Countryside Village Lodge

Last inspection

February 12, 2024

Inspections

3, 0 deficiencies cited

Substantiated abuse

2

Substantiated licensing violations

2

Regulatory actions

0

Fines assessed

$376.00 (2 violations)

Current owner since

June 26, 2019

• No deficiencies cited at the last 2 inspections (November 2022 to December 2023)

Inspections

• February 12, 2024: Validation, 0 deficiencies cited report
  • C0000: Comment severity level 0
• December 18, 2023: State Licensure, 0 deficiencies cited report
  • C0000: Comment severity level 0
• November 22, 2022: Complaint Investig., 0 deficiencies cited report
  • C0000: Comment severity level 0

Substantiated abuse or neglect

• December 30, 2022: Failed to provide safe environment Abuse: Neglect; Level 2 - Minor harm or potential for moderate harm; fine $188.00; report
  Rules: 411-054-0025 (Facility Administration); 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)
  State’s findings

  The Alleged Victim relies on the facility for his or her safety. On or about December 30, 2022, around 4:47 am, the facility received a telephone call from police that AV was outside of the facility knocking on doors in the community. It was discovered that a kitchen door lock was broken, and AV eloped. Alleged Perpetrator #2 and #3 (AP2-3) were not doing safety checks on AV as stated in the service plan, which is considered neglect of care, and constitutes abuse. The facility failed to provide a safe environment, which is a violation of resident’s rights, is considered neglect of care and constitutes abuse.

• November 19, 2022: Failed to provide safe environment Abuse: Neglect; Level 2 - Minor harm or potential for moderate harm; fine $188.00; report
  Rules: 411-054-0025 (Facility Administration); 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)
  State’s findings

  The Alleged Victim (AV) and Witness #1 (W1) were known to have altercations. On or about November 19, 2022, AV was agitated and yelling at residents and staff. AV was trying to calm W1 down while staff watched. Staff did not intervene to remove AV from W1 during this time. AV swung his/her left arm at W1 and didn't make contact, however, right after, posed an aggressive stance towards AV and then slapped AV. The facility's failure to provide a safe environment is a violation of resident rights, is considered neglect of care and constitutes abuse.

Substantiated licensing violations

• September 19, 2024: Failed to follow care plan Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0025 (Facility Administration); 411-054-0036 (Service Plan – General)
  State’s findings

  Alleged Victim (AV) relies on the facility for his/her care, is a fall risk, and is care planned for safety checks every 30 minutes. On or about September 19, 2024, Alleged Perpetrator #2 (AP2) did not check on AV for approximately 2 hours and AV was ultimately found on the floor with a head wound. AP2 failed to follow the care plan, which is a violation of resident rights, is considered neglect of care and constitutes abuse. The facility failed to ensure the care plan was being followed, which is a violation of Oregon Administrative Rules.

• January 13, 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

  The facility failed to exercise reasonable precautions against any condition that may threaten the health, safety, or welfare of the residents. An investigation determined a licensing violation or abuse occurred.

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 28 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.