Print Inspection: KIT007901

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: On 11/17/25, from 1:33 pm thru 2:00 pm, the facility main kitchen was observed, and the following was identified: 1. The following areas needed cleaning: * Baseboards throughout the kitchen, especially in the corners, had a build-up of black residue; * Dry food storage area had a ceiling vent with layers of dust. The bottom vent of the ice machine had layers of dust. Drain near the ice maker contained brown residue or food build-up; * Walk-in cooler contained an open bag of shredded cheese that was not dated. The vent and sprinkler heads had layers of dust; * Walk-in freezer had a broken bottom shelf, and the floor had scattered food and debris; * A portable fan had layers of dust and was operating during the kitchen tour, blowing directly toward the clean equipment storage rack; * Drain under the three-compartment sink had black residue; and * Wall and interior of the janitor’s sink had brown residue. 2. The following areas needed repair: * Dry food storage area had ceiling lights with no covers on three of the fixtures; * Walk-in freezer had a broken bottom shelf; and * Colored cutting boards were heavily scored - uncleanable surfaces. 3. Observations of the Maple Cottage kitchenette on 11/18/25 at 11:19 am revealed the following: * Wall near the trashcan had visible food residue and spills; * Exterior of the cabinet and drawers, particularly at the edges, were worn, exposing raw materials and sticky to the touch; * Inside of the cabinets and drawers had visible spills, debris, dust, and water damage; * Inside of cabinets had multiple bags of opened bread, a box of cereal, and a package of cookies that were not dated; * One freestanding refrigerator did not have a thermometer inside or outside and had multiple opened bags of bread, eggroll wrappers, milk, and dressing that were not dated; * A container of sugar on the countertop was uncovered; * Wall under the soap dispenser at the handwashing sink had missing paint or gouges, revealing raw materials; and * One cabinet door next to the dishwasher was loose. 4. Observations of the Pine Cottage kitchenette on 11/18/25 at 11:30 am revealed the following: * A trashcan was not covered when not in use; * Exterior of the cabinets and drawers, particularly at the edges, were worn, exposing raw materials and sticky to the touch; * Inside of the cabinets and drawers had visible spills, debris, dust, and water damage; and * Inside of cabinets had multiple bags of opened bread, a box of cereal, and a package of cookies that were not dated. 5. Observations of the Oak Cottage kitchenette on 11/18/25 at 11:38 am revealed the following: * Wall near the trashcan and eye station had visible food residue and spills; * Exterior of the cabinets and drawers, particularly at the edges, were worn, exposing raw materials and sticky to the touch; * Inside of the cabinets and drawers had visible spills, debris, dust and water damage; * Inside of cabinets had bags of opened bread that were not dated; * Cabinet under the three-compartment food warmer had spills and cracks; * One cabinet door was missing; * Kitchen door frame had food debris and spills; and * The supporting panel under the countertop had food debris, chips, and gouges. The areas of concern were observed and discussed with Staff 1 (Administrator), Staff 2 (Dietary Supervisor), Staff 4 (Director of Nursing), Staff 5 (LPN), Staff 6 (Admission Coordinator), and Staff 7 (RCM) on 11/18/25 at 12:15 pm and at 12:26 pm. The findings were acknowledged.

C240 1: The identified areas on the SOD have been cleaned throughly. The areas also were added to the weekly deep cleaning list. With follow being conducted by head of kitchen, Head of housekeeping, and Administrator. 2: The areas identified that were in need of repair. The identified areas that needed to be repaired have been addressed. Lights fixed, New cutting boards ordered, and broken bottome shelf parts ordered to repair. Maintance is to fix and report once fixed to the Administator to follow up on repairs. 3. Maple Cottage kitchenette: Area's that required cleaning have been cleaned. Added to weekly spot checks. House keeping to maintain area in each cottage. All foods have been dated and will be spot checked by kitchen staff. Thermometer's added to each fridge.

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 not limited to: Refer to C240.

see C 240

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: