Meals. The assisted living manager shall ensure that: A resident is provided three meals in a common dining area and additional snacks during each 24-hour period, 7 days a week; Meals and snacks are well-balanced, varied, palatable, properly prepared, and of sufficient quality and quantity to meet the daily nutritional needs of each resident with specific attention given to the preferences and needs of each resident; At a minimum, residents have access to snacks or food supplements between breakfast and lunch, between lunch and dinner, and during the evening hours; All food is prepared in accordance with all State and local sanitation and safe food handling requirements; Food preparation areas are maintained in accordance with all State and local sanitation and safe food handling requirements; and Portion sizes are in accordance with orders from a health care practitioner. The assisted living program shall ensure that menus are nutritionally adequate by having a dietitian or nutritionist review the 4-week menu: Prior to initial licensure; If substantive changes beyond accepted food substitutions have been made; and At least every 3 years. Menus. Menus shall be written at least 1 week in advance. The assisted living program shall post a weekly menu in a conspicuous place that is visible to residents and other interested parties. Menus shall be maintained on file, as served, for 6 months. Special Diets. The assisted living program staff shall: Prepare or arrange for the provision of special diets as ordered by the resident’s health care practitioner or as needed by the resident’s condition; and Document special diets in the resident’s record. If the diet is beyond the capability of the assisted living program, the resident or the resident’s health care practitioner shall make other arrangements for the resident’s care, or the assisted living program shall discharge the resident. Monitoring. The assisted living manager shall ensure that each resident is monitored on a daily basis to ensure that the resident’s service plan is being properly implemented. Adaptive Equipment and Assistive Devices. The assisted living manager or their designee shall ensure that all adaptive equipment and assistive devices are in proper working order. The assisted living manager or designee shall facilitate the repair or replacement of adaptive equipment and assistive devices, as needed. Assisted living staff shall assist the resident, as needed, to utilize the adaptive equipment and assistive devices. Nursing Services. The assisted living manager, in consultation with the delegating nurse, shall ensure that all nursing services are provided consistent with the Nurse Practice Act, Health Occupations Article, Title 8, Annotated Code of Maryland. Personal Care Services. The assisted living manager shall provide or ensure the provision of all necessary personal care services, including, but not limited to, the range of assistance needed by a resident to complete the activities of daily living as defined in Regulation .02B(2) of this chapter. Housekeeping Services. The assisted living manager shall ensure that: Housekeeping services are provided; and All areas of the facility are maintained in a clean and orderly condition. Health Care and Social Services. The assisted living manager is responsible for facilitating access to any appropriate health care and social services for the resident as determined in the resident’s assessment, including, but not limited to: Social work services; Rehabilitative services, including occupational, physical, speech, and audiology therapies; Home health services; Hospice services; Skilled nursing services; Health care practitioner services; Oral health care; Dietary consultation and services; Counseling; Psychiatric services; Psychological services; and Other specialty health services. Social and Recreational Activities. In accordance with the resident’s service plan, the assisted living program staff shall encourage resident participation in social and recreational activities, including: Providing or arranging for transportation to these activities in accordance with the resident’s service plan; and Assisting a resident with communication, interpersonal, and social skills, including managing difficult behaviors in accordance with the resident’s service plan. The assisted living manager shall provide or arrange appropriate opportunities for socialization, social interaction, and leisure activities that reflect the resident’s preferences and promote the physical and mental well-being of each resident. Spiritual Activities. The assisted living manager or designee shall facilitate access to spiritual and religious activities consistent with the preferences and beliefs of the resident. The assisted living manager or designee shall provide or arrange for transportation to spiritual and religious activities in accordance with the resident’s service plan.