Aging and People with Disabilities
Safety, Oversight and Quality
Print Violation: 00225340-AP-183824
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
- 10/10/2022
- Report number
- 00225340-AP-183824
- Type
- Licensing Violation
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to provide a safe medication administration system
- Result
- Substantiated
- Rule(s) Violated
-
External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0055(1)(a) and (f)
- Findings
- Alleged Perpetrator 2 (AP2) neglected Alleged Victim (AV) by failing to administer AV's medication as ordered which placed AV a risk of potential harm. AP2's actions is considered neglect of care which constitutes abuse. The facility failed to provide a safe medication administration system for AV which is a violation of Oregon Administrative Rules.