Print Violation: 00222027-AP-180754

Provider Information

Countryside Living Memory Care South

406 NW 2ND AVENUE
Canby, OR 97013

Date: 9/18/2022
Report number: 00222027-AP-180754
Type: Licensing Violation
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)(a) and (b)
Findings: On or about September 18, 2022, Alleged Perpetrator 2 (AP2) wheeled Alleged Victim (AV) into his/her room, left AV in his/her wheelchair, closed AV's bedroom door, and did not provide safety checks on AV between 12:27am and 4:12am. Based on facility documentation and interviews, AV has a history of slipping out of AV's wheelchair. AP2's actions placed AV at risk of harm and is considered neglect of care which constitutes abuse. The facility's failure to provide AV a safe environment is a violation of Oregon Administrative Rules.