Print Inspection: KIT004892

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, record review, and interview, it was determined the facility failed to ensure the kitchen was maintained in accordance with the Food Sanitation Rules OAR 333-150-000. Findings include, but are not limited to: Observations of the main facility kitchen, food storage areas, food preparation, and food service on 06/13/25 revealed: 1. Memory care unit’s Fireside kitchenette was observed at 11:00 am and the following was identified: a) Splatters, spills, drips, dust and food/debris noted on: * Interior of reach in refrigerator and freezer; * Interior and exterior of multiple drawers and cabinets; * Backsplash and wall behind the sink; * Exterior and interior of the oven; * Interior of the microwave; * Cabinet under the sink; and * Kitchenette flooring and baseboards. b. A plastic tub containing cloths was stored on the floor. c. The cabinet behind the paper towel rack had chipped finished and exposed surface and was in need of repair. 2. Memory care unit’s Gardenside kitchenette was observed at 11:15 am and the following was identified: a. Splatters, spills, drips, dust and food/debris noted on: * Interior of reach in refrigerator and freezer; * Backsplash and wall behind the sink; * Exterior and interior of the oven; * Interior of the microwave; and * Kitchenette flooring and baseboards. b. There was a missing cabinet door adjacent to the entry of the kitchenette that was in need of repair. c. Dish machine was found not sanitizing at correct sanitation level, and rinse temperature’s maximum rinse temperature observed was 100 degrees F. During an interview on 06/13/25 at 11:40 am, Staff 1(Administrator) confirmed the machine was put out of order until maintenance could attend to the issue. On 06/13/25 at approximately 12:45 pm, the areas in need of cleaning, repair and attention were reviewed with Staff 1. She acknowledged the findings.

OAR 411-057-0140(2) Administration Compliance - Referral Citation Z0142 OAR 411-057-0140 (2) The same corrections outlined in C0240 apply and have been Implemented under the oversight of The Administrator or designee will review all facility inspections to ensure compliance with both OAR 411-054 and 411-057.

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, interview, and record review, 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.

OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule 1 (a) Immediate Action Completed by 6/17/2025 -Both Fireside and Gardenside kitchenettes received deep cleaning by housekeeping staff. 2 (a) Daily, weekly, & monthly cleaning audits will be performed and documented. 3 (a) Kitchen staff will be responsible for completing daily kitchen cleaning and once weekly cleaning audits will be completed. 4. (a) The community administrator, dietary manager, and RCC will be responsible for overseeing these corrections. 1 (b) Immediate Action Completed - the plastic tub containing cloths was removed. 2 (b) Education will be provided to kitchen staff related to infection control measures. During weekly audits staff will ensure the floor is free of any clutter and that clean cloths are stored appropriately. 3 (b) The kitchen will have daily, weekly, and monthly cleaning and kitchen cleanliness and infection control measures will be audited once weekly. 4 (b) The community administrator, dietary manager, and RCC will be responsible for overseeing coorections. 1 (c) Immediate action taken - Damage to cabinet was repaired. 2 (c) During weekly kitchen audits any identified building or appliance repair needs will be communicated to the maintenance director and addressed within 72hrs. 3 ( c) Weekly kitchen audits and walk-throughs will be conducted to ensure cleanliness and that the building and appliances are in good repair. 4 ( c) The facility administrator, dietary manager, RCC and maintenance director will be responsible for overseeing corrections. 1 (2a) Immediate correction - the refrigerator, freezer, backsplash, oven, microwave, flooring and baseboards were deep cleaned to remove all spills, dirt, and debris. 2 (2a) Daily, weekly, and monthly cleaning/deep-cleaning will be conducted with weekly audits completed to ensure cleanliness. 3 (2a) Weekly kitchen audits will be performed to ensure compliance. 4 (2a) The administrator, dietary manager, and RCC will be responsible for overseeing corrections. 1 (2b) Immeidate Action - Missing cabinet door has been replaced. 2 (2b) During weekly kitchen audits, any identified building or appliance repair needs will be communicated to the community maintenance director and will be addressed within 72hrs. 3 (2b) Weekly audits will be performed to ensure cleanliness and building/appliance repair needs are addressed. 4 (2b) The community administrator, dietary manager, RCC, and maintenance director will be responsible for overseeing corrections. 1 (2c) Immeadiate action - The community maintenance director adjusted water temperature to ensure water reaches appropriate temperatures in the dishwasher. 2 (2c) Weekly water temperatures will be obtained and recorded. 3 (2c) The maintenance director will obtain and record weekly water temperatures and will report any findings outside of required temps to the administrator. 4 (2c) The facility administrator and maintenance director will be responsible for overseeing corrections.

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: