Provider Details - Forest Glen Senior Living | Licensed Long-Term Care Settings Search

Forest Glen Senior Living

200 SW FRONTAGE RD
Canyonville, OR 97417

(541) 839-4266

louise.cousins@forestglenseniorresidence.com

ID: 50M209
Status: Closed
Type: Residential Care Facility
Licensed beds: 0
Accepts Medicaid: Yes
Memory Care: No

This provider was closed on 5/19/2023.

If you have questions about this provider or its inspection and compliance history, please contact the provider at the phone number listed above.

Review Consumer Statements

This tab displays five years of inspection history. For inspection information older than five years, please visit ODHS Records Request .
To learn more about inspections see: Provider Information

Records that are highlighted and show the icon, occurred under the current provider owner.

Inspections
	Date Date From To	Event ID	Inspection type(s) Inspection type(s)	Deficiencies cited Deficiencies cited Between And	Actions
	12/12/2022	L9M5	State Licensure	2
	10/20/2022	DEPM	Complaint Investig.	1

2 records found

This list shows confirmed (substantiated) instances of abuse from 2010 onward. Open investigations and complaints that are being appealed by the provider are not listed. To learn more about abuse definitions, see: Definitions of Abuse

Records that are highlighted and show the icon, occurred under the current provider owner.

Abuse violations
Date Date From To	Report number Report number	Allegation Allegation Failed to address resident's behavior Failed to adequately care plan related to falls Failed to administer medication as ordered Failed to answer call light in a timely manner Failed to assist with eating Failed to assure timely medical treatment Failed to care plan in accordance with assessment Failed to follow care plan Failed to have medication available Failed to intervene when resident's condition changed Failed to keep medication record current or accurate Failed to properly plan care Failed to protect resident from rough treatment Failed to provide a safe medication administration system Failed to provide or assist with hygiene Failed to provide safe environment Failed to provide service	Level Level Between And	Type Type Abuse: Financial abuse Abuse: Neglect Abuse: Physical Abuse
3/31/2023	00255242-AP-210753	Failed to provide safe environment	2	Abuse: Neglect
8/7/2020	00096793-AP-073286	Failed to provide a safe medication administration system	2	Abuse: Neglect
8/6/2020	00096592-AP-073147	Failed to provide safe environment	2	Abuse: Neglect
5/11/2018	RS187995	Failed to administer medication as ordered	3	Abuse: Neglect
5/9/2018	RS187885	Failed to provide a safe medication administration system	2	Abuse: Neglect
12/14/2016	RS168860	Failed to provide safe environment	2	Abuse: Neglect
10/20/2016	RS168051B	Failed to intervene when resident's condition changed	4	Abuse: Neglect
7/12/2016	RS166756	Failed to provide a safe medication administration system	2	Abuse: Neglect
5/3/2016	RS165739	Failed to provide service	2	Abuse: Neglect
10/12/2015	RS153156	Failed to properly plan care	2	Abuse: Neglect

32 records found | Page 1 of 4

This list shows confirmed (substantiated) licensing violations from 2010 onward. Open investigations and complaints that are being appealed by the provider are not listed.

Records that are highlighted and show the icon, occurred under the current provider owner.

Licensing violations
Date Date From To	Report number Report number	Allegation Allegation Failed to administer medication as ordered Failed to assist with dressing or grooming Failed to assist with toileting Failed to assure food safety Failed to assure physician services Failed to assure resident rights Failed to assure resident was safe Failed to control pests Failed to follow care plan Failed to have medication available Failed to keep medication record current or accurate Failed to keep resident record current or accurate Failed to maintain a safe physical environment Failed to obtain medical order Failed to provide a safe medication administration system Failed to provide appropriate housekeeping services Failed to provide appropriate pain control Failed to provide appropriate staffing Failed to provide or maintain resident care equipment Failed to provide proper food/nutrition Failed to provide safe environment Failed to provide service Failed to provide transportation for medical or social purposes Failed to report potential or suspected abuse	Level Level Between And	Type Type Licensing Violation
2/15/2023	00247144-AP-203226	Failed to provide a safe medication administration system	2	Licensing Violation
10/14/2022	OR0003827801	Failed to control pests	3	Licensing Violation
9/3/2022	00219413-AP-178314	Failed to provide a safe medication administration system	2	Licensing Violation
6/7/2022	OR0003621400	Failed to provide proper food/nutrition	2	Licensing Violation
4/19/2022	OR0003542300	Failed to provide safe environment	2	Licensing Violation
12/15/2021	OR0003352101	Failed to maintain a safe physical environment	1	Licensing Violation
12/15/2021	OR0003352100	Failed to maintain a safe physical environment	1	Licensing Violation
10/27/2021	OR0003282400	Failed to provide appropriate staffing	1	Licensing Violation
8/18/2021	OR0003171800	Failed to provide safe environment	1	Licensing Violation
7/23/2021	OR0003124102	Failed to provide safe environment	1	Licensing Violation

70 records found | Page 1 of 7

Formal regulatory actions can range from a condition placed upon a license due to non-compliance or a notice to revoke a license. This section of the website currently displays only license conditions dating back to 2010 and no other types of regulatory action. Additional records will be added over time as resources allow.

Records that are highlighted and show the icon, occurred under the current provider owner.

Regulatory actions
	Sanction Sanction	Allegation Allegation Failed to control pests Failed to provide safe environment	Type Type License Condition	Effective date Effective date From To	End date End date From To	Actions
	RCFCD22-01530	Failed to control pests	License Condition	10/21/2022	5/22/2023
	RCFCD20-01441	Failed to provide safe environment	License Condition	12/3/2020	4/27/2021

2 records found

The Oregon Department of Human Services publishes annual reports about assisted living and residential care facilities, including those with memory care endorsements. The reports show how facilities are doing in areas like staffing, safety, and resident experience.

Facilities submit this information once each year using an online reporting tool. The results reflect how each facility operated during that year. The information is self-reported by facilities and is not independently audited by the department. This means the reports show what facilities report about their own performance.

Each year, assisted living and residential care facilities must report information on:

Retention of direct care staff
Compliance with staff training requirements
Number of resident falls that result in injury
Incidence of use of antipsychotic medications for non-standard purposes
Results of an annual resident satisfaction survey conducted by an independent entity

Facilities submit this information electronically each year. Reporting began in 2020. Instructions and definitions are updated annually and published on the Residential Care Quality Metrics Program web page

Provider Details - Forest Glen Senior Living

About these reports

Annual reporting requirements

Available reports

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