Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Inspection: WEJL

Provider Information


Dallas Retirement Village Assisted Living

340 NW BRENTWOOD ST
Dallas, OR 97338

Provider ID
70M018
Administrator
Kanoe Creech
Phone
(503) 831-0214
Email
kcreech@drvhome.com

Inspection Details


Date
3/16/2023
Event ID
WEJL
Inspection type(s)
Complaint Investig.
Deficiencies cited
2

Citation Details


C0010: Licensing Complaint Investigation


Visit Number
1
Visit Date
3/16/2023
Corrected Date
N/A
Details

Assisted Living and Residential Care Facilities must operate and provide services in compliance with all applicable State and local laws, regulations and codes.  This report reflects the findings of the complaint investigation conducted 03/16/2023.  The facility was evaluated for compliance with Oregon Administrative Rule 411, Division 54 and if applicable, Oregon Administrative Rule 411, Division 57.  The following deficiencies were identified:



Abbreviations possibly used in this document:


ADL:activities of daily living

bid:twice a day

CBG:capillary blood glucose or

blood sugar

cc:cubic centimeter

CG:caregiver

cm:centimeter

F:Fahrenheit

HH:Home Health

HS or hs:hour of sleep

LPN:Licensed Practical Nurse

MA:Medication Aide

MAR:Medication Administration

Record

MCCMemory Care Community

mg:milligram

ml:milliliter

O2 sats:oxygen saturation in the

blood

OT:Occupational Therapist

PT: Physical Therapist

PRN:as needed

qd:every day or daily

qid:four times a day

RN:Registered Nurse

SP:service plan

TAR:Treatment Administration

Record

tid:three times a day






























































































C0295: Infection Prevention & Control


Visit Number
1
Visit Date
3/16/2023
Corrected Date
N/A
Details

Based on observation, interview and record review, Compliance Specialist (CS) was unable to confirm that the facility failed visually observe the resident take the medication. Findings include but not limited to:


During an unannounced site visit on 03/16/2023, CS completed several walk throughs of the facility and did not see any medications on the floor outside of resident rooms or left in resident rooms. CS observed Staff #4 (S4) pass medications to two residents and S4 observed both residents take their medications.


During interview, S4 stated that they are required to observe all residents take their medications and that they have never seen a staff member leave medications at a resident's door.


A review of the facility's Medication& Treatment Pass/Administration Policy and Procedure dated 10/22 stated "observe the resident taking the medication/treatment."


These findings were reviewed with Staff #6-Staff #7 (S6-S7) on 03/16/2023.