Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Violation: CALMS - 00035601

Provider Information


Maple Grove Memory Care

17309 NE GLISAN
Portland, OR 97230

Provider ID
5MA223
Administrator
Charity Jammeh
Phone
(503) 253-4920
Email
charity.jammeh@sincerisl.com

Violation Details


Date
12/1/2022
Report number
CALMS - 00035601
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 December 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 November 1, 2022, to November 30, 2022, for a total of 30 days.
Sanction
RCFCP22-01855 $0.00 fine assessed