Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

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Print Violation: SR20074

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
10/16/2019
Report number
SR20074
Type
Licensing Violation
Level
3 - Moderate harm or potential for serious harm
Allegation
Failed to report potential or suspected abuse
Result
Substantiated
Findings
Facility failed to report suspected abuse
Sanction
RCFCP20-0207 $1000.00 fine assessed