Print Violation: 00312847-AP-265311

Provider Information

Pacific Grove Memory Care

3334 22ND AVE
Forest Grove, OR 97116

Date: 2/13/2024
Report number: 00312847-AP-265311
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)
External site: 411-054-0027(1)(g) and (s)
External site: 411-054-0028(2)
Findings: On February 13, 2024, medical transport came to the facility to pick up Alleged Victim (AV) from the locked facility. Witness 4 (W4) called Alleged Perpetrator 2 (AP2) to verify whether AV could leave, and AP2 told W4 to allow AV to leave to h/h appointment. At approximately 10am, the clinic called the facility to see who was picking AV up as AV did not have an appointment. Medical transport was called to pick AV up, but when transport arrived, AV was not at clinic. AV was later found by LEA and brought back to the facility. AP2 and The facility failed to provide a safe environment, which is a violation of Oregon Administrative Rules.