Aging and People with Disabilities
Safety, Oversight and Quality
Print Inspection: T9VF
Provider Information
3042 HYACINTH ST NE
Salem, OR 97303
- Provider ID
- 50R300
- Administrator
- ANGELIQUE HATLESTAD
- Phone
- (503) 763-2722
- hawthorne@pacificlivingcenters.com
Inspection Details
- Date
- 3/14/2024
- Event ID
- T9VF
- Inspection type(s)
- State Licensure
- Deficiencies cited
- 3
Citation Details
C0000: Comment
- Visit Number
- 1
- Visit Date
- 3/14/2024
- Corrected Date
- N/A
- Details
-
The findings of the kitchen inspection, conducted 03/14/24, 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.
- Visit Number
- 2
- Visit Date
- 5/15/2024
- Corrected Date
- N/A
- Details
-
The findings of the first revisit to the kitchen inspection of 03/14/24, conducted 05/15/24, 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.
C0240: Resident Services Meals, Food Sanitation Rule
- Visit Number
- 1
- Visit Date
- 3/14/2024
- Corrected Date
- N/A
- Details
-
Based on observation and interview, it was determined the facility failed to ensure the kitchen was clean and in good repair, and food and/or equipment was stored appropriately in accordance with the Food Sanitation Rules OARs 333-150-0000. Findings include, but are not limited to:
On 03/14/24 at 10:40 am through 12:45 pm, the facility kitchen was observed to need cleaning in the following areas:
* Stove top;
* Stove vent hood;
* Interior of reach in freezer;
* Walls behind counters/food prep areas;
* Interior of cabinets;
* Drawer under oven storing pan lids;
* Floor in pantry in garage; and
* Interior of cabinet with trash can.
The following areas failed to meet the food code standards:
* Bulk containers containing ice and flour had scoop stored in the product;
* Multiple food items were not dated when opened as required;
* Items were found in reach in refrigerator open to potential contamination;
* Food for staff was noted stored on the counter in kitchen space;
* Staff were operating dish machine on the quick cycle and that cycle had not been validated to effectively sanitize dishes;
* White cutting board found heavily scored/stained and in need of replacement. Cookie sheet pan found with heavy grease/carbon debris and in need of replacement;
* Freezer in garage area observed with heavy frost accumulation and in need of defrosting;
* Thermometer probe was noted bent and in need of replacement;
* Fabric Towel/place mat found stored in meat drawer;
* Bag of potatoes was observed stored on the floor;
* Kitchen staff were observed to handle the ready to eat rolls for lunch with bare hands, grabbing and tearing them open then placing in bowl for service.
Upon interview with Staff 1 (Executive Director) it was determined that the majority of food preparation occurred on night shifts. Other facility staff then warmed the food or finished cooking the food for the meals for the day. Facility staff were not able to correctly identify the reheat temperature requirement of 165 degrees. Staff 1 validated they were designated as person in charge. Staff 1 acknowledged the staff on night shift did not have any additional knowledge base to validate person in charge knowledge needs or responsibilities.
At approximately 1:00 pm, areas needing cleaning, repair and correction were reviewed with Staff 1 (Administrator), they acknowledged the identified areas.
- Plan of Correction
-
1. Staff will be retrained on kitchen cleaning and storing food and/or equipment appropriately in accordance with the food and sanitation rules. As well as making sure all freezers are being defrosted.
ALL CLEANING WAS DONE TO:
*Stove top;
*Stove vent hood;
*Interior of reach in freezer;
*Walls behind counters/food prep areas;
*Interior of cabinets;
*Drawer under oven storing pan lids
*Floor in pantry in garage; and Interior of cabinet with trash can.
* Bulk containers containing ice and flour had scoop stored in the product.
NO LONGER HAVE SCOOPS.
* Multiple food items were not dated
when opened as required
ALL ITEMS HAVE OPEN DATES.
* Items were found in reach in refrigerator open to potential contamination.
NO ITEMS ARE IN REFRIGERATOR OPENED THAT ARE AT RISK FOR POTENTIAL CONTAMINATION.
Food for staff was noted stored on the kitchen space;
STAFF HAVE AN AREA TO STORE FOOD NO LONGER KEEPING FOOD IN THE KTICHEN AREA.
*Staff were operating dish machine on the quick cycle and that cycle had not been validated to effectively sanitize dishes;
DISHWASHER WAS VALIDATED THAT QUICKWASH CAN BE USED AND DISHES ARE BEING SANITIZED.
*White cutting board found heavily scored/stained and in need of replacement. Cookie sheet pan found with heavy grease/carbon debris and in need of replacement;
CUTTING BOARDS WERE THROWN OUT AND REPLACED AS WELL AS COOKIE SHEET PAN.
*Freezer in garage area observed with heavy frost accumulation and in need of defrosting;
FREEZER WAS DEFROSTED
*Thermometer probe was noted bent and in need of replacement;
THERMOMETER PROBE WAS REPLACED
*Fabric Towel/place mat found stored in meat drawer;
TOWEL WAS TAKEN OUT.
*Bag of potatoes was observed stored on the floor;
NO LONGER BEING STORED ON THE FLOOR IN PANTRY
*Kitchen staff were observed to handle the ready to eat rolls for lunch with bare hands, grabbing and tearing them open then placing in bowl for service.
STAFF WAS RETRAINED ON HANDLING FOOD APPROPRIATELY.
2. All staff will be responsible for making sure kitchen is cleaned after their shift and NOC shift will be responsible to ensure kitchen is deep cleaned nightly. Task sheets have been made for all shifts on kitchen cleaning duties.
3. Executive Director will check weekly to ensure kitchen is up to code and freezers do not have ice build up.
4. Executive Director will be responsible of making sure corrections are in compliance.
- Visit Number
- 2
- Visit Date
- 5/15/2024
- Corrected Date
- 5/13/2024
- Details
-
There are no detail notes for this visit.
Z0142: Administration Compliance
- Visit Number
- 1
- Visit Date
- 3/14/2024
- Corrected Date
- N/A
- Details
-
Based on observation, record review, 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 C 240.
- Plan of Correction
-
1. Refer to page 1 for corrections for C240.
- Visit Number
- 2
- Visit Date
- 5/15/2024
- Corrected Date
- 5/13/2024
- Details
-
There are no detail notes for this visit.