Print Inspection: KIT007437

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 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. Findings include, but are not limited to: 1. On 10/21/25, from 10:20 am through 12:45 pm, the facility dinning room was observed. a. The following areas needed cleaning: • Beverage station countertop had spills; • Juice machine - an accumulation of splatters; • Wall next to the coffee maker had brown residue; and • One fan had accumulated dust and was blowing directly onto the plastic rack where clean utensils were stored. b. The following areas needed repair: • Cabinet under the sink in the dining room had water damage. 2. On 10/21/25, from 10:20 am through 12:45 pm, the facility main kitchen was observed. a. The following areas needed cleaning: • Juice machine - an accumulation of splatters; • Multiple fans had a buildup of dust; • Deep fryer had grease buildup on the front and sides; • Three-compartment sink contained dirty items, including pans and pots from the previous night; • Paper towel dispenser had spills; • Handwashing sink was stained inside; • Handwashing sink, especially around the faucet area, had brown residue; • Walls throughout the kitchen, especially near the handwashing sink and the pre-clean station, dishwasher area, and three-compartment sink had spills, food debris and grease buildup; • Vent above the three-compartment sink and two-door refrigerator had accumulated dust; • Ceiling throughout the kitchen, especially around the dishwasher and above the oven area had spills and grease buildup; • Inside the one-door freezer was a buildup of ice; • Rack used for storing clean utensils was rusty and the vent next to the rack area had rust and accumulated dust; • Commercial can opener had black reside inside; • The walk-in freezer had a large ice buildup on the floor; • Janitor’s closet floor and walls had accumulated black residue; • Multiple sprinkler heads had spiderwebs and rust; • Oven and grills had heavy grease buildup front, side and back; • Floor and baseboards around the dishwasher area the corners of the kitchen had black buildup; • Drains throughout the kitchen had black residue buildup; • The ice machine had accumulated dust on the side and rear piping area; and • Inside of the steamer had brown residue. b. The following areas needed repair: • The top panel of the freezer was detached and hanging; and • The exterior of the soup warmer had multiple chips. 3. Improper food storage: • Multiple chopped vegetables and food items in the salad cooler, including sliced ham, macaroni, carrot salad, and chopped lettuce were undated; • The brown sugar container had a scoop inside; • Storage rack had multiple food items, including several open cereal bags were undated; • One-door freezer contained multiple open packages of frozen meat were not completely sealed and were undated; • Two-door refrigerator had several open food items including bottles of dressing and milk were undated; and • In the walk-in cooler, multiple food items including cheese and milk were undated and a container of chopped tomatoes was undated and appeared to have white fungus on top. 4. Other areas of concern include: • Silverware on the preset dining tables was not wrapped or covered; • Multiple trash cans were uncovered when not in use; • Multiple staff were observed placing their thumbs inside clean cups and bowls while handling them; • Multiple kitchen staff were not properly restraining their hair; • Staff failed to change between clean and dirty tasks; and • Staff failed to use alcohol wipes to clean the thermometers after each use. 5. On 10/21/25, from 10:20 am thru 12:45 pm, the facility’s Cottage one kitchenette was observed, and the following areas were noted: • Inside the cabinet, a container of peanut butter, cocoa powder, and multiple cereal bags were undated; • Baseboard next to the juice dispenser showed signs of water damage; • Inside the cabinet, below the juice dispenser, brown residue had accumulated; and • Juice dispenser had a sticky buildup. 6. On 10/21/25, from 10:20 am though 12:45 pm, the facility’s Cottage two kitchenette was observed, and the following areas were noted: • Inside the cabinet, a container of peanut butter and a bottle of light corn syrup were undated; • An open bag of powdered sugar was not completely sealed and was undated; • Cabinet below the juice dispenser showed signs of water damage; • Juice dispenser had a sticky buildup; and • Baseboard at the entrance of the kitchenette showed signs of water damage. The areas of concern were observed and reviewed with Staff 1 (ED) and Staff 2 (Regional Director) on 10/21/25 at 12:48 pm. The findings were acknowledged.

FACILITY MAIN KITCHEN -POC 1. The following items have been completed or are in process Violation 1 - a) Cleaned the countertop spills, juice machine splatters, cleaned brown residue from the wall next to the coffee maker, removed fans from the kitchen. b) Repair cabinet under the sink in the dining room. Violation 2 - (a)-Juice machine splatters cleaned. -Removed fans from the dining room. -Deep fryer grease scheduled to be deep cleaned 3rd party commercial cleaning company. -Three-compartment sink pans washed and put away. -Cleaned paper towel dispenser. -Cleaned stains from the handwashing sink. -Hired 3rd party commercial cleaning company to clean the handwashing sink, pre-clean station, dishwasher area, and three compartment sink of food debris and grease build up. -Hired 3rd party company to clean the vents throughout the kitchen and two door refrigerator dust accumulation. -Hired 3rd party company to clean the spills and grease from ceiling throughout the kitchen and around the dishwasher/oven area. -Removed ice from inside the one-door freezer with built up ice. -Rack used for storing clean utensils replaced and accumulated dust removed. -Hired 3rd party cleaning company to clean the black residue inside of the commercial can opener. -Removed the large ice build-up on the floor in the walk-in freezer. -Cleaned black residue from janitor's closet floor and walls. -Cleaned spiderwebs and rust from sprinkler heads. -Hired 3rd party company to clean the heavy grease build-up on the front, side, and back of the oven and grills. -Hired 3rd party to clean the floor and baseboards around the dishwasher area. -Cleaned the black residue from the drains throughout the kitchen. -Cleaned the dust on the side and rear piping area of the ice machine. -Cleaned the brown residue from the steamer. (b) -repaired the top panel of the freezer. -Replaced the soup warmer. Violation 3- -Disposed of all items without a date. -Removed the scoop from the brown sugar. -Disposed of the food items including cereal bags without a date. -Disposed of the food items in the freezer without a date. -Disposed of the food items in the two door refrigerator without a date. -Disposed of the food items in the walk in cooler without a date. -Disposed of the tomatoes. Violation 4 - -Silverware will be wrapped or provided upon food service. -Lids put onto all trash cans in the kitchen and dining room. -Kitchen staff were educated on not placing their thumbs inside clean cups and bowls. -Kitchen staff provided hair nets and educated on restraining hair. -Kitchen staff educated on changing gloves between dirty and clean tasks. -Kitchens staff educated on cleaning thermometers after each use. 2. (a) A revised routine cleaning schedule that includes by shift, daily, weekly, monthly, and quarterly cleaning tasks. This was implemented immediately (b) Provided education to the kitchen staff on use of the task sheets, food sanitation rules, and food storage. Will continue to provide education to staff as needed. 3. Daily, weekly, monthly, and quarterly kitchen audits and monitoring will be performed by leadership team. 4. Dining Services Director, Business Office Manager, Memory Care Director, and Executive Director will oversee to ensure corrections are completed and assist with ongoing monitoring of the program.

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 and interview, it was determined the facility failed to follow licensing rules for Residential Care and Assisted Living Facilities. Findings include, but are limited to: Refer to C240

1. The following actions have been taken or are in process Cottage 1 & 2 • All undated food items were discarded. • Cabinets were emptied, cleaned, and sanitized. • Brown residue below the juice dispenser was removed and the area sanitized. • Juice dispenser was thoroughly cleaned, sticky residue removed and sanitized. • Baseboard next to the juice dispenser was inspected and repaired to address water damage.Water damaged cupboard will be repaired and sealed to avoid further deterioration. 2. a. A revised cleaning checklist by shift daily to include cleaning of the juice dispensors, cabinets, etc was implemented. b. Daily walk through of kitchette areas in both Cottages will be completed by administrator or designee to spot check for cleanliness and food labeling. c. Staff training was completed with all staff to include proper food labeling, sealing, storing and sanitation procedures. 3. • Daily walk throughs will be conducted by adminstrator to ensure cleanliness and proper storage of food items. Weekly inspections of cabinets and food storage areas will now be conducted by the Dietary Supervisor. • Maintenance staff will inspect baseboards monthly for signs of damage or moisture. 4. The Memory Care Administrator and Executive Director will be responsible for all corrections and monitoring to ensure compliance

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: