Print Inspection: KIT011030

OAR 411-054-0025 (1) Facility Administration: Operation (1) FACILITY OPERATION. (a) The licensee is responsible for the operation of the facility and the quality of services rendered in the facility. (b) The licensee is responsible for the supervision, training, and overall conduct of staff when staff are acting within the scope of their his or her employment duties.(c) The licensee is responsible for ensuring that the facility complies with the tuberculosis screening recommendations in OAR 333-019-0041.(d) The licensee is responsible for obtaining background checks on all subject individuals. This Rule is not met as evidenced by: Based on observation and interview, it was determined that administrative oversight to ensure adequate food sanitation practices in the facility main kitchen and kitchenettes was ineffective. Findings include, but are not limited to: Refer to C240.

The management team will meet on a weekly basis along with the kitchen staff to implement check lists and ensure all deficiencies are corrected and remain in compliance. This will be monitored on a weekly and as needed basis. This will be completed by June 21st, 2026. The Administrator, Chief of Financial Operations, Infection Control Specialist, and/or Office Manager will be responsible in monitoring this correction is complete.

OAR 411-054-0025 (1) Facility Administration: Operation (1) FACILITY OPERATION. (a) The licensee is responsible for the operation of the facility and the quality of services rendered in the facility. (b) The licensee is responsible for the supervision, training, and overall conduct of staff when staff are acting within the scope of their his or her employment duties.(c) The licensee is responsible for ensuring that the facility complies with the tuberculosis screening recommendations in OAR 333-019-0041.(d) The licensee is responsible for obtaining background checks on all subject individuals. This Rule is not met as evidenced by:

OAR 411-054-0025 (1) Facility Administration: Operation (1) FACILITY OPERATION. (a) The licensee is responsible for the operation of the facility and the quality of services rendered in the facility. (b) The licensee is responsible for the supervision, training, and overall conduct of staff when staff are acting within the scope of their his or her employment duties.(c) The licensee is responsible for ensuring that the facility complies with the tuberculosis screening recommendations in OAR 333-019-0041.(d) The licensee is responsible for obtaining background checks on all subject individuals. This Rule is not met as evidenced by: Based on observation and interview, it was determined the licensee failed to ensure adequate administrative oversight of facility operations for food services. Findings include, but are not limited to: During the first revisit of the kitchen inspection of 04/22/26, conducted 06/26/26, administrative oversight to ensure adequate food services rendered in the facility was found to be ineffective based on failure to implement plan of correction and ensure adequate oversight to correct deficiencies. Refer to C240

The management team will meet on a regular basis and implement a check list to ensure all kitchen deficiencies are corrected and remain in compliant. This will be monitored on a daily and as needed basis. This will be completed by August 8th, 2026. The Administrator, Chief of Financial Operations, and Site Manager will be responsible in monitoring this correction is complete.

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 ensure the kitchen was clean and in good repair in accordance with the Food Sanitation Rules OAR 333-150-000. Findings include, but are not limited to: Observation of the main facility kitchen and the two kitchenettes on 04/22/26, from 10:45 am through 12:30 pm, revealed the following deficient practices: 1. Main Kitchen a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, black matter, rust, and grease was visible on or underneath the following: * Interior of commercial ice machine; * Hood exhaust (Vent-a-hood) filters; and * Industrial can opener and can opener mounting plate. b. Items in need of maintenance or repair: * Industrial can opener and opener mounting plate; and * Interior thermometer for standing reach-in cooler in kitchen. c. Garbage cans throughout kitchen uncovered when not in use. d. Lack of hair restraints on multiple cooks. e. Multiple bulk food containers in the dry storage area observed with serving scoops being stored directly in the food product, potentially contaminating the food items. f. Serving scoop for commercial ice machine observed to be stored inside of machine directly on top of the ice, potentially causing cross contamination. g. Improper probe thermometer procedures observed. h. Bare hand contact with ready-to-eat food, potentially resulting in cross contamination. i. Lack of handwashing practices after coughing/touching face/changing gloves. j. Hand washing occurring in sink other than designated hand washing sink. k. Improper use of sanitation towels, using a damp cloth repeatedly to wipe food prep/service surfaces, potentially causing cross contamination. l. Lunchtime meal prepared and served without a surface sanitation solution bucket set up and in use. m. Food items for lunch serve out in “Building 1” kitchenette were not being held at a minimum temperature of 135 degrees Fahrenheit prior to being plated. n. Person-in-charge (PIC) unable to articulate two-stage cooling method. o. PIC unable to articulate how often surface sanitation solution bucket should be changed. p. PIC unable to articulate an example of cross-contamination. 2. Building 1 Kitchenette: a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, black matter, and grease was visible on or underneath the following: * Interior of microwave. b. Multiple food items in refrigerator without an open date. c. Packaged food item in cabinet not properly closed and without an open date. d. Packaged food item in drawers next to refrigerator not properly closed and without an open date. e. Multiple packaged food items on countertop without open dates. f. Food item on countertop transferred from original packaging without label or date. g. Food item on countertop with the serving spoon stored inside of the container, potentially causing cross contamination. 3. Building 3 Kitchenette: a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, black matter, and grease was visible on or underneath the following: * Floor drain under sink. b. Food items on countertop with the serving spoons stored inside of the containers, potentially causing cross contamination. c. Food items in the refrigerator transferred from original packaging without an identifying label or transfer date. d. Multiple packaged food items in the refrigerator without an open date. e. Prepared food item in refrigerator without a label or preparation date. f. Food items on the shelf transferred from original packaging without an identifying label or transfer date. At 12:30 pm surveyor met with Staff 1 (Administrator) and Staff 2 (Head Cook) to discuss findings. The findings were acknowledged by Staff 1 and Staff 2.

The management team will create a daily and weekly checklist to ensure all areas of kitchen are properly clean. This list will include checking that all kitchen equipment are maintained and in working order. Kitchen staff have been instructed to use food warmers and how to check take temperatures of food to ensure it is at the adequate 135 degree fahrenheit. A checklist has been created to remind staff to wear proper attire (hair nets, gloves, apron, and masks as needed). This is posted and in the kitchen binder. The management team will implement additional training and reminders focusing on the following topics: not leaving scoops in the ice machines and bulk storage containers, using date open, prepared, transferred, and expired labels, use of sanitation solution buckets, cross contamination, and other topics to correct all listed deficiencies. This will be monitored on a daily, weekly, and as needed basis. This will be completed by June 21st, 2026. The Administrator, Chief of Financial Operations, and/or Infection Control Specialist will be responsible in monitoring this correction is complete.

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 411-054-0030 (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: IHOME Care 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 OAR 333-150-000. This is a repeat citation. Findings include, but are not limited to: The findings of the first revisit kitchen inspection of 04/22/26, conducted 06/24/26, between 11:00 am and 11:45 am, are documented in this report. Main Kitchen: 1. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, black matter, rust, and/or grease was visible on or underneath the following: * Interiors of commercial ice machine; and * Industrial can opener and can opener mounting plate. 2. Sanitation and food handling: * Improper glove use; * Lack of hand washing between changing gloves; * Damp towel used to wipe food service surfaces without first being in a surface sanitation solution bucket/not returned to sanitation bucket after use; * Handwashing occurring in sink other than designated hand washing sink; * Improper probe thermometer procedures observed; and * Lack of knowledge pertaining to cross contamination - causes and prevention. 3. Food storage: * Multiple opened packaged food items in walk-in cooler without open dates; and * Serving scoops/spoons being stored directly in product, potentially causing cross contamination. 4. Other areas of concern: * Person in charge requires more knowledge regarding sanitation, cross contamination prevention/infection control procedures, and food storage. Building 1 Kitchenette: 1. Food storage: * Multiple items in refrigerator without an open date; * Multiple packaged food items on countertop without an open date; and *Multiple food items on countertop transferred from original packaging without label or date. Building 3 Kitchenette: 1. Food Storage: * Food items on countertop/shelves transferred from original packaging without date or identifying label; * Packaged food item in refrigerator without an open date; and * Prepared food item in refrigerator without an identifying label. At approximately 11:45 am the surveyor met with Staff 1 (Administrator) and Staff 2 (Kitchen Manager) to review deficiencies. The deficiencies were acknowledged by Staff 1 and Staff 2.

A deep cleaning will be done to remove food spills, splatters, loose food, dust, or any other matter from all surfaces paying close attention to the interiors of the commerical ice machine, industrial can opener, and can opener mounting plate. Kitchen staff will continue education of proper hand washing steps, using the designated hand washing sink, use of gloves, properly wiping down food service surfaces using sanitation solution, and correctly sanitizing the probe thermometer to prevent and/or cause cross contamination. Kitchen staff will be reminded to properly label packaged food items with open dates and/or identifying what the food item is and not to store scoops/spoons in storage bins directly with the products. The management team will go over information with all kitchen staff regarding sanitation, cross contamination prevention/infection control procedures, and food storage. This will be monitored on a daily and as needed basis. This will be completed by August 8th, 2026. The Administrator, Chief of Financial Operations, and Assistant Administrator will be responsible in monitoring this correction is complete.

OAR 411-054-0050(1-5) Infection Prevention & Control (Amended 03/18/2022)(1) Facilities must establish and maintain infection prevention and control protocols to provide a safe, sanitary and comfortable environment. This includes protocols to prevent the development and transmission of communicable diseases.(2) Each facility must designate an individual to be the facility ' s "Infection Control Specialist" responsible for carrying out the infection prevention and control protocols and serving as the primary point of contact for the Department regarding disease outbreaks. The Infection Control Specialist must:(a) Be qualified by education, training and experience or certification; and(b) Complete specialized training in infection prevention and control protocols within three months of being designated under this paragraph, unless the designee has received the specialized training within the 24-month period prior to the time of the designation. The Department will describe trainings that will be acceptable to meet the specialized training requirement in rule, by January 1, 2022.(3) Each facility must establish infection prevention and control protocols and have an Infection Control Specialist, trained as required in this rule, by July 1, 2022.(4) Facilities must comply with masking requirements as prescribed in OAR 333-019-1011 or, if applicable, OAR 437-001-0744, to control the spread of COVID-19.(5) Facilities must comply with vaccination requirements for COVID-19 as prescribed in OAR 333-019-1010.Stat. Auth.: ORS 410.070, 443.004, 443.012, 443.450Stats. Implemented: ORS 443.004, 443.400-443.455, 443.991 This Rule is not met as evidenced by: Based on observation and interview, it was determined the facility failed to establish and maintain infection prevention and control protocols to provide a safe, sanitary, and comfortable environment. Findings include, but are not limited to: At approximately 12:25 pm on 04/23/26, the surveyor requested written copies of the facility’s food worker illness and exclusion policy and their infection control protocols regarding gastrointestinal illnesses policy. Staff 3 (Infection Control Specialist) was unable to provide the documents. The findings were reviewed with and acknowledged by Staff 1 (Administrator) and Staff 3 on 04/23/26 at 12:30 pm.

The management team printed the food worker illness and exclusion policy along with the infection control protocols for gastrointestinal illnesses policy. This has been added to a binder located in the kitchen. Management has reviewed the policy & protocols with the kitchen staff. This will be monitored on a weekly and as needed basis as updates are made. This will be completed by June 21st, 2026. The Administrator, Infection Control Specialist, and/or Office Manager will be responsible in monitoring this correciton is complete.

OAR 411-054-0050(1-5) Infection Prevention & Control (Amended 03/18/2022)(1) Facilities must establish and maintain infection prevention and control protocols to provide a safe, sanitary and comfortable environment. This includes protocols to prevent the development and transmission of communicable diseases.(2) Each facility must designate an individual to be the facility ' s "Infection Control Specialist" responsible for carrying out the infection prevention and control protocols and serving as the primary point of contact for the Department regarding disease outbreaks. The Infection Control Specialist must:(a) Be qualified by education, training and experience or certification; and(b) Complete specialized training in infection prevention and control protocols within three months of being designated under this paragraph, unless the designee has received the specialized training within the 24-month period prior to the time of the designation. The Department will describe trainings that will be acceptable to meet the specialized training requirement in rule, by January 1, 2022.(3) Each facility must establish infection prevention and control protocols and have an Infection Control Specialist, trained as required in this rule, by July 1, 2022.(4) Facilities must comply with masking requirements as prescribed in OAR 333-019-1011 or, if applicable, OAR 437-001-0744, to control the spread of COVID-19.(5) Facilities must comply with vaccination requirements for COVID-19 as prescribed in OAR 333-019-1010.Stat. Auth.: ORS 410.070, 443.004, 443.012, 443.450Stats. Implemented: ORS 443.004, 443.400-443.455, 443.991 This Rule is not met as evidenced by:

OAR 411-054-0105 (2-4) Inspections and Investigation: Insp Interval (Amended 12/15/21)(2) The facility shall not interfere with a good faith disclosure of information by an employee or volunteer concerning abuse or other action affecting a resident's safety or welfare, as described in OAR 411-054-0028(4).(3) Staff of the Department shall visit and inspect every facility at least but not limited to once every two years for a full in-person survey to determine whether the facility is maintained and operated in accordance with these rules.(a) For each year during which a facility does not have a full survey, the Department shall conduct an in-person inspection of the kitchen and other areas where food is prepared for residents.(b) Subsection (a) will not go into effect until July 1, 2022.(c) Facilities not in compliance with these rules must submit, within ten days of receipt of the inspection report, a plan of correction that satisfies the Department.(d) The Department may impose sanctions for failure to comply with these rules.(4) Department staff may consult with and advise the facility administrator concerning methods of care, records, housing, equipment, and other areas of operation. This Rule is not met as evidenced by: Based on observation and interview, it was determined the facility failed to ensure their kitchen survey plan of correction was implemented and satisfied the Department. Findings include, but are not limited to: Refer to C240.

The management team will meet with the kitchen staff on a regular basis to ensure all corrections are made and the kitchen remains in compliant in all reported deficiencies. This will be monitored on a daily and as needed basis. This will be completed by August 8th, 2026. The Administrator, Chief of Financial Operations, and Assistant Administrator will be responsible in monitoring that this correction is complete.