Aging and People with Disabilities
Safety, Oversight and Quality
Print Violation: 00145665-AP-115089
Provider Information
Countryside Living Memory Care
390 NW 2ND AVE
Canby, OR 97013
- Provider ID
- 50R283
- Administrator
- STACY ZIMMERMAN
- Phone
- (503) 266-3031
- ed@countrysidelivingcanby.com
Violation Details
- Date
- 3/31/2021
- Report number
- 00145665-AP-115089
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to provide safe environment
- Result
- Substantiated
- Rule(s) Violated
-
External site: 411-054-0025(1)(b)
External site: 411-054-0027(1)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0036(2)(g)
- Findings
- On or about March 28, 2021, Alleged Perpetrator 2 (AP2) gave Alleged Victim (AV) another resident's medication. An investigation determined that AP2 did not follow the five (5) rights of medication administration and admitted to giving AV another resident's medication. AP2's action is considered neglect of care which constitutes abuse. AV is care planned as a moderate fall risk and having poor safety awareness. An investigation determined that facility records did not address interventions for AV's risk of falls and facility records did not address interventions for AV's behaviors to refuse to care. The facility failed to properly care plan for AV which is a violation of resident rights, is considered neglect of care and constitutes abuse. As the new owner of this facility, you are responsible for correcting any deficiencies which pre-date your ownership. You must correct violations which occurred under previous ownership, as directed by the Department. You will not be responsible for paying civil penalties incurred by previous owner(s). However, if you fail to correct identified deficiencies within the specified time you may be subject to aggravated civil penalties.