Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

Oregon Department of Human Services Logo

Print Violation: OR0004839100

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
2/14/2024
Report number
OR0004839100
Type
Licensing Violation
Level
3 - Moderate harm or potential for serious harm
Allegation
Failed to provide a safe medication administration system
Result
Substantiated
Findings
Based on observation, interview, and record review, conducted during a site visit on February 07, 2024, through February 15, 2024, it was confirmed the facility failed to ensure a safe medication system for a resident who was evaluated as unable to self-administer his/her own insulin for 1 of 1 sampled resident (# 1). Resident 1 was unable to administer his/her own insulin and was hospitalized on February 10, 2024, for high blood sugars. The Facility’s non-compliance places residents in immediate jeopardy. Facility failed to provide a safe medication administration system and failed to evaluate a resident and assure ability to safely self-administer medications.