Aging and People with Disabilities
Safety, Oversight and Quality
Print Violation: 00220670-AP-179441
Provider Information
Countryside Living Memory Care South
406 NW 2ND AVENUE
Canby, OR 97013
- Provider ID
- 50R380
- Administrator
- STACY ZIMMERMAN
- Phone
- (503) 266-3031
- ed@countrysidelivingcanby.com
Violation Details
- Date
- 9/10/2022
- Report number
- 00220670-AP-179441
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to properly plan care
- Result
- Substantiated
- Rule(s) Violated
-
External site: 411-054-0027(1)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0036(2)(g)
- Findings
- The facility failed to implement interventions and provide appropriate supervision related to the Alleged Victim’s (AV) known history of falls. The failure resulted in AV experiencing an unwitnessed fall on or about September 10, 2022, causing unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
- Sanction
- RCFCP23-00048 $250.00 fine assessed