Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Inspection: H6XE

Provider Information


Brookstone Alzheimer's Special Care Center

5881 WOODSIDE DR SE
Salem, OR 97306

Provider ID
5MA151
Administrator
BRANDY KHLYSTOV
Phone
(503) 316-0687
Email
brandy.khlystov@sincerisl.com

Inspection Details


Date
1/18/2023
Event ID
H6XE
Inspection type(s)
State Licensure
Deficiencies cited
3

Citation Details


C0000: Comment


Visit Number
1
Visit Date
1/18/2023
Corrected Date
N/A
Details

The findings of the kitchen inspection, conducted on 01/18/23, 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.




Visit Number
2
Visit Date
4/11/2023
Corrected Date
N/A
Details

The findings of the revisit to the kitchen inspection of 1/18/23, conducted 4/11/23, are documented in this report. It was determined the facility was 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.


C0240: Resident Services Meals, Food Sanitation Rule


Visit Number
1
Visit Date
1/18/2023
Corrected Date
N/A
Details

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 333-150-0000. Findings include, but are not limited to:


On 01/18/23 at 10:30 am, the kitchen was observed to need cleaning and repair in the following areas:


* Dust/grease buildup on wall and piping above the stove;

 

* Vents above the toaster and steam table had buildup of dust/grease; and


* Lights in dry food storage area did not have covers on them.


The areas which required cleaning and repair were observed and discussed with Staff 1 (Food Service Director) on 01/18/23. The findings were acknowledged.

Plan of Correction

C 240


* Dust / grease buildup on wall and piping above the stove was professionally cleaned within days of survey visit and will be on a quarterly cleaning schedule (and as needed).


* Dust / grease buildup on the vents above the toaster and steam table were taken down and cleaned. Will be on a cleaning rotation.


* Light covers in the store room were put on and will remain in place.



Food Service Director will add items to kitchen cleaning tool and will audit with Administrator to ensure plan of correction continues to be followed.   


Visit Number
2
Visit Date
4/11/2023
Corrected Date
1/25/2023
Details

There are no detail notes for this visit.

Z0142: Administration Compliance


Visit Number
1
Visit Date
1/18/2023
Corrected Date
N/A
Details

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 C 240.



Plan of Correction

Z 142


* Please refer to C 240 above


Visit Number
2
Visit Date
4/11/2023
Corrected Date
1/25/2023
Details

There are no detail notes for this visit.