Print Regulatory Action: CALMS - 00026765

Provider Information

Pine Rose

475 S SHASTA PL
Burns, OR 97720

Effective date: 4/11/2022
End date: 1/24/2023
Reference number: CALMS - 00026765
Allegation: Failed to provide safe environment
Description: Re-Licensure Survey #PMV311 on March 31, 2022 determined that the facility was not in substantial compliance with Oregon Administrative Rules and that the failure to comply with DHS rules and the number of citations in the Re-Licensure survey, places residents at risk of serious harm.
Rule(s) Violated: 411-054-0025(1)(a) and (b), (4), (5)(b) and (c) and (9)
411-054-0028(1) and (2)
411-054-0030(1)(a)(C), (c) and (d)
411-054-0034(2) and (3)
411-054-0036(2) and (4)
411-054-0040(1) and (2)
411-054-0045(1)(f)(A), (2)(a)
411-054-0055(1)(a), (f) and (g), (2)(a), (b)(C) and (E)
411-054-0065(1)
411-054-0070(1)(a), (f) and (g), (2), (3)(a), (4)(a-c), (6)(a), (b)(A-E) and (G)
411-054-0090(1) and (5)
411-054-0200(3)(a), (c) and (e), (4)(e)(B), (f), (h), and (i), (7)(d)(A) and (B), (9)(a), and (11)(a) and (
Findings: Facility failed to provide a safe environment
Sanction: RCFCD22-00712