Aging and People with Disabilities
Safety, Oversight and Quality
Print Inspection: GRX0
Provider Information
2112 OAK ST
Forest Grove, OR 97116
- Provider ID
- 70M035
- Administrator
- Lisa Vincent
- Phone
- (503) 359-1002
- aled@pacificgroveslc.com
Inspection Details
- Date
- 2/7/2024
- Event ID
- GRX0
- Inspection type(s)
- Complaint Investig.
- Deficiencies cited
- 17
Citation Details
C0150: Facility Administration: Operation
- Scope
- L2 Widespread
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0154: Facility Administration: Policy & Procedure
- Scope
- L2 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0155: Facility Administration: Records
- Scope
- L3 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0200: Resident Rights and Protection - General
- Scope
- L2 Widespread
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0231: Reporting & Investigating Abuse-Other Action
- Scope
- L4 Pattern
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0243: Resident Services: Adls
- Scope
- L2 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0260: Service Plan: General
- Scope
- L3 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0270: Change of Condition and Monitoring
- Scope
- L4 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0290: Res Hlth Srvc: On- and Off-Site Health Srvc
- Scope
- L3 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0295: Infection Prevention & Control
- Scope
- L3 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0300: Systems: Medications and Treatments
- Scope
- L3 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0301: Systems: Medication Administration
- Scope
- L2 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0302: Systems: Tracking Control Substances
- Scope
- L3 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0303: Systems: Treatment Orders
- Scope
- L3 Widespread
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0360: Staffing Requirements and Training: Staffing
- Scope
- L3 Widespread
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0361: Acuity-Based Staffing Tool
- Scope
- L2 Widespread
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-
C0450: Inspections and Investigations
- Scope
- L2 Isolated
- Visit Number
- 1
- Visit Date
- 2/15/2024
- Corrected Date
- N/A
- Details
-