Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

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Print Violation: OR0002135202

Provider Information


Kellyville RCF

12221 SE KELLY STREET
Portland, OR 97236

Provider ID
50R454
Administrator
Maricel Asa
Phone
(503) 954-2561
Email
maricel@kellyvillercfpdx.com

Violation Details


Date
10/4/2019
Report number
OR0002135202
Type
Licensing Violation
Level
1 - No harm or potential for minor harm
Allegation
Failed to provide appropriate staffing
Result
Substantiated
Findings