Provider Details - Pitisi Moalaeua
23196 SW MANSFIELD STREET
Sherwood, OR 97140
- Administrator name
- Pitisi Moalaeua
- ID
- 516276
- Status
- Open
- Type
- Adult Foster Home
- Classification
- 3
- Licensed beds
- 5
- Accepts Medicaid
- Yes
- Memory Care
- No
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 | |
|---|---|---|---|---|---|
| 2/12/2026 | RL009612 | Re-Licensure | 20 | ||
| 1/2/2025 | RL001963 | Re-Licensure | 13 | ||
| 12/21/2023 | QHQP | Re-Licensure | 19 | ||
| 6/9/2023 | K8V6 | Complaint Investig. | 2 | ||
| 6/22/2022 | 7D6W | Complaint Investig. | 0 | ||
| 6/10/2022 | K8LK | Complaint Investig. | 0 | ||
| 5/26/2022 | 30MU | Complaint Investig. | 1 | ||
| 5/24/2022 | 4ZF0 | Complaint Investig. | 5 | ||
| 3/10/2022 | C4MS | Validation | 5 |
Records that are highlighted and show the icon, occurred under the current provider owner.
| Date | Report number Report number | Allegation | Level | Type | Actions | |
|---|---|---|---|---|---|---|
| 6/14/2021 | 00144644-AP-114204 | Failed to protect resident from physical abuse | 3 | Abuse: Neglect |
Records that are highlighted and show the icon, occurred under the current provider owner.
| Date | Report number Report number | Allegation | Level | Type | Actions | |
|---|---|---|---|---|---|---|
| 1/2/2025 | CALMS - 00070504 | Failed to make facility or resident records accessible | 3 | Licensing Violation | ||
| 1/2/2025 | CALMS - 00070503 | Failed to make facility or resident records accessible | 3 | Licensing Violation | ||
| 1/2/2025 | CALMS - 00070501 | Failed to hire according to administrative rules | 3 | Licensing Violation | ||
| 1/2/2025 | CALMS - 00070502 | Failed to assure a qualified caregiver was present | 3 | Licensing Violation | ||
| 1/2/2025 | CALMS - 00070500 | Failed to assure a qualified caregiver was present | 3 | Licensing Violation | ||
| 12/21/2023 | CALMS - 00051668 | Failed to provide a safe medication administration system | 3 | Licensing Violation | ||
| 5/26/2022 | CALMS - 00028647 | Failed to answer call light in a timely manner | 1 | Licensing Violation | ||
| 3/10/2022 | CALMS - 00026067 | Failed to hire according to administrative rules | 1 | Licensing Violation | ||
| 3/11/2021 | CALMS - 00016109 | Failed to provide safe environment | 3 | Licensing Violation | ||
| 11/8/2019 | CO19681 | Failed to provide a safe medication administration system | 3 | 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 | |
|---|---|---|---|---|---|---|
| AFHCD20-00031 | License Condition | 3/19/2020 | 5/1/2020 |