Print Inspection: MUL7

The findings of the kitchen inspection, conducted 01/04/24, are documented in this report. The survey was conducted to determine compliance with the OARs 411-054-0030 for Residential Care and Assisted Living Facilities for Resident Services  - Meals and Oregon Health Service Food Sanitation Rules OARs 333-150-0000.

The findings of the first revisit to the kitchen inspection 01/04/24, conducted 03/14/24, are documented in this report. It was determined the facility was in substantial compliance with the OARs 411-054-0030 for Residential Care and Assisted Living Facilities for Resident Services- Meals, and Oregon Health Service Food Sanitation Rules OARs 333-150-0000.

Based on observation and interview, it was determined the facility failed to ensure kitchen practices and protocols were in accordance with the Food Sanitation Rules OARs 333-150-0000. Findings include, but are not limited to:

On 01/04/24 at 11:00 am, the kitchen was observed in need of cleaning and repairs in the following areas:

a. Food debris, dust, black matter and trash were observed on or under the following:

* The wall behind sink in the dishwashing area;

* Ceiling vents above the dish racks in the dishwashing area;

* Lids on food bins containing flour, brown sugar and granulated sugar;

* Shelve under prep counter;

* Manual can opener; and

* The floor under and behind ice machine.

b. The following areas needed repair:

* The flooring under garbage disposal;

* The wall behind dishwasher; and

* Leak on the ice machine.

Garbage cans were uncovered when not in use.

Beard restraints were not being used.

The areas of concern were observed and discussed with Staff 1 (Dining Services Manager) and the concerns were discussed with Staff 2 (Executive Director - training new Executive Director) and Staff 3 (Executive Director in training) on 01/04/24. The findings were acknowledged.

1. DSM immediately cleaned the areas of concern in the SOD. Maintanence Director (MD) contacted Central Support immediatley regarding repairs needed in the SOD. Joe Zody with Zody Architecture LLC sent a contractor to the facility on 1/11/24 to assess the wall behind the dishwasher and flooring underneath the disposal. Joe's contractor plans to remove the lower section of the wall and the flooring to determine the cause of damage & scope of the repair. Contractor is scheduled to come again on 1/26/24 to start. MD inspected the ice machine immediately but was unable to locate a leak. ED called appliance repair on 1/19/24 and are scheduled to inspect machine on 1/23/24. ED ordered beard restraints on 1/17/24. DSM to in-service dietary staff the week of 1/22/24 on the importance of cleanliness in the kitchen, the daily cleaning checklist and what is required, the use of lids on garbage cans when not in use, and the use of beard restraints

2. DSM to review and update the daily cleaning checklist if necessary to include the areas of concern in the SOD. DSM or designee to review cleaning checklist weekly and ED to follow up as needed. DSM and ED will attend monthly QAPI meetings for 6 months, and then quarterly thereafter to ensure cleanliness in the kitchen and improvements in cleaning proceses, and will review/offer re-training.

3. The areas needing correction will be monitored/evaluated daily by the use of the cleaning checklist. Once the repairs mentioned in the SOD are finished, the DSM will monitor the areas weekly to ensure the rot and black matter have not returned to the wall and floor and that the ice machine is free of leaks. Our TELs system requires the ice machine receive regular maintenance every 6 months as well.  

4. The DSM and the ED are responsible for the completion of these corrections and continuous monitoring to ensure systems are appropriate and remain in place.