OAR 411-054-0200 (4)(d-i) Doors, Walls, Elevators, Odors (d) INTERIOR DOORS. Lever-type door handles must be provided on all doors used by residents.(e) EXIT DOORS. Exit doors may not include locks that delay evacuation except as specified by the building codes. Such locks may not be installed except with written approval of the Department.(A) Exit doors may not include locks that prevent evacuation.(B) If an electronic code must be entered to use an exit door that code must be clearly posted for residents, visitors, and staff use.(f) WALLS AND CEILINGS. Walls and ceilings must be cleanable in kitchen, laundry, and bathing areas. Kitchen walls must be finished smooth per OAR 333-150-0000 (Food Sanitation Rules).(g) ELEVATORS. A RCF with residents on more than one floor must provide at least one elevator that meets Oregon Elevator Specialty Code (OESC) requirements.(h) The interior of the facility must be free from unpleasant odors.(i) All interior and exterior materials and surfaces (e.g., floors, walls, roofs, ceilings, windows, and furniture) and all equipment necessary for the health, safety, and comfort of the resident will be kept clean and in good repair. This Rule is not met as evidenced by: Based on observation and interview, it was?determined?the facility?failed to?ensure the environment was kept clean, in good repair, and free from odors. Findings include, but are not limited to: Observations of the MCC facility on 08/10/26 at 10:10 am revealed the following: * Resident rooms 117, 118, 119, 120,?and?122,?and the entry/exit door to?the?unit,?had scraped doors and/or jambs; * The common hallway bathroom, near Room 125, had discolored caulking around the toilet base; * Urine odors were?evident?in the television room. Additionally, several chairs were discolored with stains on the seats and arms;? * A chair in the activity room had stains on the seat and back; and? * An approximate eight-inch section of baseboard was missing from a wall edge near the entrance. The surveyor toured the environment with Staff 1 (MCC Administrator) on 08/10/26 at 10:55 am. She acknowledged the findings.?

1) A-Interior doors for rooms 117, 118, 119, 120, 122, and the Entry door to the unit patched and painted to repair scraped doors/jambs. B-Dicolored caulking will be removed and recaulked for common area hallway bathroom near room 125. C-Television room and all chairs in common areas will be cleaned to remove odor and stains on seats and arms of chairs. D-Chair in activity in room that was identified with stains and seat and back will be cleaned to remove stains. E-The 8 inch section of baseboard will be replaced on the wall edge near the entrance. 2) A-Entry doors and door jambs will monitored quarterly, and addressed as needed. B-Common are toilet will be montored quarterly and addressed as needed for discoloration. C-Odors in television room and chairs will be monitored daily for odors, discoloration and stains and addressed as needed. D-Chair identified with stains on the seat and back will be monitored daily, and addressed as needed. E-Baseboard in MC unit will be monitored quarterly and repaired/replaced as needed. 3) A-Quarterly and as needed. B-Quarterly and as needed. C-Daily and as needed. D-Daily and as needed. E-Quarterly and as needed. 4) A-Maintenance director, Arbor Administrator, Executive Director. B-Maintenance Director, Arbor Administrator, Executive Director. C-Care staff, housekeepers, Arbor Administrator. D-Care staff, housekeepers, Arbor Administrator. E-Maintenance Director, Arbor Administrator, Executive Director.

OAR 411-054-0200 (4)(d-i) Doors, Walls, Elevators, Odors (d) INTERIOR DOORS. Lever-type door handles must be provided on all doors used by residents.(e) EXIT DOORS. Exit doors may not include locks that delay evacuation except as specified by the building codes. Such locks may not be installed except with written approval of the Department.(A) Exit doors may not include locks that prevent evacuation.(B) If an electronic code must be entered to use an exit door that code must be clearly posted for residents, visitors, and staff use.(f) WALLS AND CEILINGS. Walls and ceilings must be cleanable in kitchen, laundry, and bathing areas. Kitchen walls must be finished smooth per OAR 333-150-0000 (Food Sanitation Rules).(g) ELEVATORS. A RCF with residents on more than one floor must provide at least one elevator that meets Oregon Elevator Specialty Code (OESC) requirements.(h) The interior of the facility must be free from unpleasant odors.(i) All interior and exterior materials and surfaces (e.g., floors, walls, roofs, ceilings, windows, and furniture) and all equipment necessary for the health, safety, and comfort of the resident will be kept clean and in good repair. 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?C513.

Refer to?C513.

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:

OAR 411-057-0155(1-6) Staff Training Requirements (1) A memory care community must ensure staff who provide support to residents with dementia have a basic understanding and fundamental knowledge of the residents' emotional and unique health care needs prior to providing services to residents. The training requirements for staff who work in memory care communities are described in the following sections. (2) ALL STAFF TRAINING REQUIREMENTS. All staff who work in memory care communities licensed as residential care facilities or assisted living facilities must complete the following: (a) Orientation as required in OAR 411-054-0070(3) before performing any job duties. (b) Pre-service dementia care training as required before independently providing personal care or other services. The dementia care training must address these topics: (A) Education on the dementia disease process, including the progression of the disease, memory loss and psychiatric and behavioral symptoms. (B) Techniques for understanding, communicating and responding to distressful behavioral symptoms; including but not limited to, reducing the use of antipsychotic medications for non-standard uses when responding to distressful behavioral symptoms. (C) Strategies for addressing social needs of persons with dementia and engaging them with meaningful activities; (D) Information concerning specific aspects of dementia care and ensuring safety of residents with dementia including, but not limited to, how to: (i) Identify and address pain; (ii) Provide food and fluid; (iii) Prevent wandering and elopement; (iv) Use a person-centered approach. (c) Additional pre-service training topics that must be completed before independently providing personal care to residents: (A) Environmental factors that are important to resident ' s well-being (e.g. noise, staff interactions, lighting, room temperature, etc.); (B) Family support and the role the family may have in the care of the resident; (C) How to recognize behaviors that indicate a change in the resident ' s condition and report behaviors that require on-going assessment. (3) DIRECT CARE STAFF TRAINING REQUIREMENTS. Direct care staff must be directly supervised by a qualified staff person until they have successfully demonstrated satisfactory performance in any task assigned in the provision of individualized resident services. In addition to training required for all staff as described in paragraph (2): (a) Before independently providing personal care or other services to residents, direct care staff must complete training on: (A) How to provide personal care to a resident with dementia, including an orientation to the resident and the resident ' s service plan, as required in OAR 411-054-0070(4). (B) The use of supportive devices with restraining qualities in memory care communities. (b) Within 30 days after hire, direct care staff must complete training as outlined in OAR 411-054-0070(5). (c) Direct care staff who work in memory care communities licensed as residential care facilities or assisted living facilities must complete a total of 16 hours of in-service training annually. The six hours of annual dementia care training required pursuant to OAR 411-054-0070(6) may be included in the 16 hours of in-service training. Annual in-service hours required of each staff are due by the anniversary date of that person ' s hire. All completed trainings must be documented by the facility. (4) NURSING FACILITY STAFF. Staff who work in memory care communities licensed as nursing facilities must complete the following: (a) Orientation as outlined in OAR 411-086-0310, 42 CFR ? 483.95 (F 943). (b) Pre-service dementia care training as outlined in paragraphs (2)(b) and (c) and paragraph (3)(a) of this section. (c) A total of 16 hours of annual in-service training must be completed by direct care staff only. Four of the 16 hours must be dementia care training and may be included in the 16 hours of in-service training. Annual in-service hours required of each staff are due by the anniversary date of that person ' s hire. All completed trainings must be documented by the facility. (5) Persons providing or overseeing the training of staff must have experience and knowledge in the care of individuals with dementia. (6) The memory care community must have a method for determining and documenting each staff person ' s competency of training in accordance with the licensing rules. All training must be documented and available to the Department upon request. This Rule is not met as evidenced by: Based on interview and record review, it was determined the facility failed?to ensure 2 of 4 sampled newly hired?staff (#s?4 and 5) completed all required pre-service training prior to performing any job duties and/or demonstrated competency in all assigned duties within 30 days of hire. Findings include, but are not limited to: Staff training records, reviewed on 08/10/26,?identified?the following:?? ? a. There was no documented evidence Staff 4 (Maintenance), hired 04/01/26, completed the following required pre-service orientation training topics:?? ? * Resident rights and values of CBC care;?? * Abuse reporting requirements;?? * Infectious Disease Prevention;?? * Home and Community Based Services (HCBS) training;?? * LGBTQIA2S+ training;?? * Dementia disease process including progression, memory loss, psychiatric and behavioral symptoms;?? * Techniques for understanding, communicating and responding to behaviors;?? * Strategies for addressing social needs and engaging them in meaningful activities; and?? * Specific aspects of dementia including addressing pain, providing food/fluids, preventing wandering, and the use of person-centered approach. b. There was no documented evidence Staff 5 (MT/CG)?demonstrated?competency in job duties within 30 days of hire and prior to working independently in the following areas: * The role of service plans in providing individualized care; *?Providing assistance?with ADLs; * Changes associated with normal aging; * Identification,?documentation?and reporting of changes of condition; * Conditions that require assessment, treatment, observation, and reporting; and * Medication Administration. The surveyor informed Staff 1 (MCC Administrator)?on 08/11/26?that Staff 5 could not administer medications until training was completed. The findings were acknowledged.?

1) A-Preservice orientation training topics will be completed for staff #4. Including: * Resident rights and values of CBC care; * Abuse reporting requirements; * Infectious Disease Prevention; * Home and Community Based Services (HCBS) training; * LGBTQIA2S+ training; * Dementia disease process including progression, memory loss, psychiatric and behavioral symptoms; * Techniques for understanding, communicating and responding to behaviors; * Strategies for addressing social needs and engaging them in meaningful activities; and * Specific aspects of dementia including addressing pain, providing food/fluids, preventing wandering, and the use of person-centered approach. B-Staff #5 has completed and demonstrated competency and has been documented for their file, including: * The role of service plans in providing individualized care; *?Providing assistance?with ADLs; * Changes associated with normal aging; * Identification,?documentation and reporting of changes of condition; * Conditions that require assessment, treatment, observation, and reporting; and * Medication Administration. 2) A-All staff will complete required preservice training prior to performing any job duties and/or demonstrated competency in all assigned duties within 30 days of hire. B-All staff will complete required preservice training prior to performing any job duties and/or demonstrated competency in all assigned duties within 30 days of hire. 3) A-Preservice training will be evaluated prior to performing any job duties. B-Demonstrated competency will be completed within 30 days of hire to the DHS and prior to working independently. 4) A-Business office manager, Arbor Administrator and Executive Director. B-Heath Services Director, Arbor Administrator and Executive Director and Business office Manager.

OAR 411-057-0155(1-6) Staff Training Requirements (1) A memory care community must ensure staff who provide support to residents with dementia have a basic understanding and fundamental knowledge of the residents' emotional and unique health care needs prior to providing services to residents. The training requirements for staff who work in memory care communities are described in the following sections. (2) ALL STAFF TRAINING REQUIREMENTS. All staff who work in memory care communities licensed as residential care facilities or assisted living facilities must complete the following: (a) Orientation as required in OAR 411-054-0070(3) before performing any job duties. (b) Pre-service dementia care training as required before independently providing personal care or other services. The dementia care training must address these topics: (A) Education on the dementia disease process, including the progression of the disease, memory loss and psychiatric and behavioral symptoms. (B) Techniques for understanding, communicating and responding to distressful behavioral symptoms; including but not limited to, reducing the use of antipsychotic medications for non-standard uses when responding to distressful behavioral symptoms. (C) Strategies for addressing social needs of persons with dementia and engaging them with meaningful activities; (D) Information concerning specific aspects of dementia care and ensuring safety of residents with dementia including, but not limited to, how to: (i) Identify and address pain; (ii) Provide food and fluid; (iii) Prevent wandering and elopement; (iv) Use a person-centered approach. (c) Additional pre-service training topics that must be completed before independently providing personal care to residents: (A) Environmental factors that are important to resident ' s well-being (e.g. noise, staff interactions, lighting, room temperature, etc.); (B) Family support and the role the family may have in the care of the resident; (C) How to recognize behaviors that indicate a change in the resident ' s condition and report behaviors that require on-going assessment. (3) DIRECT CARE STAFF TRAINING REQUIREMENTS. Direct care staff must be directly supervised by a qualified staff person until they have successfully demonstrated satisfactory performance in any task assigned in the provision of individualized resident services. In addition to training required for all staff as described in paragraph (2): (a) Before independently providing personal care or other services to residents, direct care staff must complete training on: (A) How to provide personal care to a resident with dementia, including an orientation to the resident and the resident ' s service plan, as required in OAR 411-054-0070(4). (B) The use of supportive devices with restraining qualities in memory care communities. (b) Within 30 days after hire, direct care staff must complete training as outlined in OAR 411-054-0070(5). (c) Direct care staff who work in memory care communities licensed as residential care facilities or assisted living facilities must complete a total of 16 hours of in-service training annually. The six hours of annual dementia care training required pursuant to OAR 411-054-0070(6) may be included in the 16 hours of in-service training. Annual in-service hours required of each staff are due by the anniversary date of that person ' s hire. All completed trainings must be documented by the facility. (4) NURSING FACILITY STAFF. Staff who work in memory care communities licensed as nursing facilities must complete the following: (a) Orientation as outlined in OAR 411-086-0310, 42 CFR ? 483.95 (F 943). (b) Pre-service dementia care training as outlined in paragraphs (2)(b) and (c) and paragraph (3)(a) of this section. (c) A total of 16 hours of annual in-service training must be completed by direct care staff only. Four of the 16 hours must be dementia care training and may be included in the 16 hours of in-service training. Annual in-service hours required of each staff are due by the anniversary date of that person ' s hire. All completed trainings must be documented by the facility. (5) Persons providing or overseeing the training of staff must have experience and knowledge in the care of individuals with dementia. (6) The memory care community must have a method for determining and documenting each staff person ' s competency of training in accordance with the licensing rules. All training must be documented and available to the Department upon request. This Rule is not met as evidenced by: