Print Violation: CALMS - 00108258

Provider Information

Dallas Retirement Village Memory Care Center

377 NW JASPER ST
Dallas, OR 97338

Date: 12/17/2024
Report number: CALMS - 00108258
Type: Licensing Violation
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to administer medication as ordered
Result: Substantiated
Rule(s) Violated: 411-054-0055(1)(a) and (f)
Findings: On April 1, 2026, the ODHS Licensing Complaint Unit (LCU) conducted an investigation. The facility’s failure to administer medications as prescribed was substantiated for Residents #1, #2, and #6. Resident #1’s Medication Administration Record (MAR) dated December 17, 2024, indicated the resident did not receive the scheduled 8:00 p.m. doses of Melatonin and Mirtazapine. Resident #2’s MAR dated December 17, 2024, showed the resident did not receive the scheduled 8:00 p.m. doses of Caltrate and Vitamin D3. Resident #6’s MAR dated December 17, 2024, reflected the resident did not receive the scheduled 8:00 p.m. doses of Tamsulosin and Senna. The investigation concluded that these findings constitute violations of Oregon Administrative Rules.