Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Inspection: XL5P

Provider Information


Royal Anne Assisted Living

10610 SE CLAY STREET
Portland, OR 97216

Provider ID
70A264
Administrator
KYMBERLY WELLS
Phone
(503) 408-0404
Email
kwells@cherrywoodvillage.net

Inspection Details


Date
5/2/2024
Event ID
XL5P
Inspection type(s)
State Licensure
Deficiencies cited
2

Citation Details


C0000: Comment


Visit Number
1
Visit Date
5/2/2024
Corrected Date
N/A
Details

The findings of the kitchen inspection, conducted on 05/02/24, 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
7/15/2024
Corrected Date
N/A
Details

The findings of the first re-visit to the kitchen inspection of 05/02/24, conducted on 07/15/24, 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
5/2/2024
Corrected Date
N/A
Details

Based on observation and interview, it was determined the facility failed to ensure the kitchen was maintained in accordance with the Food Sanitation Rules OAR 333-150-000. Findings include, but are not limited to:


Observations of the facility kitchen, food storage and food preparation areas on 05/02/24 noted the following in need of cleaning or repair:


* Multiple doors and door frames throughout the kitchen had chipped paint and black and brown substances on the surfaces;

* Stainless-steel shelves above and below the preparation tables throughout the kitchen had build up of grease and food particles on the surfaces;

* Laminate floor to the supply closet was damaged, exposing the subfloor which had a black substance on it's surface and was uncleanable;

* Tile floor near kitchen entrance had an unsealed crack rendering the surface uncleanable;

* Ceramic floor drains throughout the kitchen had blackened areas and food debris and garbage present;

* Open bags of onion rings and chicken tenders in the white deep freezer; and

* Plastic scoops were left in the dry storage bins containing rice and cereal,.


The areas in need of cleaning and repair were reviewed with Staff 2 (Culinary Director) and Staff 3 (Culinary Director) on 05/02/24. They acknowledged the findings.


Plan of Correction

C240 - Resident Services Meals, Food Sanitation

1) Doors/door frames throughout the kitchen will be cleaned, repaired, and/or painted in order to provide a clean and cleanable surface.


Stainless-steel shelves above and below the preparation tables throughout the kitchen will be cleaned to remove grease build up.


Laminate floor to the supply closet will be replaced to provide a cleanable surface.


Tiles with cracks near kitchen entrance will be filled or replaced to proved a cleanable surface.


Ceramic floor drains throught the kitchen will be cleaned and cleared of debris.


Open bags in white deep freezer will be closed between access to food products.


Plastic scoops in dry food bins will be removed from bins and stored in proper slot for scoop storage between uses.


2) The system will be corrected by providing an inservice to  kitchen staff on the following topics:

Proper storage of food items in freezers.

Proper storage of dry food scoops - not in bins.

Proper cleaning of stainless steel shelves.

Proper cleaning of ceramic floor drains.

Proper cleaning doors and floors.

Laminated signs will be added to freezers as reminders to close/cover food items.


Laminated signs will be added to dry storage bins as reminders to not leave scoops in bins.


Review of TELS usage (facility maintenance work order tracking system) with Culinary Directors and Executive Chef for repair needs such as chipped paint, broken/cracked floor tiles, torn laminate, etc. to ensure maintenance of cleanable surfaces.


3) How often will the area needing correction be evaluated?

*Frequency will be identifed on the kitchen cleaning schedule.

*Cleaning quality will be audited weekly by Executive Chef.

*Items requiring repair will be entered into TELS system by Culinary Director or Executive Chef upon identification.

*Monthly kitchen inspection will be completed by Executive Chef (or designee) to ensure ongoing compliance of areas identifed above. Copy of inspection report will be submitted to Assisted Living Executive Director and Senior Executive Director mothly for review.


4) Who will be responsible to see that corrections are completed/monitored:

Executive Chef

Culinary Director

Executive Director





Visit Number
2
Visit Date
7/15/2024
Corrected Date
7/1/2024
Details

There are no detail notes for this visit.