have surface sanitizing methods. Staff 3 (Cook) was working during survey observations and was not aware of the need to have a sanitizing solution for surfaces. S/he was not aware of needed concentration for sanitation. Chlorine sanitizing strips were noted in windowsill that were damaged and exposed to air/moisture. Soapy water was observed in the red sanitizing bucket.

g. Facility staff were unable to articulate what cycle on the dishwasher would effectively sanitize the dishes. Staff 2 (Person in Charge) confirmed the dishwasher was the sanitizing step for dishwashing; however, the facility did not have an established system to ensure dishes were effectively sanitized using one of the cycles.

h. Menus were reviewed, and surveyor identified several meals where there were missing nutritious elements. The menu served to residents during survey was potato soup and crackers. There was no protein element and/or no significant source of fruit or vegetable for the meal. The facility's four-week cycle identified six breakfast meals without a significant protein source, 15 lunches without vegetables or fruit, two lunches without a significant protein source, and nine dinners without a vegetable or fruit option. None of the snacks listed included any protein choices. Staff 2 acknowledged the facility created the menus. Staff 1 (Administrator) and Staff 2 verified that they did not have any nutrition breakdown/analysis of their menu to validate they were providing the necessary vitamins/minerals/calories and protein required for a balanced and nutritious diet. Staff 1 and 2 confirmed the menu had not been reviewed by a nutritionist or dietitian to ensure it was nutritious and providing the necessary components for a healthy diet. There was no recipe located for the cook to use for the potato soup. Staff 3 stated s/he was new to the position and to cooking for residents in a care facility. The potato soup did not contain liquid or a protein source. Staff 2 acknowledged there were not recipes for all menu items, and they were in the process of developing those. Staff 2 acknowledged the meal served to residents was not nutritionally balanced and was missing protein and vegetable servings.

i. Staff 2 was interviewed and was unable to correctly state cooking temperatures for different meat products, correct reheat temperatures, or appropriate cooling processes.

j. Multiple caregiving staff were observed in the kitchen area and serving residents their lunch meal without aprons. Aprons (clean barriers) are required for caregiving staff when preparing and/or serving food to residents, to prevent potential spread of infectious agents that could arise from caregiving tasks.

At approximately 1:30 pm, surveyor reviewed above areas with Staff 1 (Administrator), who acknowledged the identified areas.

Reach in coolers, freezers, cupboards, drawers, underneath sink, drain under sink, interior of microwave, small applianceds, interior of ovens, and light fixture above stoves were cleaned of spills, splatters, and any debris. All cupboards and drawers and missing caulking near sink were repaired. All food items were inspected for proper covered storage and dated. Staff trained on use of sanitation strips, temperature range for different meat products, reheating temperatures, cooling processes, wearing a clean barrier when serving food, and effective sanitizing dishwasher temperatures. Menus with missing nutritional elements were removed from circulation.

All areas of kitchen and storage inspected and cleaned or repaired as needed. Menus updated to reflect the need to provide the necessary components for a healthy diet. Staff trained to alert Admin about any defects immediately. Daily temperature logs for foods, freezers, coolers, dates on food, and dishwashers created for staff use. Daily kitchen cleaning task list created for kitchen staff. Kitchen inspection included on Monthly Maintenance Rounds to identify future areas which may need repair. Administrator or designee will intermittently monitor temperature logs, maintenance rounds, open dates, and cleaning checklists at minimum weekly, including direct observation of meal service, and bring results to QA Committee for at least 3 months to ensure compliance.

Based on observation, record review, 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