Provider Details - Stacy Lewitzke
4598 WARD DR NE
Salem, OR 97305
- Administrator name
- Stacy Lewitzke
- ID
- 7728723110
- Status
- Open
- Type
- Adult Foster Home
- Classification
- 2
- 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 | |
|---|---|---|---|---|---|
| 12/1/2023 | X8YU | Re-Licensure | 0 | ||
| 4/28/2023 | K8R8 | Other | 0 | ||
| 11/28/2022 | 5H21 | Re-Licensure | 3 | ||
| 3/11/2022 | ZOR6 | Other | 4 | ||
| 1/11/2022 | SSER | Other | 9 | ||
| 11/12/2021 | 2J9T | Re-Licensure | 9 | ||
| 9/24/2021 | E48D | Other | 0 |
Records that are highlighted and show the icon, occurred under the current provider owner.
| Date | Report number Report number | Allegation | Level | Type | Actions | |
|---|---|---|---|---|---|---|
| 5/14/2021 | 00139652-AP-109955 | Failed to provide safe environment | 2 | Abuse: Neglect | ||
| 1/10/2021 | 00124514-AP-096833 | Failed to administer medication as ordered | 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 | |
|---|---|---|---|---|---|---|
| 11/28/2022 | CALMS - 00035725 | Failed to provide safe environment | 3 | Licensing Violation | ||
| 1/11/2022 | CALMS - 00024043 | Failed to assure a qualified caregiver was present | 3 | Licensing Violation | ||
| 11/12/2021 | CALMS - 00023211 | Failed to provide a safe medication administration system | 3 | Licensing Violation | ||
| 7/28/2021 | CALMS - 00018135 | Failed to properly plan care | 2 | Licensing Violation | ||
| 6/1/2021 | CALMS - 00016064 | Failed to administer medication as ordered | 3 | Licensing Violation | ||
| 3/8/2021 | CALMS - 00016106 | Failed to provide a safe medication administration system | 2 | Licensing Violation | ||
| 1/26/2021 | CALMS - 00011319 | Falsified records | 3 | Licensing Violation | ||
| 1/26/2021 | CALMS - 00014572 | Failed to keep resident record current or accurate | 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 | |
|---|---|---|---|---|---|---|
| AFHCD21-00335 | Failed to administer medication as ordered | License Condition | 3/2/2021 | 10/15/2021 |