Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Violation: 00006992AP-005309

Provider Information


Kellyville RCF

12221 SE KELLY STREET
Portland, OR 97236

Provider ID
50R454
Administrator
Maricel Asa
Phone
(503) 954-2561
Email
maricel@kellyvillercfpdx.com

Violation Details


Date
6/11/2018
Report number
00006992AP-005309
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide or maintain resident care equipment
Result
Substantiated
Findings
The facility neglected AV as defined in OAR 4110200002(1)(b)(A)(i) byfailing to follow doctors orders, which resulted in risk of serious harm.
Sanction
RCFCP19-116 $250.00 fine assessed