Countryside Living Memory Care South

Last inspection

June 12, 2024

Inspections

3, 13 deficiencies cited

Substantiated abuse

6

Substantiated licensing violations

4

Regulatory actions

0

Fines assessed

$1,751.00 (6 violations)

Current owner since

October 1, 2021

• Every deficiency from the June 12, 2024 inspection was corrected by June 13, 2024

Inspections

• June 12, 2024: State Licensure, 2 deficiencies cited report
  • C0000: Comment severity level 0
  • C0240: Resident Services Meals, Food Sanitation Rule severity level 2, scope L2 Widespread, corrected June 13, 2024
  • Z0142: Administration Compliance severity level 2, scope L2 Widespread, corrected June 13, 2024
• August 8, 2023: State Licensure, 0 deficiencies cited report
  • C0000: Comment severity level 0
• April 11, 2022: Validation, 11 deficiencies cited report
  • C0000: Comment severity level 0
  • C0240: Resident Services Meals, Food Sanitation Rule severity level 2, scope L2 Widespread, corrected June 11, 2022
  • C0252: Resident Move-In and Eval: Res Evaluation severity level 2, scope L2 Pattern, corrected June 11, 2022
  • C0282: Rn Delegation and Teaching severity level 2, scope L2 Isolated, corrected August 20, 2022
  • C0310: Systems: Medication Administration severity level 2, scope L2 Pattern, corrected August 20, 2022
  Show all 14

  • C0330: Systems: Psychotropic Medication severity level 2, scope L2 Isolated, corrected August 20, 2022
  • C0372: Training Within 30 Days: Direct Care Staff severity level 2, scope L2 Isolated, corrected August 20, 2022
  • C0455: Inspections and Investigation: Insp Interval severity level 2, scope L2 Pattern, corrected August 20, 2022
  • C0555: Call Sys, Exit Dr Alarm, Phones, Tv, Or Cable severity level 2, scope L2 Widespread, corrected June 11, 2022
  • Z0142: Administration Compliance severity level 2, scope L2 Widespread, corrected June 11, 2022
  • Z0155: Staff Training Requirements severity level 2, scope L2 Isolated, corrected August 20, 2022
  • Z0162: Compliance With Rules Health Care severity level 2, scope L2 Pattern, corrected August 20, 2022
  • Z0164: Activities severity level 2, scope L2 Pattern, corrected August 20, 2022
  • Z0173: Secure Outdoor Recreation Area severity level 2, scope L2 Widespread, corrected June 11, 2022

Substantiated abuse or neglect

• December 12, 2022: Failed to properly plan care Abuse: Neglect; Level 2 - Minor harm or potential for moderate harm; fine $375.00; report
  Rules: 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0030 (Resident Services); 411-054-0036 (Service Plan – General)
  State’s findings

  The facility failed to implement interventions and appropriately monitor Witness 1 (W1) according to his/her known behavior and prior altercations. The failure resulted in a physical altercation, resulting in a risk of serious harm to the Alleged Victim (AV), which is a violation of resident rights, is considered neglect of care and constitutes abuse.

• December 5, 2022: Failed to properly plan care Abuse: Neglect; Level 3 - Moderate harm or potential for serious harm; fine $500.00; report
  Rules: 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0030 (Resident Services); 411-054-0036 (Service Plan – General)
  State’s findings

  The facility failed to implement interventions and appropriately care plan related to The Alleged Victim’s (AV) known aggressive behaviors. The failure resulted in a physical altercation between AV, facility staff, and other residents necessitating Law Enforcement to intervene and tase AV to calm AV down. AV received injuries as a result of this incident which caused unreasonable discomfort. The facility's failure is a violation of resident rights, is considered neglect of care and constitutes abuse.

• September 12, 2022: Failed to properly plan care Abuse: Neglect; Level 2 - Minor harm or potential for moderate harm; fine $188.00; report
  Rules: 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0036 (Service Plan – General)
  State’s findings

  The facility failed to implement interventions and appropriately care plan related to Alleged Victim's (AV) transfer needs which resulted in AV having several unexplained bruises. The facility's failure to develop and/or maintain a comprehensive care plan to address AV's care needs resulted in unreasonable discomfort which is a violation of resident rights, is considered neglect of care and constitutes abuse.

• September 10, 2022: Failed to properly plan care Abuse: Neglect; Level 2 - Minor harm or potential for moderate harm; fine $250.00; report
  Rules: 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0036 (Service Plan – General)
  State’s findings

  The facility failed to implement interventions and provide appropriate supervision related to the Alleged Victim’s (AV) known history of falls. The failure resulted in AV experiencing an unwitnessed fall on or about September 10, 2022, causing unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse.

• July 25, 2022: Failed to provide a safe medication administration system Abuse: Neglect; Level 2 - Minor harm or potential for moderate harm; fine $250.00; report
  Rules: 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0055 (Medications and Treatments)
  State’s findings

  The facility failed to provide a safe medication administration system by failing to adequately account for The Alleged Victim's (AV) medications. The facility's failure is a violation of resident rights, is considered neglect of care and constitutes abuse.

• May 26, 2022: Failed to provide safe environment Abuse: Neglect; Level 2 - Minor harm or potential for moderate harm; fine $188.00; report
  Rules: 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare); 411-054-0036 (Service Plan – General)
  State’s findings

  The facility failed to provide appropriate supervision to the Alleged Victim (AV) according to his/her needs. The failure resulted in AV eloping the secured building, without staff knowledge, placing him/her at risk of harm, which is a violation of resident rights, is considered neglect of care and constitutes abuse.

Substantiated licensing violations

• November 17, 2022: Failed to submit timely or adequate staffing documentation Licensing Violation; Level 2 - Minor harm or potential for moderate harm; RCFCP22-01682 $0.00 fine assessed; report
  Rules: 411-061-0010
  State’s findings

  Withdrawn 12/2/22: On or about November 1, 2022, the Oregon Health Authority reported to the Department that Respondent failed to comply with weekly reporting requirements of vaccinated individuals, residents and staff, to the proper authority as required by law. This failure has been ongoing for a total of 30 days”.

• October 10, 2022: Failed to provide a safe medication administration system Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0025 (Facility Administration); 411-054-0055 (Medications and Treatments)
  State’s findings

  Alleged Perpetrator 2 (AP2) neglected Alleged Victim (AV) by failing to administer AV's medication as ordered which placed AV a risk of potential harm. AP2's actions is considered neglect of care which constitutes abuse. The facility failed to provide a safe medication administration system for AV which is a violation of Oregon Administrative Rules.

• October 1, 2022: Failed to submit timely or adequate staffing documentation Licensing Violation; Level 2 - Minor harm or potential for moderate harm; RCFCP22-01682 $0.00 fine assessed; report
  Rules: 411-061-0010
  State’s findings

  On or about October 1, 2022, the Oregon Health Authority reported to the Department that Respondent failed to comply with weekly reporting requirements of vaccinated individuals, residents and staff, to the proper authority as required by law. This failure has been ongoing from September 1, 2022 to September 30, 2022, for a total of 30 days.

• September 18, 2022: Failed to provide safe environment Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0025 (Facility Administration)
  State’s findings

  On or about September 18, 2022, Alleged Perpetrator 2 (AP2) wheeled Alleged Victim (AV) into his/her room, left AV in his/her wheelchair, closed AV's bedroom door, and did not provide safety checks on AV between 12:27am and 4:12am. Based on facility documentation and interviews, AV has a history of slipping out of AV's wheelchair. AP2's actions placed AV at risk of harm and is considered neglect of care which constitutes abuse. The facility's failure to provide AV a safe environment is a violation of Oregon Administrative Rules.

Read the full record on the state’s site →

ODHS lists only substantiated violations: “either a substantiated instance of abuse or a licensing violation. Open investigations and complaints that are being appealed by the provider are not listed.” Oregon counts neglect as a form of abuse; see the state’s definitions of abuse. Each violation shows the level ODHS gives it, in the state’s words (for example “2 - Minor harm or potential for moderate harm”), and any fine ODHS assessed. Inspection citations show the state’s severity level and scope, and the date ODHS recorded the problem as corrected when it lists one. Rule names come from the Oregon Administrative Rules. ODHS: “Formal regulatory actions can range from a condition placed upon a license due to non-compliance or a notice to revoke a license.” This community is licensed for 20 residents; larger communities are inspected and reported on more often, so read counts with size in mind. Source: Oregon Department of Human Services, Long-Term Care Licensing, data as of October 15, 2026, showing the last five years. Always visit in person and ask the community about anything listed here.