Health inspection·July 27, 2023

F 0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure an effective pest control program was implemented so the facility was free of pests and rodents for two halls out of six halls (200 and 300 hall), facility's only dining room, and facility's conference room. Residents Affected - Some The facility failed to keep an effective pest control program to ensure resident dining rooms, facility conference room and resident rooms on 200 and 300 halls were free of flies, crickets, gnats, and roaches. This failure could place residents at risk for a reduced quality of life. Findings included: Interview on 07/27/23 at 09:45 AM with Resident #1 revealed that there are a lot of flies. He stated there were more flies in the room than there is outside. There were flies in the dining room when they ate daily. Observation on 09/27/23 at 09:45 AM revealed one fly on Resident#1's leg as well as two more flies in the air around Resident #1. Observation on 07/27/23 at 09:50 AM revealed: one fly on the table close to where food was served outside of kitchen area one fly on another table directly in front of the kitchen area cricket on the floor directly in front of the kitchen door moving towards the kitchen area one fly on the table near the snack machine (within dining area) Page 1 of 3 455970 455970 07/27/2023 Avir at River Valley 1907 Refinery Rd Gainesville, TX 76240

F 0925 - Level of Harm - Minimal harm or potential for actual harm one fly in the hallway in beginning of 300 hall in the middle of hallway Residents Affected - Some Observation on 07/27/23 at 10:00 AM revealed three dead flies on the windowsill and one flying in resident room [ROOM NUMBER]. Observation on 07/27/23 at 10:00 AM revealed one fly on the window, one fly on a blanket, and one fly on the wall in resident room [ROOM NUMBER]. Observation on 07/27/23 at 10:01 AM revealed five flies on a sleeping resident, two ants and two gnats around the bed, and four gnats in the bathroom in resident room [ROOM NUMBER]. Observation on 07/27/23 at 10:01 AM revealed one fly in 200 hall on the wall. Observation on 07/27/23 at 10:02 AM revealed one fly on the bed in resident room [ROOM NUMBER]. Observation on 07/27/23 at 10:02 AM revealed two flies and one gnat near the window in resident room [ROOM NUMBER]. Interview on 07/27/23 at 10:04 AM with Resident #2 revealed that she often has flies in her room. She stated she mentioned it to staff, and she was told that her flowers attract bugs and she needed to get rid of the flowers. She told them no because her family member brought them for her. Observation on 07/27/23 at 10:04 AM of Resident #2's room revealed one fly around her food, one on the chair, and one on the ceiling. Interview on 07/27/23 at 10:11 AM with Resident #3 revealed they had flies. I have only seen one today but usually there are many. Resident #3 pointed to the fly swatter in the windowsill and stated that her and her family member use it to kill flies. Observation on 09/27/23 at 10:22 AM of the conference room revealed a light brown cockroach on the floor next to the wall and a dead cricket in the restroom. Interview with the Maintenance Director on 07/27/23 at 11:07 AM revealed that pest control comes out once a month, but they will call them out more often as needed. He stated that they recently came July 12th, 2023. He stated any staff can report pest control issues to the maintenance director, and they also have an online system to report issues. They have ordered air curtains for exits/entries to help control flies. The Maintenance director stated that flies and other pests could be possibly unsanitary for residents. Interview on 07/27/23 at 12:19 PM with the Administrator revealed that pest control was out on July 12th, and they did not see issues. The Administrator noticed an increase in flies that last couple days. He stated facility has ordered air curtains for each door and thinks that will help with the flies. The Administrator stated they did call pest control to come back out again , but they have not yet. The Administrator stated it could be unsanitary or irritable for the residents. Review of the facility's pest control service reflected on 07/12/23, states no rooms reported for any pest issues. Pest activity found: No findings noted during service. Location - exterior area - I 455970 Page 2 of 3 455970 07/27/2023 Avir at River Valley 1907 Refinery Rd Gainesville, TX 76240

F 0925 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some noticed that several holes located around the building especially underneath the eves of the building. I noticed birds flying. Action needed/taken: Please address structural concern. This has been documented several times. Review of the facility's policy Pest Control revised May 2008 reflected our facility shall maintain an effective pest control program .This facility maintains an on-going pest control program to ensure that the building is kept free of insects and rodents. 455970 Page 3 of 3