Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Violation: 00009425AP-006825A

Provider Information


Pacific Grove Memory Care

3334 22ND AVE
Forest Grove, OR 97116

Provider ID
5MA242
Administrator
Amanda Hatcher
Phone
(503) 359-1002
Email
mced@pacificgroveslc.com

Violation Details


Date
12/1/2018
Report number
00009425AP-006825A
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide a safe medication administration system
Result
Substantiated
Findings
Neglect of Care AP1 neglected AV as defined in OAR 4110200002(1)(b)(A)(i) by failing to provide a safe environment to AV as ordered, which resulted in risk of serious harm.