Inspection Reports for Monarch Gardens Memory Care
984 Parkview Dr, Brookings, OR 97415, USA, OR, 97415
Back to Facility ProfileDeficiencies (last 3 years)
Deficiencies (over 3 years)
16.7 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
149% worse than Oregon average
Oregon average: 6.7 deficiencies/yearDeficiencies per year
20
15
10
5
0
Inspection Report
Routine
Capacity: 55
Deficiencies: 2
Jun 17, 2025
Visit Reason
Facility failed to maintain a clean and sanitary kitchen with multiple areas needing cleaning or repair. Issues included damaged flooring, debris on shelves, spills on refrigerator units, broken equipment, and dust accumulation. Administration compliance deficiencies were also noted.
Findings
Facility failed to maintain a clean and sanitary kitchen with multiple areas needing cleaning or repair. Issues included damaged flooring, debris on shelves, spills on refrigerator units, broken equipment, and dust accumulation. Administration compliance deficiencies were also noted.
Deficiencies (2)
| Description |
|---|
| OAR 411-054-0030 — Resident Services Meals, Food Sanitation Rule |
| OAR 411-057-0140 — Administration Compliance |
Inspection Report
Capacity: 55
Deficiencies: 20
May 15, 2024
Visit Reason
Multiple deficiencies related to food sanitation, administration compliance, resident evaluations, service plans, medication orders, fire and life safety, and staff training. Some deficiencies were corrected by the last revisit in January 2025, while others remained uncorrected.
Findings
Multiple deficiencies related to food sanitation, administration compliance, resident evaluations, service plans, medication orders, fire and life safety, and staff training. Some deficiencies were corrected by the last revisit in January 2025, while others remained uncorrected.
Deficiencies (20)
| Description |
|---|
| OAR 411-054-0030 — Resident Services Meals, Food Sanitation Rule |
| OAR 411-057-0140 — Administration Compliance |
| OAR 411-054-0455 — Inspections and Investigation: Insp Interval |
| OAR 411-054-0231 — Reporting & Investigating Abuse-Other Action |
| OAR 411-054-0252 — Resident Move-In and Eval: Res Evaluation |
| OAR 411-054-0260 — Service Plan: General |
| OAR 411-054-0270 — Change of Condition and Monitoring |
| OAR 411-054-0303 — Systems: Treatment Orders |
| OAR 411-054-0305 — Systems: Resident Right to Refuse |
| OAR 411-054-0330 — Systems: Psychotropic Medication |
| OAR 411-054-0420 — Fire and Life Safety: Safety |
| OAR 411-054-0422 — Fire and Life Safety: Training For Residents |
| OAR 411-054-0513 — Doors, Walls, Elevators, Odors |
| OAR 411-054-0555 — Call Sys, Exit Dr Alarm, Phones, Tv, Or Cable |
| OAR 411-057-0142 — Administration Compliance |
| OAR 411-057-0155 — Staff Training Requirements |
| OAR 411-057-0162 — Compliance With Rules Health Care |
| OAR 411-057-0163 — Nutrition and Hydration |
| OAR 411-057-0164 — Activities |
| OAR 411-057-0168 — Outside Area |
Inspection Report
Capacity: 55
Deficiencies: 18
Nov 28, 2023
Visit Reason
Change of ownership survey with multiple deficiencies including failure to investigate abuse incidents, incomplete resident move-in evaluations, inadequate service plans, medication administration errors, fire and life safety issues, and staff training deficiencies. Some deficiencies were corrected by the May 2024 revisit.
Findings
Change of ownership survey with multiple deficiencies including failure to investigate abuse incidents, incomplete resident move-in evaluations, inadequate service plans, medication administration errors, fire and life safety issues, and staff training deficiencies. Some deficiencies were corrected by the May 2024 revisit.
Deficiencies (18)
| Description |
|---|
| OAR 411-054-0000 — Comment |
| OAR 411-054-0231 — Reporting & Investigating Abuse-Other Action |
| OAR 411-054-0252 — Resident Move-In and Eval: Res Evaluation |
| OAR 411-054-0260 — Service Plan: General |
| OAR 411-054-0270 — Change of Condition and Monitoring |
| OAR 411-054-0303 — Systems: Treatment Orders |
| OAR 411-054-0305 — Systems: Resident Right to Refuse |
| OAR 411-054-0330 — Systems: Psychotropic Medication |
| OAR 411-054-0420 — Fire and Life Safety: Safety |
| OAR 411-054-0422 — Fire and Life Safety: Training For Residents |
| OAR 411-054-0513 — Doors, Walls, Elevators, Odors |
| OAR 411-054-0555 — Call Sys, Exit Dr Alarm, Phones, Tv, Or Cable |
| OAR 411-057-0142 — Administration Compliance |
| OAR 411-057-0155 — Staff Training Requirements |
| OAR 411-057-0162 — Compliance With Rules Health Care |
| OAR 411-057-0163 — Nutrition and Hydration |
| OAR 411-057-0164 — Activities |
| OAR 411-057-0168 — Outside Area |
Inspection Report
Capacity: 55
Deficiencies: 3
Apr 5, 2023
Visit Reason
Kitchen inspection identified multiple sanitation and repair issues including food spills, debris, damaged flooring, and equipment in need of repair or replacement. Administration compliance deficiencies were also noted. Some deficiencies were corrected by the August 2023 revisit.
Findings
Kitchen inspection identified multiple sanitation and repair issues including food spills, debris, damaged flooring, and equipment in need of repair or replacement. Administration compliance deficiencies were also noted. Some deficiencies were corrected by the August 2023 revisit.
Deficiencies (3)
| Description |
|---|
| OAR 411-054-0000 — Comment |
| OAR 411-054-0240 — Resident Services Meals, Food Sanitation Rule |
| OAR 411-057-0142 — Administration Compliance |
Inspection Report
Complaint Investigation
Capacity: 55
Deficiencies: 2
Apr 4, 2023
Visit Reason
Complaint investigation identified deficiencies related to licensing complaint investigation and acuity-based staffing tool. Both deficiencies were not corrected as of the inspection date.
Findings
Complaint investigation identified deficiencies related to licensing complaint investigation and acuity-based staffing tool. Both deficiencies were not corrected as of the inspection date.
Deficiencies (2)
| Description |
|---|
| OAR 411-054-0010 — Licensing Complaint Investigation |
| OAR 411-054-0361 — Acuity-Based Staffing Tool |
Inspection Report
Complaint Investigation
Capacity: 55
Deficiencies: 5
Apr 4, 2023
Visit Reason
Unannounced complaint investigation found no deficiencies related to the complaint. Additional deficiencies related to change of condition, medications, and treatments were identified and not corrected as of the inspection date.
Findings
Unannounced complaint investigation found no deficiencies related to the complaint. Additional deficiencies related to change of condition, medications, and treatments were identified and not corrected as of the inspection date.
Deficiencies (5)
| Description |
|---|
| OAR 411-054-0010 — Licensing Complaint Investigation |
| OAR 411-054-0270 — Change of Condition and Monitoring |
| OAR 411-054-0300 — Systems: Medications and Treatments |
| OAR 411-054-0301 — Systems: Medication Administration |
| OAR 411-054-0303 — Systems: Treatment Orders |
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