Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Violation: CALMS - 00033045

Provider Information


Countryside Living Memory Care South

406 NW 2ND AVENUE
Canby, OR 97013

Provider ID
50R380
Administrator
STACY ZIMMERMAN
Phone
(503) 266-3031
Email
ed@countrysidelivingcanby.com

Violation Details


Date
10/1/2022
Report number
CALMS - 00033045
Type
Licensing Violation
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to submit timely or adequate staffing documentation
Result
Substantiated
Findings
On or about October 1, 2022, the Oregon Health Authority reported to the Department that Respondent failed to comply with weekly reporting requirements of vaccinated individuals, residents and staff, to the proper authority as required by law. This failure has been ongoing from September 1, 2022 to September 30, 2022, for a total of 30 days.
Sanction
RCFCP22-01682 $0.00 fine assessed