Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Violation: 00030302AP-021378

Provider Information


Providence Irvington Village Assisted Living

420 NE MASON
Portland, OR 97211

Provider ID
70A271
Administrator
Stephanie Simmons
Phone
(503) 546-9292
Email
stephanie.simmons@providence.org

Violation Details


Date
5/5/2019
Report number
00030302AP-021378
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide safe environment
Result
Substantiated
Findings
The facility neglected AV as defined in OAR 4110200002(1)(b)(A)(i) by failing to provide basic care or services to maintain the health and safety of AV after AV was sprayed with pepper mace causing pain and agony.
Sanction
ALFCP19-325 $375.00 fine assessed