Aging and People with Disabilities
Safety, Oversight and Quality
Print Violation: 00055794AP-039255
Provider Information
Kellyville RCF
12221 SE KELLY STREET
Portland, OR 97236
- Provider ID
- 50R454
- Administrator
- Maricel Asa
- Phone
- (503) 954-2561
- maricel@kellyvillercfpdx.com
Violation Details
- Date
- 9/29/2019
- Report number
- 00055794AP-039255
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to administer medication as ordered
- Result
- Substantiated
- Rule(s) Violated
-
External site: 411-054-0027(1)(f)
External site: 411-054-0028(2)
External site: 411-054-0055(1)(a) and (f)
- Findings
- The facility neglected AV as defined in OAR 4110200002(1)(b)(A)(i) by failing to administer medications to AV as ordered, which resulted in pain and discomfort.
- Sanction
- RCFCP20-0199 $250.00 fine assessed