Provider Details - Olepa Polataivao
3499 DELTA WATERS ROAD
Medford, OR 97504
- Administrator name
- Olepa Polataivao
- ID
- 518447
- Status
- Open
- Type
- Adult Foster Home
- Classification
- 3
- Licensed beds
- 5
- Accepts Medicaid
- Yes
- Memory Care
- No
- Owner
-
Olepa Polataivao
3499 DELTA WATERS ROAD
Medford, 97504
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 | |
|---|---|---|---|---|---|
| 9/5/2025 | RL006694 | Re-Licensure | 8 | ||
| 9/11/2024 | RL000381 | Re-Licensure | 7 | ||
| 2/13/2024 | C05K | Licensure Complaint | 0 | ||
| 9/21/2023 | 8GN8 | Re-Licensure | 9 | ||
| 9/14/2022 | IS1U | Re-Licensure | 5 | ||
| 8/8/2022 | MKW5 | Re-Licensure | 4 | ||
| 1/27/2022 | RU6V | Other | 1 | ||
| 10/6/2021 | M282 | State Licensure | 4 |
Records that are highlighted and show the icon, occurred under the current provider owner.
| Date | Report number Report number | Allegation | Level | Type | Actions | |
|---|---|---|---|---|---|---|
| 8/17/2022 | 00216803-AP-175862 | Failed to assure resident rights | 3 | Abuse: Neglect | ||
| 11/17/2016 | MS168454 | Failed to provide safe environment | 3 | Abuse: Neglect | ||
| 1/12/2011 | MS116122 | Failed to follow care plan | 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 | |
|---|---|---|---|---|---|---|
| 9/5/2025 | CALMS - 00090568 | Failed to properly secure or store medication | 3 | Licensing Violation | ||
| 9/5/2025 | CALMS - 00090565 | Failed to keep medication record current or accurate | 3 | Licensing Violation | ||
| 9/5/2025 | CALMS - 00090564 | Failed to keep medication record current or accurate | 3 | Licensing Violation | ||
| 9/5/2025 | CALMS - 00090569 | Failed to have medication available | 3 | Licensing Violation | ||
| 9/5/2025 | CALMS - 00090570 | Failed to assure a qualified caregiver was present | 3 | Licensing Violation | ||
| 9/5/2025 | CALMS - 00090567 | Failed to assure a qualified caregiver was present | 3 | Licensing Violation | ||
| 9/5/2025 | CALMS - 00090566 | Failed to assure a qualified caregiver was present | 3 | Licensing Violation | ||
| 9/11/2024 | CALMS - 00063988 | Failed to provide a safe medication administration system | 3 | Licensing Violation | ||
| 9/11/2024 | CALMS - 00063987 | Failed to properly secure or store medication | 3 | Licensing Violation | ||
| 9/11/2024 | CALMS - 00063989 | Failed to maintain a safe physical environment | 3 | Licensing Violation |
| Sanction Sanction | Allegation | Type | Effective date | End date | Actions | |
|---|---|---|---|---|---|---|
| No Results Found | ||||||