Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Violation: OR0004751100

Provider Information


Pacific Grove Memory Care

3334 22ND AVE
Forest Grove, OR 97116

Provider ID
5MA242
Administrator
Amanda Hatcher
Phone
(503) 359-1002
Email
mced@pacificgroveslc.com

Violation Details


Date
1/12/2024
Report number
OR0004751100
Type
Licensing Violation
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to follow care plan
Result
Substantiated
Findings
Based on interview and record review, conducted during a site visit on 02/07/24 through 02/13/24, it was confirmed the facility failed to ensure the implementation of services for 1 of 1 sampled residents (#18 ).It was determined the facility failed to ensure the implementation of services and follow care instructions in the residents service plan.