Redwood Terrace

Last inspection

July 29, 2024

Inspections

4, 4 deficiencies cited

Substantiated abuse

0

Substantiated licensing violations

4

Regulatory actions

0

Current owner since

February 6, 2003

• Every deficiency from the July 29, 2024 inspection was corrected by September 29, 2024

Inspections

• July 29, 2024: Re-Licensure, 2 deficiencies cited report
  • C0000: Comment severity level 0
  • C0305: Systems: Resident Right to Refuse severity level 2, scope L2 Pattern, corrected September 29, 2024
  • C0330: Systems: Psychotropic Medication severity level 2, scope L2 Isolated, corrected September 29, 2024
• June 4, 2024: State Licensure, 1 deficiency cited report
  • C0000: Comment severity level 0
  • C0240: Resident Services Meals, Food Sanitation Rule severity level 2, scope L2 Widespread, corrected August 3, 2024
• May 29, 2024: Complaint Investig., 1 deficiency cited report
  • C0303: Systems: Treatment Orders severity level 2, scope L2 Isolated
• January 19, 2023: State Licensure, 0 deficiencies cited report
  • C0000: Comment severity level 0

Substantiated licensing violations

• May 5, 2026: Failed to administer medication as ordered Licensing Violation; Level 2 - Minor harm or potential for moderate harm; 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); 411-054-0055 (Medications and Treatments)
  State’s findings

  The Alleged Victim (AV) relies on the facility for their care, including medication management. According to an investigation, on or about, May 5, 2026, Alleged Perpetrator 2 (AP2) gave AV the wrong medication, resulting in AV's systolic blood pressure dropping and AV going to the hospital where they received fluids and monitoring. AP2’s action is considered neglect of care which constitutes abuse as defined in OAR 411-020-0002(1)(b)(A)(i). The facility failed to ensure the care plan was followed, which is a violation of Oregon Administrative Rules.

• April 8, 2026: Failed to follow care plan Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0025 (Facility Administration); 411-054-0027 (Resident Rights and Protections); 411-054-0028 (Reporting and Investigating Abuse and Other Actions Affecting Resident Welfare)
  State’s findings

  The Alleged Victim (AV) relies on the facility for their care. The AV had an order to have dressing changed by facility staff on Saturday. According to an investigation, Alleged Perpetrator 2 (AP2) did not change AV’s dressing, but marked that they did. As a result, AV went for approximately four days without their dressing being changed causing AV’s wound to smell and increase in size. AV was transported to urgent care and prescribed two different types of antibiotics for the infected wound. AP2’s action is considered neglect of care, which constitutes abuse as defined in OAR 411-020-0002(1)(b)(A)(i). The facility failed to ensure the care plan was followed, which is a violation of Oregon Administrative Rules.

• April 19, 2024: Failed to administer medication as ordered Licensing Violation; Level 2 - Minor harm or potential for moderate harm; report
  Rules: 411-054-0055 (Medications and Treatments)
  State’s findings

  The facility failed to carry out medication and treatment orders as prescribed. The facility’s failure is a violation of Oregon Administrative Rules.

• August 30, 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

  According to the documentation, Alleged Perpetrator 2 (AP2) failed to follow the facilities medication protocols. The failure resulted in the Alleged Victim (AV) receiving the wrong medication and needed to be sent out to the hospital for monitoring of potential side effects. This is a violation of resident rights, is considered neglect of care and constitutes abuse. The facility failed to provide a safe medication administration system which 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 49 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.