Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Inspection: QL1R

Provider Information


Applegate Place

1465 EAST CENTRAL
Sutherlin, OR 97479

Provider ID
70M022
Administrator
REGAN TUCKER
Phone
(541) 459-6300
Email
director@applegateplace.net

Inspection Details


Date
10/4/2023
Event ID
QL1R
Inspection type(s)
Complaint Investig.
Deficiencies cited
6

Citation Details


C0010: Licensing Complaint Investigation


Visit Number
1
Visit Date
10/4/2023
Corrected Date
N/A
Details



The findings of the on-site investigation, conducted 10/04/23 through 10/04/23, 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.


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



C0200: Resident Rights and Protection - General


Visit Number
1
Visit Date
10/4/2023
Corrected Date
N/A
Details

The findings of the on-site investigation, conducted 10/04/23 through 10/04/23, 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.


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







C0231: Reporting & Investigating Abuse-Other Action


Visit Number
1
Visit Date
10/4/2023
Corrected Date
N/A
Details

The findings of the on-site investigation, conducted 10/04/23 through 10/04/23, 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.


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








C0260: Service Plan: General


Visit Number
1
Visit Date
10/4/2023
Corrected Date
N/A
Details

The findings of the on-site investigation, conducted 10/04/23 through 10/04/23, 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.


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


Visit Number
1
Visit Date
10/4/2023
Corrected Date
N/A
Details

The findings of the on-site investigation, conducted 10/04/23 through 10/04/23, 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.


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






C0370: Staffing Requirements and Training – Pre-Serv


Visit Number
1
Visit Date
10/4/2023
Corrected Date
N/A
Details

The findings of the on-site investigation, conducted 10/04/23 through 10/04/23, 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.


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