Inspection Report
Capacity: 86
Deficiencies: 16
Apr 10, 2024
Visit Reason
State-compiled facility profile showing 3 inspections from 2021 to 2024 with deficiency history and licensing violations.
Findings
Across all inspections, the facility had multiple deficiencies primarily related to food sanitation, resident service plans, infection prevention, medication orders, staff training, and fire and life safety. Some deficiencies were corrected upon revisit, while others remained uncorrected.
Complaint Details
Complaint investigation conducted 02/16/2021 found no deficiencies related to the complaint.
Deficiencies (16)
| Description |
|---|
| C0000 - Comment: Findings of kitchen inspection and revisit regarding compliance with OARs 411-054-0030 and Oregon Health Service Food Sanitation Rules OARs 333-150-0000. |
| C0240 - Resident Services Meals, Food Sanitation Rule: Facility failed to ensure food was handled and kitchen maintained according to Food Sanitation Rules OAR 333-150-000, including multiple sanitation and food storage violations. |
| C0000 - Comment: Findings of re-licensure survey and revisit regarding compliance with OARs 411 Division 54 and 411 Division 004. |
| C0240 - Resident Services Meals, Food Sanitation Rule: Facility failed to maintain kitchen in clean and sanitary manner; food items uncovered, unlabeled, dented cans, and improper storage observed. |
| C0260 - Service Plan: General: Facility failed to ensure service plans reflected residents' needs and provided clear direction to staff for 2 of 5 sampled residents. |
| C0270 - Change of Condition and Monitoring: Facility failed to document monitoring of short term changes of condition until resolution for 4 sampled residents. |
| C0295 - Infection Prevention & Control: Facility failed to ensure staff consistently wore face masks properly as required by OAR 333-019-1011. |
| C0303 - Systems: Treatment Orders: Facility failed to ensure medication orders were carried out as prescribed and signed physician orders documented for 2 of 4 sampled residents. |
| C0305 - Systems: Resident Right to Refuse: Facility failed to notify physician when a resident refused medication for 1 of 2 sampled residents. |
| C0325 - Systems: Self-Administration of Meds: Facility failed to evaluate resident's ability to safely self-administer medications for 1 of 3 sampled residents. |
| C0370 - Staffing Requirements and Training – Pre-Serv: Facility failed to ensure all pre-service training was completed prior to job duties for 2 newly hired direct care staff and infectious disease training for 1 long term staff. |
| C0372 - Training Within 30 Days: Direct Care Staff: Facility failed to ensure 2 newly hired staff had documented competency demonstration within 30 days of hire. |
| C0374 - Annual and Biennial Inservice For All Staff: Facility failed to ensure 2 long term staff completed required annual in-service training including dementia training. |
| C0420 - Fire and Life Safety: Safety: Facility failed to ensure fire drills were conducted and documented every other month and fire and life safety instruction provided on alternate months. |
| C0422 - Fire and Life Safety: Training For Residents: Facility failed to ensure fire and life safety instruction was provided to residents upon move in and at least annually. |
| C0010 - Licensing Complaint Investigation: No deficiencies identified in relation to the complaint investigation conducted 02/16/2021. |
Report Facts
Inspections on page: 3
Total Surveys: 3
Total Deficiencies: 13
Licensing Violations: 20
Abuse Violations: 0
Notices: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff 1 | Executive Director | Named in multiple findings and acknowledgements across inspections |
| Staff 2 | Wellness Director/RN | Named in multiple findings and acknowledgements across inspections |
| Staff 14 | Regional RN | Named in multiple findings and acknowledgements across inspections |
| Staff 16 | Agency Caregiver | Interviewed in service plan deficiency |
| Staff 11 | Caregiver | Named in pre-service training deficiency |
| Staff 12 | Medication Technician | Named in pre-service training and annual training deficiencies |
| Staff 4 | Community Relations Director | Named in infectious disease training deficiency |
| Staff 6 | Medication Technician | Named in annual training deficiency |
| Staff 8 | Medication Technician | Named in annual training deficiency |
| Staff 9 | Medication Technician | Named in training within 30 days deficiency |
| Staff 10 | Medication Technician | Named in training within 30 days deficiency |
Loading inspection reports...
