Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Inspection: U9LS

Provider Information


Princeton Village Assisted Living Community

14370 SE OREGON TRAIL DRIVE
Clackamas, OR 97015

Provider ID
70M213
Administrator
Mikayla Valencia
Phone
(503) 558-1215
Email
mikayla.valencia@cogirusa.com

Inspection Details


Date
9/22/2022
Event ID
U9LS
Inspection type(s)
State Licensure
Deficiencies cited
2

Citation Details


C0000: Comment


Visit Number
1
Visit Date
9/22/2022
Corrected Date
N/A
Details

The findings of the kitchen inspection, conducted on 9/22/2022, 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
11/8/2022
Corrected Date
N/A
Details

The findings of the first revisit to the kitchen inspection survey of 09/22/22, conducted 11/08/22 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
9/22/2022
Corrected Date
N/A
Details

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


On 9/22/2022 at 10:50 am, the facility kitchen was observed and the following areas were noted:


*The refrigerator storing food items such as juice, milk and produce had a temperature of 47 degrees F. It also contained uncovered food items which included jello, peaches and cottage cheese. Staff 1 (Administrator) indicated the temperature would be addressed promptly.


*The dairy refrigerator had the following food items unlabeled and not dated: open bag of shredded cheese, meat patties, pickles, oatmeal, mandarin oranges, peanut butter and diced peaches. The following food items were not sealed, dated or labeled: hot dogs, sliced meats, lettuce and sausage.


*Dry storage area food bins (flour and salt) had scoops in them. The bin covers were covered in food particles, debris and were sticky to touch. A cardboard box of foam cups and two gallon containers of cooking wine were sitting directly on the floor.


*The prep area near the coffee making area and eye wash sink had a crate and two cardboard boxes sitting directly on the floor containing potatoes.  On the counter in the same area a container of powdered sugar had a cup in it.


*The bread freezer had uncovered/unlabeled serving containers of ice cream.


*The dishwasher had a data plate indicating both high and low temperatures. Staff 2 and Staff 3 (kitchen staff) were unsure what the temperature should be. Gauges indicated 150 for wash and 180 for rinse. Observations of wash temperature only reached 142 degrees F. Staff 1 was  informed and stated they would have machine checked promptly.


*In the dish room the wall behind the sink with the sprayer was covered in food splatters and the top of the dishwasher had food debris and dust.


*Three garbage cans in the food prep areas were uncovered.


*The salad cart had food debris on the shelves.


*Vents above the stove had debris/grease. Pipes leading to the stove hood above the handwashing sink had a layer of dust/debris.


The findings above were discussed with Staff 1 on 9/22/2022. The findings were acknowledged.

Plan of Correction

Refrigerator was at 47 degrees, community was waiting for part that has been installed. Food containers uncovered community is purchasing more containers with lids and all other packages if opened will have open date stickers. DSD will do daily audit to make sure they are covered and labeled. flour/sugar containers had scoop in them, scoops are now put in container aqbove larger containers and al lids have been cleaned/sanitized and will be puit on cleaning schedule. cardboard and cooking wine were placed on floore, both have been put away and off the floor. prep area had boxes directly on the floor, community has placed them on a rolling cart and it will remain under the prep table. Freezer with bread in it did not have dated items. This will be corrected and looked at daily by DSD to assure ongoing labels in place. Dishwasher temp at 142 instead of 150. Dining services will do daily temps and dwill contact dishwasher leasing company to come in and fix. Dishwasher area had items on the wall, community will post a cleaning sheet for daily tasks. Garbage cans did not have lids on them-community will purchase lids and attach to side of cans to assure they are being used. Salad cart had food on shelves-this will be cleaned after each 10/10/22 10/30/2022 10/15/2022 10/10/2022 10/10/2022 10/30/2022 10/10/2022 10/30/2022 10/30/2022 10/10/2022

Accepted

Yes No

2. How will the system

be corrected so this

violation will not

happen again?

Accepted

Yes No

3. How often will the

area needing correction

be evaluated?

Accepted

Yes No

4. Who will be

responsible to see that

the corrections are

completed/monitored?

Accepted

Yes No

meal. Vents above stove has debris/grease - This will be on the cleaning schedule weekly.


Visit Number
2
Visit Date
11/8/2022
Corrected Date
10/30/2022
Details

There are no detail notes for this visit.