Print Inspection: B86J

Provider Information

Brookstone Alzheimer's Special Care Center

5881 WOODSIDE DR SE
Salem, OR 97306

Provider ID: 5MA151
Administrator: BRANDY KHLYSTOV
Phone: (503) 316-0687
Email: brandy.khlystov@sincerisl.com

Inspection Details

Date: 7/20/2023
Event ID: B86J
Inspection type(s): Licensure Complaint
Deficiencies cited: 2

Citation Details

C0010: Licensing Complaint Investigation

Visit Number

Visit Date

7/20/2023

Corrected Date

N/A

Details

The findings of the on-site investigation conducted 07/20/2023 and 07/13/2023 are documented in this report. The investigation was conducted to determine compliance with the OARs 411 Division 54 for Residential Care and Assisted Living Facilities, OARs 411 Division 57 for Memory Care Communities.

Abbreviations possibly used in this document:

ADL:activities of daily living

CBG:capillary blood glucose or blood sugar

CG:caregiver

CS: Compliance Specialist

cm:centimeter

ED:Executive Director

F:Fahrenheit

HH:Home Health

LPN:Licensed Practical Nurse

MT: Medication Tech

MAR:Medication Administration Record

MCC:Memory Care Community

OT:Occupational Therapist

PT: Physical Therapist

PRN:as needed

RCC:Resident Care Coordinator

RN:Registered Nurse

C0361: Acuity-Based Staffing Tool