Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Violation: 00038816AP-027271

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
7/7/2019
Report number
00038816AP-027271
Type
Abuse: Neglect
Level
3 - Moderate harm or potential for serious harm
Allegation
Failed to follow care plan
Result
Substantiated
Findings
OAR 4110200002 (1)(b)(A)(ii) Neglect: Facility self reported that on 7/7/2019 @ 04:05 AV was found in his/her room with an injury to his/her head.
Sanction
RCFCP20-0115 $375.00 fine assessed