Print Inspection: KIT014141

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: Jennings McCall RCF 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: Observations of the food handling procedures in the MCC kitchenette on 09/09/26, from approximately 10:55 am through 11:15 am, revealed the following: 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: * Interior of under-the-counter style reach-in cooler (Fridge #3). 2. Items in need of maintenance or repair: * Interior temperature of under-the-counter style cooler (Fridge #3) was observed to be between 55 degrees Fahrenheit and 63 degrees Fahrenheit. 3. Sanitation and food handling: * Care staff/serving staff observed to deliver food items and assist with resident feeding without using a protective barrier/apron; * No clear system in place to ensure protective barriers/aprons were always available to care staff/serving staff and in use; * Care staff/serving staff observed to handle plated food for lunch service without proper hair restraint, potentially causing physical contamination of food items; * The surface sanitation solution bucket only had hot water in it and no chemical sanitizer, potentially causing cross contamination; * There were no test strips available for the surface sanitation solution bucket to determine whether the sanitizer was within an effective range; * Care staff/serving staff member was unable to articulate the effective parts per million range for the sanitizing chemical in use; * Kitchenette dedicated hand washing sink had multiple soiled pieces of silverware in it; and * Care staff/serving staff observed to wash hands above soiled silverware. 4. Food storage: * Opened packaged food item in standing refrigerator without an open date. At approximately 12:45 pm surveyor met with Staff 1 (Administrator), Staff 2 (Memory Care Administrator) and Staff 3 (Food Service Director) to review deficiencies. The findings were acknowledged by Staff 1, Staff 2 and Staff 3.

1. Staff were educated on 9/9/2026 regarding the requirement to maintain the refrigerator in a clean and sanitary condition, free of debris, dirt, dust, black matter, rust, grease, and other contaminants. The Administrator or Med Tech will complete daily spot checks to ensure the refrigerator remains clean and sanitary. Any concerns identified will be corrected immediately, with additional staff education provided as needed. 2. Refrigerator #3 was removed from Memory Care. The Med Tech will check and document the refrigerator temperature in both main refrigerators in the MAR twice daily to ensure it remains within the required temperature range. The Administrator or Med Tech will complete weekly spot checks to verify temperatures are being monitored and documented appropriately. 3. Staff education was completed on 9/9/2026 regarding the importance of wearing protective barriers/aprons and hair restraints throughout meal service. Staff received an educational handout and completed a quiz to verify understanding. The Administrator or Med tech will conduct weekly spot checks during meals to ensure staff are wearing the required protective barriers/aprons and hair restraints. Any concerns identified will be addressed immediately with staff education and follow-up by Administrator. The Maintenance Director purchased a no-rinse sanitizer to simplify the sanitizing process and eliminate an additional step associated with the previous red-bucket system. The red bucket was removed. The Food Service Director provided test strips, and the Administrator completed training on their proper use to verify the correct QAC PPM level is maintained. Staff education was completed on 9/9/2026 regarding proper handwashing procedures and ensuring the sink is clean and free of debris before use. The Administrator or Med Tech will complete 3 times weekly spot checks during meal service to monitor compliance and provide on-the-spot training and correction as needed. 4. Staff training was completed on 9/9/2026 regarding the importance of dating opened food items stored in the refrigerator. Staff were instructed to ensure all opened items are properly labeled with the date opened and discarded according to applicable food safety requirements. The Administrator or designee will complete daily spot checks to ensure compliance and provide on-the-spot education and correction as needed.

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: Facility is not in compliance with ALF/RCF rules. Refer to Tag C240

1. Staff were educated on 9/9/2026 regarding the requirement to maintain the refrigerator in a clean and sanitary condition, free of debris, dirt, dust, black matter, rust, grease, and other contaminants. The Administrator or Med Tech will complete daily spot checks to ensure the refrigerator remains clean and sanitary. Any concerns identified will be corrected immediately, with additional staff education provided as needed. 2. Refrigerator #3 was removed from Memory Care. The Med Tech will check and document the refrigerator temperature in both main refrigerators in the MAR twice daily to ensure it remains within the required temperature range. The Administrator or Med Tech will complete weekly spot checks to verify temperatures are being monitored and documented appropriately. 3. Staff education was completed on 9/9/2026 regarding the importance of wearing protective barriers/aprons and hair restraints throughout meal service. Staff received an educational handout and completed a quiz to verify understanding. The Administrator or Med tech will conduct weekly spot checks during meals to ensure staff are wearing the required protective barriers/aprons and hair restraints. Any concerns identified will be addressed immediately with staff education and follow-up by Administrator. The Maintenance Director purchased a no-rinse sanitizer to simplify the sanitizing process and eliminate an additional step associated with the previous red-bucket system. The red bucket was removed. The Food Service Director provided test strips, and the Administrator completed training on their proper use to verify the correct QAC PPM level is maintained. Staff education was completed on 9/9/2026 regarding proper handwashing procedures and ensuring the sink is clean and free of debris before use. The Administrator or Med Tech will complete 3 times weekly spot checks during meal service to monitor compliance and provide on-the-spot training and correction as needed. 4. Staff training was completed on 9/9/2026 regarding the importance of dating opened food items stored in the refrigerator. Staff were instructed to ensure all opened items are properly labeled with the date opened and discarded according to applicable food safety requirements. The Administrator or designee will complete daily spot checks to ensure compliance and provide on-the-spot education and correction as needed.