Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Violation: OR0004713600

Provider Information


Pacific Grove Senior Living Community

2112 OAK ST
Forest Grove, OR 97116

Provider ID
70M035
Administrator
Lisa Vincent
Phone
(503) 359-1002
Email
aled@pacificgroveslc.com

Violation Details


Date
12/25/2023
Report number
OR0004713600
Type
Licensing Violation
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide social services
Result
Substantiated
Findings
Based on interview and record review, conducted during a site visit on 02/07/24 through 02/15/24, it was confirmed the facility failed to provide relevant information to an outside provider for 1 of 1 sampled resident (# 5). During an interview on 02/09/24, Resident 5 stated s/he had been taken to the emergency room on 12/25/23. On 12/25/23, Staff called EMS for Resident 5 and was only able to print a face sheet for medical responders and were unable to print MARs. It was determined the facility failed to provide relevant information to an outside provider.