Aging and People with Disabilities
Safety, Oversight and Quality
Print Violation: CALMS - 00037207
Provider Information
Providence Cully Residential Care
5119 NE 57TH AVE
Portland, OR 97218
- Provider ID
- 50R321
- Administrator
- TARA WAGNER-YOSHIWARA
- Phone
- (503) 215-8050
- tara.wagner-yoshiwara@providence.org
Violation Details
- Date
- 1/18/2023
- Report number
- CALMS - 00037207
- Type
- Licensing Violation
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to submit timely or adequate staffing documentation
- Result
- Substantiated
- Rule(s) Violated
-
External site: 411-061-0010(2)
- Findings
- On or about January 18, 2023, 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 December 1, 2022, to December 31, 2022, for a total of 30 days.