Provider Details - Providence Cully Residential Care
5119 NE 57TH AVE
Portland, OR 97218
- Administrator name
- TARA WAGNER-YOSHIWARA
- ID
- 50R321
- Status
- Open
- Type
- Residential Care Facility
- Licensed beds
- 42
- Accepts Medicaid
- No
- Memory Care
- No
- Owner
-
Providence Health & Services-Oregon
1801 LIND AVENUE SW
Renton, 98057
- Owner since
- 12/31/2009
If you have questions about this provider or its inspection and compliance history, please contact the provider at the phone number listed above.
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.
| Date | Event ID | Inspection type(s) Inspection type(s) | Deficiencies cited | Actions | |
|---|---|---|---|---|---|
| 4/30/2026 | RL011498 | Re-Licensure | 12 | ||
| 12/18/2024 | KIT001740 | Kitchen | 1 | ||
| 1/11/2024 | QLS0 | State Licensure | 0 | ||
| 2/6/2023 | 53X2 | Validation | 14 | ||
| 1/12/2023 | 5RDR | State Licensure | 0 |
Records that are highlighted and show the icon, occurred under the current provider owner.
| Date | Report number Report number | Allegation | Level | Type | Actions | |
|---|---|---|---|---|---|---|
| 9/24/2023 | 00296815-AP-250438 | Failed to provide a safe medication administration system | 3 | Abuse: Neglect | ||
| 12/10/2017 | BC185520 | Failed to provide safe environment | 2 | Abuse: Financial abuse | ||
| 12/3/2017 | BC174930 | Failed to provide safe environment | 2 | Abuse: Financial abuse |
Records that are highlighted and show the icon, occurred under the current provider owner.
| Date | Report number Report number | Allegation | Level | Type | Actions | |
|---|---|---|---|---|---|---|
| 8/30/2024 | CALMS - 00106324 | Failed to update staffing plan based on ABST | 2 | Licensing Violation | ||
| 8/17/2024 | 00351701-AP-302030 | Failed to protect resident from physical abuse | 2 | Licensing Violation | ||
| 1/18/2023 | CALMS - 00037207 | Failed to submit timely or adequate staffing documentation | 2 | Licensing Violation | ||
| 4/30/2012 | BC129951 | Failed to administer medication as ordered | 2 | Licensing Violation |
Records that are highlighted and show the icon, occurred under the current provider owner.
| Sanction Sanction | Allegation | Type | Effective date | End date | Actions | |
|---|---|---|---|---|---|---|
| RCFCD26-00562 | Failed to provide safe environment | License Condition | 5/29/2026 | 7/21/2026 |
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