Inspection Report Summary
The most recent inspection on July 22, 2025, identified deficiencies related to kitchen sanitation and administrative compliance, with some issues remaining uncorrected as of the last revisit. Earlier inspections showed a pattern of deficiencies across resident rights, infection control, medication administration, fire and life safety, and administrative oversight, with repeated citations in kitchen sanitation and compliance areas. A complaint investigation in June 2024 substantiated failures in policy implementation, resident monitoring, and administrative oversight, leading to a condition placed on the facility. Enforcement actions such as fines or license suspensions were not listed in the available reports. The facility’s inspection history shows ongoing challenges with sanitation and administration, with some improvements noted after re-licensure surveys but recent findings indicate that certain issues persist.
Deficiencies (last 3 years)
Deficiencies (over 3 years)
19 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
184% worse than Oregon average
Oregon average: 6.7 deficiencies/yearDeficiencies per year
20
15
10
5
0
Inspection Report
Routine
Capacity: 52
Deficiencies: 2
Date: Jul 22, 2025
Visit Reason
Facility failed to ensure kitchen practices and protocols were in accordance with Food Sanitation Rules. Multiple areas in the kitchen required cleaning and food storage was improper. Administrative compliance issues were also noted. Deficiencies were not corrected as of the last revisit.
Findings
Facility failed to ensure kitchen practices and protocols were in accordance with Food Sanitation Rules. Multiple areas in the kitchen required cleaning and food storage was improper. Administrative compliance issues were also noted. Deficiencies were not corrected as of the last revisit.
Deficiencies (2)
OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule
OAR 411-057-0140(2) Administration Compliance
Inspection Report
Re-licensure
Capacity: 52
Deficiencies: 20
Date: Jul 8, 2024
Visit Reason
Re-licensure survey identified multiple deficiencies including resident rights, reporting abuse, service plans, infection control, medication administration, fire and life safety, and administrative compliance. Several deficiencies were repeated and some were corrected in subsequent visits. The facility was found in substantial compliance by the third revisit.
Findings
Re-licensure survey identified multiple deficiencies including resident rights, reporting abuse, service plans, infection control, medication administration, fire and life safety, and administrative compliance. Several deficiencies were repeated and some were corrected in subsequent visits. The facility was found in substantial compliance by the third revisit.
Deficiencies (20)
OAR 411-054-0020 Resident Rights and Protection - General
OAR 411-054-0045 Resident Health Services
OAR 411-054-0030 Resident Services Meals, Food Sanitation Rule
OAR 411-054-0025 Reasonable Precautions
OAR 411-054-0040 Change of Condition and Monitoring
OAR 411-054-0050 Inspections and Investigation: Insp Interval
OAR 411-054-0035 Infection Prevention & Control
OAR 411-054-0060 Systems: Tracking Control Substances
OAR 411-054-0065 Systems: Medication Administration
OAR 411-054-0070 Fire and Life Safety: Safety
OAR 411-054-0075 Fire and Life Safety: Training For Residents
OAR 411-054-0080 Systems: Psychotropic Medication
OAR 411-054-0085 Restraints and Supportive Devices
OAR 411-054-0090 Acuity-Based Staffing Tool
OAR 411-054-0095 Staff Training Requirements
OAR 411-054-0100 Compliance With Rules Health Care
OAR 411-054-0105 Nutrition and Hydration
OAR 411-054-0110 Activities
OAR 411-054-0115 Secure Outdoor Recreation Area
OAR 411-054-0120 Resident Rooms
Inspection Report
Complaint Investigation
Capacity: 52
Deficiencies: 5
Date: Jun 5, 2024
Visit Reason
Complaint investigation found failures in policy implementation for referral of sexual assault victims, failure to monitor residents consistent with evaluated needs, failure to notify RN of nursing needs, and ineffective administrative oversight of the Memory Care Community. Safety plans were requested and accepted. Department placed a condition on the facility.
Findings
Complaint investigation found failures in policy implementation for referral of sexual assault victims, failure to monitor residents consistent with evaluated needs, failure to notify RN of nursing needs, and ineffective administrative oversight of the Memory Care Community. Safety plans were requested and accepted. Department placed a condition on the facility.
Deficiencies (5)
OAR 411-054-0010 Licensing Complaint Investigation
OAR 411-054-0025 Facility Administration: Policy & Procedure
OAR 411-054-0040 Change of Condition and Monitoring
OAR 411-054-0045 Resident Health Services
OAR 411-054-0050 Administration Responsibilities
Inspection Report
Capacity: 52
Deficiencies: 10
Date: Apr 3, 2024
Visit Reason
State licensure and other inspections identified deficiencies in kitchen sanitation, resident rights, service plans, infection prevention and control, medication administration, fire and life safety, and administrative compliance. Some deficiencies were corrected in subsequent visits while others remained uncorrected as of the last visit.
Findings
State licensure and other inspections identified deficiencies in kitchen sanitation, resident rights, service plans, infection prevention and control, medication administration, fire and life safety, and administrative compliance. Some deficiencies were corrected in subsequent visits while others remained uncorrected as of the last visit.
Deficiencies (10)
OAR 411-054-0030 Resident Services Meals, Food Sanitation Rule
OAR 411-054-0020 Resident Rights and Protection - General
OAR 411-054-0025 Reasonable Precautions
OAR 411-054-0040 Change of Condition and Monitoring
OAR 411-054-0045 Resident Health Services
OAR 411-054-0050 Administration Responsibilities
OAR 411-054-0060 Systems: Tracking Control Substances
OAR 411-054-0065 Systems: Medication Administration
OAR 411-054-0070 Fire and Life Safety: Safety
OAR 411-054-0080 Systems: Psychotropic Medication
Inspection Report
Re-licensure
Capacity: 52
Deficiencies: 17
Date: Aug 14, 2023
Visit Reason
Validation and re-licensure survey identified numerous deficiencies including reasonable precautions, resident rights, service plans, infection prevention and control, medication administration, fire and life safety, staff training, and administrative compliance. Several deficiencies were repeated and some were corrected in subsequent visits. The facility was found in substantial compliance by the third revisit.
Findings
Validation and re-licensure survey identified numerous deficiencies including reasonable precautions, resident rights, service plans, infection prevention and control, medication administration, fire and life safety, staff training, and administrative compliance. Several deficiencies were repeated and some were corrected in subsequent visits. The facility was found in substantial compliance by the third revisit.
Deficiencies (17)
OAR 411-054-0025 Reasonable Precautions
OAR 411-054-0020 Resident Rights and Protection - General
OAR 411-054-0030 Resident Services Meals, Food Sanitation Rule
OAR 411-054-0045 Resident Health Services
OAR 411-054-0050 Administration Responsibilities
OAR 411-054-0060 Systems: Tracking Control Substances
OAR 411-054-0065 Systems: Medication Administration
OAR 411-054-0070 Fire and Life Safety: Safety
OAR 411-054-0080 Systems: Psychotropic Medication
OAR 411-054-0085 Restraints and Supportive Devices
OAR 411-054-0090 Acuity-Based Staffing Tool
OAR 411-054-0095 Staff Training Requirements
OAR 411-054-0100 Compliance With Rules Health Care
OAR 411-054-0105 Nutrition and Hydration
OAR 411-054-0110 Activities
OAR 411-054-0115 Secure Outdoor Recreation Area
OAR 411-054-0120 Resident Rooms
Inspection Report
Capacity: 52
Deficiencies: 3
Date: Feb 21, 2023
Visit Reason
State licensure and other inspections identified deficiencies in kitchen sanitation, resident rights, and administrative compliance. Some deficiencies were corrected in subsequent visits. The facility was found in substantial compliance during the revisit.
Findings
State licensure and other inspections identified deficiencies in kitchen sanitation, resident rights, and administrative compliance. Some deficiencies were corrected in subsequent visits. The facility was found in substantial compliance during the revisit.
Deficiencies (3)
OAR 411-054-0030 Resident Services Meals, Food Sanitation Rule
OAR 411-054-0020 Resident Rights and Protection - General
OAR 411-054-0050 Administration Compliance
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