Prices shown are estimates and subject to change. Contact your senior living advisor for current pricing.
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Amenities
Healthcare services
Activities of daily living assistance
Assistance with bathing
Assistance with dressing
Assistance with transfers
Medication management
Mental wellness program
Healthcare staffing
12-16 hour nursing
24-hour call system
24-hour supervision
Meals and dining
Diabetes diet
Meal preparation and service
Restaurant-style dining
Special dietary restrictions
Room
Air-conditioning
Cable
Fully furnished
Housekeeping and linen services
Kitchenettes
Private bathrooms
Telephone
Wifi
Memory care community services
Mild cognitive impairment
Specialized memory care programming
Transportation
Community operated transportation
Transportation arrangement
Transportation arrangement (non-medical)
Common areas
Beauty salon
Computer center
Dining room
Fitness room
Gaming room
Garden
Outdoor space
Small library
Wellness center
Community services
Concierge services
Fitness programs
Move-in coordination
Activities
Community-sponsored activities
Planned day trips
Resident-run activities
Scheduled daily activities
Reviews
3.90·(58)
Overall rating
5
4
3
2
1
Care
3.3
Staff
3.7
Meals
3.9
Amenities
4.0
Value
3.9
Pros
Compassionate, friendly caregivers
Attentive support and positive resident relationships
Professional medication assistance described by families
Effective response to a reported seizure
Kind hospice and end-of-life support
Apartment-style living that supports independence
Clean, welcoming spaces described by some families
Enjoyable meals and a salad bar
Activities that support social engagement
Helpful staff during tours, applications, and move-ins
Detailed progress updates to families
Positive changes under new management described by some reviewers
Cons
Inconsistent staffing levels and employee retention
Delays in call-light and emergency response
Uneven staff training and care skills, particularly in memory care
Inconsistent follow-through on laundry and personal-care routines
Variable meal quality and serving temperature
Uneven activity programming and resident engagement
Inconsistent cleanliness and upkeep in some common areas
Management availability and communication gaps
Inconsistent front-desk coverage and move-in orientation
Concerns about staff respect and communication tone
Questions about medication-administration training and clinical-service boundaries
Limited privacy and space in shared memory-care rooms
Summary of reviews
Reviews present a notably mixed picture of Pacific Grove Senior Living. Many residents, family members, and visitors describe caring staff, a welcoming atmosphere, and positive relationships with residents. Some families praise attentive support, useful progress updates, and staff responsiveness during a medical event. Others describe difficulty reaching caregivers, delays in answering call lights, and uneven care follow-through. Concerns about staffing levels, training, and care consistency appear particularly salient in accounts of memory care. One resident review also describes limited nursing support for needs beyond the community’s assisted-living services, with outside providers potentially required.
Dining experiences vary considerably. Positive accounts mention enjoyable meals and a popular salad bar, while critical reviews describe inconsistent food quality and meals not being served at a suitable temperature. Activity experiences also differ: some families describe full schedules, creative engagement, and social opportunities, while others perceive limited programming and reduced participation. The facility is described as clean and welcoming by some visitors, though other accounts raise concerns about cleanliness and upkeep in shared areas.
Accommodation and service arrangements differ by care area. A reviewer praised a spacious apartment with a private bathroom and in-room amenities, while another noted that memory-care rooms are shared and provide limited space and privacy. Families also value the independence residents can maintain while receiving support, though expectations about the availability of clinical services should be clarified directly with the facility.
Management and operations are a recurring point of disagreement. Some reviewers say the community has improved under new management, while others describe staffing, leadership availability, communication, and follow-through as ongoing concerns. One review cites a period when admissions were reportedly restricted over code-compliance issues; this claim is not corroborated elsewhere in the review set. Individual accounts also raise concerns about workplace culture and continuity of prior agreements during an ownership transition. Overall, the range of experiences suggests that prospective residents and families may benefit from visiting at different times, speaking with current residents and staff, and asking specifically about staffing coverage, memory-care training, response procedures, activities, meal service, and the scope of clinical support.
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Location
Pacific Grove Senior Living is located at 2112 Oak St, Forest Grove, OR, 97116.
About Pacific Grove Senior Living
Pacific Grove Senior Living sits in Forest Grove, Oregon, offering a variety of care for seniors who want some support or for those living with Alzheimer's or other kinds of dementia, and you'll find both assisted living and memory care services here, which includes help with daily needs like bathing, dressing, and medicine management, and there are options for short-term respite care if someone needs a temporary stay. This place has 64 beds, with several floor plans to pick from, and there's an on-site 24-hour staff always ready if someone needs help, and a pretty friendly and caring crew that tries to make everyone feel safe and comfortable while paying attention to personal needs.
Pacific Grove Senior Living serves meals made from good ingredients meant to support nutrition, and you'll find snacks as well as planned dining, and folks can get personal laundry help if needed. Residents go to social events and activities that encourage hobbies and keep everyone busy, and for those who might forget things or wander, there's a special memory care program with sensory gardens and bright gathering areas meant to support memory skills and encourage safe socializing, and all these services are offered in a place designed to feel like home with both private and shared spaces.
There's a focus on fairness here, with policies protecting people from being turned away from housing or services, or fired from a job, based on things like race, gender, disability, or who they love, and LGBTQ+ protections are part of how they do things, following federal law including source of income protections too. Rent covers utilities, though there aren't specifics on which ones, and parking is available but again, details aren't spelled out, and you'll find some outdoor amenities and access to local transportation even though those details are pretty basic.
Pets are close, Wi-Fi and high-speed internet are available, and there are planned activities meant to keep the mind and body active, plus recreation areas outside for enjoying the natural surroundings of Forest Grove, and if someone wants a place that tries to honor individual needs with a person-centered approach-whether someone's staying a little while or living there full-time-the staff aim to make it a welcoming spot, and you'll often see the stylized compass star logo that marks the Pacific Grove Senior Living Community.
People often ask...
Pacific Grove Senior Living offers competitive pricing, with rates starting at a cost of $4,900 per month.
Pacific Grove Senior Living offers assisted living and memory care.
There are 39 photos of Pacific Grove Senior Living on Mirador.
The full address for this community is 2112 Oak St, Forest Grove, OR 97116.
No, Pacific Grove Senior Living does not offer respite care.
Respite care in assisted living communities provides temporary, short-term relief for primary caregivers by offering professional care for their loved ones. It allows individuals to stay in an assisted living community for a limited time, giving caregivers a break while ensuring residents receive necessary support and assistance with daily activities.
Safety & Compliance
In Oregon, the Department of Human Services' Aging & People with Disabilities program licenses assisted living and residential care facilities, conducting inspections, complaint investigations, and renewals.
Deficiency—Fire and Life Safety: Training for Residents
Deficiency—General Building Exterior
Deficiency—Doors, Walls, Elevators, Odors
Deficiency—Call Sys, Exit Dr Alarm, Phones, TV, or Cable
Deficiency—Individual Rights Settings: Privacy, Dignity
Deficiency—Individual Privacy: Own Unit
Deficiency—Administration Compliance
Deficiency—Compliance with Rules Health Care
Deficiency—Secure Outdoor Recreation Area
26 May 2026Inspection
26 May 2026Inspection
Investigated failure to report and address abuse allegations, leading to uninvestigated concerns and delayed protective actions.
Licensing—Failed to report potential or suspected abuse
19 May 2026Inspection
19 May 2026Inspection
Found that a resident was not protected from inappropriate sexual contact and that staff failed to ensure a safe environment, with violations cited.
Licensing—Failed to protect resident from inappropriate sexual contact
13 Feb 2026Inspection
13 Feb 2026Inspection
Investigated and determined a violation involving failure to administer medication as ordered.
Licensing—Failed to administer medication as ordered
16 Jan 2026Inspection
16 Jan 2026Inspection
Investigated a resident safety incident and found neglect with abuse due to leaving a resident unattended in a bathroom, resulting in a fall and injury risk.
Licensing—Failed to assure resident was safe
29 Dec 2025Inspection
29 Dec 2025Inspection
Investigated the allegation and determined there was a violation for failing to administer medication as ordered.
Licensing—Failed to administer medication as ordered
10 Oct 2025Inspection
10 Oct 2025Inspection
Investigated the allegation and found a violation for failing to protect, report, and investigate abuse, including injury falls not reported to local Adult Protective Services.
Licensing—Failed to report potential or suspected abuse
09 Oct 2025Inspection
09 Oct 2025Inspection
Determined that a medication was not administered as ordered, violating state rules.
Licensing—Failed to administer medication as ordered
11 Sept 2025Abuse: Neglect
11 Sept 2025Abuse: Neglect
Found a failure to provide a safe medication administration system, resulting in a resident not receiving prescribed medication between September 11 and September 17, 2025.
Abuse—Failed to provide a safe medication administration system
02 Jul 2025Inspection
02 Jul 2025Inspection
Found failure to update the acuity-based staffing tool to reflect resident needs and care time, causing gaps between service plans and documented staff activities.
Licensing—Failed to update staffing plan based on ABST
02 Jul 2025Inspection
02 Jul 2025Inspection
Found deficiencies in oversight of a change in condition, including failure to evaluate, refer to the nurse, document the change, and update the service plan.
Licensing—Failed to provide oversight and monitoring of change of condition
08 Jun 2025Inspection
08 Jun 2025Inspection
Investigated the allegation and found a failure to evaluate behavioral symptoms and include them in the care plan for the resident.
Licensing—Failed to address resident's behavior
17 Apr 2025Inspection
17 Apr 2025Inspection
Found deficiencies in operating and providing quality services, including gaps in abuse reporting, staffing, acuity-based staffing tools, and service plans. The violations were ongoing for over a year.
Licensing—Failed to provide safe environment
01 Apr 2025Inspection
01 Apr 2025Inspection
Determined that there was a failure to immediately report potential or suspected abuse to the appropriate authorities. Found that an unwitnessed fall occurred while the service plan required a walker, which was not followed.
Licensing—Failed to report potential or suspected abuse
01 Apr 2025Inspection
01 Apr 2025Inspection
Identified deficiencies where residents' service plans did not reflect their needs and the implementation of required services was inconsistent.
Licensing—Failed to provide service
01 Apr 2025Inspection
01 Apr 2025Inspection
Investigated and identified deficiencies in the acuity-based staffing system, with ABST data not accurately reflecting resident needs and ADLs. Inconsistencies between the roster, care plans, and ABST data led to staffing not aligning with scheduled and unscheduled resident needs.
Licensing—Failed to use an ABST
01 Apr 2025Inspection
01 Apr 2025Inspection
Found staffing levels insufficient to meet residents' scheduled and unscheduled needs, causing care to be delayed or unmet.
Licensing—Failed to meet the scheduled and unscheduled needs of residents
28 Mar 2025Inspection
28 Mar 2025Inspection
Determined that staff failed to immediately notify the local Department office or local AAA of abuse or suspected abuse.
Licensing—Failed to report potential or suspected abuse
28 Mar 2025Inspection
28 Mar 2025Inspection
Found deficiencies in implementing services per care plans for two residents, including delays in toileting assistance and other ADLs.
Licensing—Failed to follow care plan
10 Mar 2025Inspection
10 Mar 2025Inspection
Identified violations in medication administration and resident rights, showing neglect and abuse. The finding noted a lapse in providing prescribed medications for a period due to improper order handling.
Licensing—
18 Jan 2025Inspection
18 Jan 2025Inspection
Investigated the allegation of failing to report potential abuse and suspected abuse; determined there was a failure to immediately notify the local Department office or local AAA and to promptly investigate such reports.
Licensing—Failed to report potential or suspected abuse
15 Dec 2024Inspection
15 Dec 2024Inspection
Found that medication was not administered as ordered. The finding constitutes a violation of Oregon Administrative Rules.
Licensing—Failed to administer medication as ordered
15 Dec 2024Abuse: Neglect
15 Dec 2024Abuse: Neglect
Investigated a case of neglect related to seizure medication management that left a resident without seizure medication for three days, resulting in hospitalization.
Abuse—Failed to provide a safe medication administration system
15 Nov 2024Abuse: Neglect
15 Nov 2024Abuse: Neglect
Found abuse by neglect due to failure to provide a safe environment and monitor an individual with elopement risk; a $375 fine was assessed.
Abuse—Failed to provide safe environment
21 Oct 2024Inspection
21 Oct 2024Inspection
Found failure to carry out prescribed medication and diet orders for a resident, leading to a mechanical soft diet and lack of Safestrraw assistance.
Licensing—Failed to administer medication as ordered
21 Oct 2024Inspection
21 Oct 2024Inspection
Investigated the allegation of failing to maintain a safe physical environment and determined a deficiency existed.
Licensing—Failed to maintain a safe physical environment
21 Oct 2024Complaint
21 Oct 2024Complaint
Investigated and identified deficiencies in following prescribed medication orders. Also found failures to develop and maintain an acuity-based staffing tool.
Deficiency—Licensing Complaint Investigation
Deficiency—Systems: Treatment Orders
Deficiency—Acuity-Based Staffing Tool
21 Oct 2024Inspection
21 Oct 2024Inspection
Investigated the allegation of failing to provide a therapeutic diet and determined a violation.
Licensing—Failed to provide a therapeutic diet
08 Oct 2024Abuse: Neglect
08 Oct 2024Abuse: Neglect
Investigated a neglect allegation and found that nail care was not performed, leaving the resident with injuries and risk of harm; a fine was assessed.
Abuse—Failed to provide service
27 Sept 2024Inspection
27 Sept 2024Inspection
Found violations of medication administration rules after a resident received 40mg of a narcotic instead of 10mg, with delayed reporting and no adverse outcome.
Licensing—Failed to administer medication as ordered
14 Sept 2024Inspection
14 Sept 2024Inspection
Investigated the allegation of failing to provide service and determined there was a rule violation.
Licensing—Failed to provide service
28 Aug 2024Inspection
28 Aug 2024Inspection
Found missed medications ordered by the ER and delays in dispensing due to unsigned orders, indicating deficiencies in medication administration processes.
Licensing—Failed to have medication available
27 Aug 2024Inspection
27 Aug 2024Inspection
Investigated and found that an updated ABST reflecting resident needs was not maintained, with inconsistencies between the resident roster, care plans, and ABST data.
Licensing—Failed to use an ABST
26 Aug 2024Inspection
26 Aug 2024Inspection
Investigated the allegation that medication was not administered as ordered and found a deficiency in medication administration.
Licensing—Failed to administer medication as ordered
26 Aug 2024Inspection
26 Aug 2024Inspection
Identified that the ABST was not updated to reflect residents' care needs, with inconsistencies between the roster, care plans, and ABST data.
Licensing—Failed to use an ABST
21 Aug 2024Inspection
21 Aug 2024Inspection
Found a violation for failing to administer ordered medication as prescribed.
Licensing—Failed to administer ordered medication
12 Aug 2024Abuse: Neglect
12 Aug 2024Abuse: Neglect
Investigated a medication-safety complaint and found a missing system for safe medication administration and insufficient evaluation of a move-in resident's ability to self-administer, leading to unsafe conditions and risk.
Abuse—Failed to provide a safe medication administration system
11 Aug 2024Inspection
11 Aug 2024Inspection
Found violations for incorrect anxiety dose administration and a missed pain medication dose.
Licensing—Failed to administer medication as ordered
19 Jun 2024Inspection
19 Jun 2024Inspection
Investigated and found a deficient safe medication administration system. The incident involved giving another resident's medications and required hospital evaluation.
Licensing—Failed to provide a safe medication administration system
28 Apr 2024Inspection
28 Apr 2024Inspection
Investigated the allegation and found a violation for failing to administer ordered medication.
Licensing—Failed to administer ordered medication
17 Apr 2024Inspection
17 Apr 2024Inspection
Identified failure to maintain an up-to-date Acuity-Based Staffing Tool with inconsistencies between roster, care plans, and ABST data.
Licensing—Failed to use an ABST
16 Apr 2024Complaint
16 Apr 2024Complaint
Identified multiple deficiencies, including failure to notify residents about move-out rights, failure to report abuse promptly, delayed nurse assessment of significant changes in condition, and inaccurate medication records.
Deficiency—Resident Rights and Protection - General
Found a deficiency in oversight and monitoring of residents' significant changes in condition due to untimely RN assessments.
Licensing—Failed to provide oversight and monitoring of change of condition
12 Apr 2024Inspection
12 Apr 2024Inspection
Investigated a resident-rights notification issue and determined a violation occurred when proper notification for move-out was not provided.
Licensing—Failed to assure resident rights
01 Apr 2024Inspection
01 Apr 2024Inspection
Investigated the allegation and found that medication orders were not carried out as prescribed, resulting in a resident receiving the wrong dose.
Licensing—Failed to administer medication as ordered
14 Mar 2024License Condition
14 Mar 2024License Condition
Found that the facility failed to provide a safe environment, placing residents at risk of serious harm.
Regulatory Action—Failed to provide safe environment
06 Mar 2024Inspection
06 Mar 2024Inspection
Found that medication orders were not administered as prescribed for 15 of 15 sampled residents, with multiple missed doses across numerous medications.
Licensing—Failed to administer medication as ordered
06 Mar 2024Inspection
06 Mar 2024Inspection
Identified deficiencies in keeping accurate medication administration records for 15 residents, with multiple missing signatures on MAR entries.
Licensing—Failed to keep medication record current or accurate
04 Mar 2024Abuse: Neglect
04 Mar 2024Abuse: Neglect
Investigated an incident involving an extra insulin dose and unsafe medication practices. Found neglect of care and abuse, with a $375 fine assessed.
Abuse—Failed to provide a safe medication administration system
29 Feb 2024License Condition
29 Feb 2024License Condition
Determined substantial non-compliance with licensing requirements and immediate jeopardy risk from failure to provide needed services.
Regulatory Action—Failed to provide safe environment
29 Feb 2024License Condition
29 Feb 2024License Condition
Investigated an allegation of failing to provide a safe environment and identified deficiencies in providing needed/necessary services.
Regulatory Action—Failed to provide safe environment
22 Feb 2024Inspection
22 Feb 2024Inspection
Found a violation of resident rights in connection with a resident-to-resident altercation that caused injuries; the incident was self-reported six days later.
Licensing—Failed to assure resident rights
14 Feb 2024Inspection
14 Feb 2024Inspection
Identified violations for failure to monitor residents' changes in condition and provide meals and monitoring, risking harm to residents.
Licensing—Failed to provide oversight and monitoring of change of condition
14 Feb 2024Inspection
14 Feb 2024Inspection
Identified a deficient safe medication administration system that left a resident unable to self-administer insulin and led to hospitalization.
Licensing—Failed to provide a safe medication administration system
13 Feb 2024Inspection
13 Feb 2024Inspection
Investigated an allegation that a safe environment was not provided and found a safety deficiency.
Licensing—Failed to provide safe environment
07 Feb 2024Complaint
07 Feb 2024Complaint
Investigated abuse reporting and care deficiencies; Found multiple rule violations across policy and procedure, records, infection control, medication handling, staffing, and acuity-based planning.
Deficiency—Staffing Requirements and Training: Staffing
Deficiency—Acuity-Based Staffing Tool
07 Feb 2024Inspection
07 Feb 2024Inspection
Found that a fire drill record was falsified and no written policy prohibited falsification of records.
Licensing—Failed to assure resident rights
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated an allegation of medication safety and found a system for tracking controlled substances and disposing of unused medications was not implemented.
Licensing—Failed to provide a safe medication administration system
07 Feb 2024Inspection
07 Feb 2024Inspection
Found failures to maintain infection prevention and control protocols. Signs about active COVID were posted, staff were observed not wearing masks, used PPE overflowed, and notification to the Safety, Oversight and Quality unit was delayed.
Licensing—Failed to provide infection control
07 Feb 2024Inspection
07 Feb 2024Inspection
Found that a resident's records were not properly prepared, complete, accurate, or preserved, and that an incident report and interim service plan related to an alleged incident were deleted.
Licensing—Failed to assure resident rights
07 Feb 2024Inspection
07 Feb 2024Inspection
Found that a resident's records were not properly prepared, complete, accurate, or preserved, including an incident report and interim service plan that were deleted.
Licensing—Failed to assure resident rights
07 Feb 2024Inspection
07 Feb 2024Inspection
Determined that a policy to refer residents who may be victims of acute sexual assault to a trained examiner within 86 hours was not implemented, and no referral was documented for a sampled resident.
Licensing—Failed to assure resident rights
07 Feb 2024Inspection
07 Feb 2024Inspection
Determined that there was a failure to immediately notify the local Department office or the local AAA of an incident of abuse or suspected abuse.
Licensing—Failed to report potential or suspected abuse
07 Feb 2024Inspection
07 Feb 2024Inspection
Found that the facility failed to have effective methods for responding to and resolving resident complaints.
Licensing—Failed to assure resident rights
07 Feb 2024Inspection
07 Feb 2024Inspection
Determined there was a deficiency in infection prevention and control that failed to provide a safe environment.
Licensing—Failed to provide safe environment
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated and found insufficient qualified awake direct care staff to meet residents' 24-hour needs.
Licensing—Failed to meet the scheduled and unscheduled needs of residents
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated and found that essential housekeeping services based on residents' needs and preferences were not provided.
Licensing—Failed to provide appropriate housekeeping services
07 Feb 2024Inspection
07 Feb 2024Inspection
Found failure to implement a written policy prohibiting falsification of narcotic log records.
Licensing—Falsified records
07 Feb 2024Inspection
07 Feb 2024Inspection
Identified insufficient qualified awake direct care staff to meet the 24-hour needs of residents.
Licensing—Failed to meet the scheduled and unscheduled needs of residents
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated an allegation that a safe medication administration system was not provided and identified a violation of Oregon Administrative Rules.
Licensing—Failed to provide a safe medication administration system
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated an allegation that medication was not administered as ordered and identified a violation of Oregon Administrative Rules.
Licensing—Failed to administer medication as ordered
07 Feb 2024Complaint
07 Feb 2024Complaint
Investigated and found a failure to ensure a safe medication system for a resident unable to self-administer insulin, leading to hospitalization for high blood sugars.
Deficiency—Change of Condition and Monitoring
Deficiency—Systems: Self-Administration of Meds
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated the allegation and found deficiencies in providing a safe environment, quality of services, and in staff supervision and conduct.
Licensing—Failed to provide safe environment
07 Feb 2024Inspection
07 Feb 2024Inspection
Found a deficiency for failing to immediately notify the local Department office or local AAA of any incident of abuse or suspected abuse.
Licensing—Failed to report potential or suspected abuse
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated the allegation of failing to report abuse and found a failure to immediately notify the local Department office or local AAA of abuse.
Licensing—Failed to report potential or suspected abuse
07 Feb 2024Inspection
07 Feb 2024Inspection
Found a deficiency: no written policy prohibiting the falsification of meal tracking logs.
Licensing—Falsified records
07 Feb 2024Inspection
07 Feb 2024Inspection
Found that the care plan was not followed, resulting in a resident not receiving a shower for three weeks.
Licensing—Failed to follow care plan
07 Feb 2024Inspection
07 Feb 2024Inspection
Found that the care plan was not followed. This constitutes a violation of Oregon Administrative Rules.
Licensing—Failed to follow care plan
07 Feb 2024Inspection
07 Feb 2024Inspection
Found a failure to observe residents taking medications, with doses left on nightstands and not verified, creating a safety risk.
Licensing—Failed to provide a safe medication administration system
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated abuse-reporting failure and determined that a violation occurred.
Licensing—Failed to report potential or suspected abuse
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated and determined that a deficiency related to resident rights existed due to ineffective methods for responding to and resolving resident complaints.
Licensing—Failed to assure resident rights
07 Feb 2024Complaint
07 Feb 2024Complaint
Investigated a complaint and found multiple deficiencies across administration, records, resident rights, services, health care, medications, infection control, and staffing.
Deficiency—Res Hlth Srvc: On- and Off-Site Health Srvc
Deficiency—Infection Prevention & Control
Deficiency—Systems: Medications and Treatments
Deficiency—Systems: Medication Administration
Deficiency—Systems: Tracking Control Substances
Deficiency—Systems: Treatment Orders
Deficiency—Staffing Requirements and Training: Staffing
Deficiency—Acuity-Based Staffing Tool
Deficiency—Inspections and Investigations
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated the abuse reporting allegation and found a failure to immediately notify the local Department office, or the local AAA, of any incident of abuse or suspected abuse.
Licensing—Failed to report potential or suspected abuse
07 Feb 2024Inspection
07 Feb 2024Inspection
Investigated an allegation of falsified records and found a lack of a written policy prohibiting falsification related to MAR. Concluded this violated Oregon Administrative Rules.
Licensing—Falsified records
07 Feb 2024Inspection
07 Feb 2024Inspection
Determined that residents were not treated with dignity and respect.
Licensing—Failed to assure resident rights
29 Jan 2024Abuse: Neglect
29 Jan 2024Abuse: Neglect
Identified failures to protect a resident from possible sexual abuse, including deleting an incident report and failing to intervene, which created risk of serious harm and resulted in a $500 fine.
Abuse—Failed to provide safe environment
12 Jan 2024Inspection
12 Jan 2024Inspection
Found that the provider failed to implement services as outlined in the resident's care plan for one resident.
Licensing—Failed to follow care plan
08 Jan 2024Inspection
08 Jan 2024Inspection
Investigated an allegation of an unsafe medication administration system and determined a violation of Oregon Administrative Rules.
Licensing—Failed to provide a safe medication administration system
27 Dec 2023Inspection
27 Dec 2023Inspection
Found failure to implement services per the care plan, including not providing twice-weekly showers for one resident.
Licensing—Failed to follow care plan
26 Dec 2023Inspection
26 Dec 2023Inspection
Investigated and found failures to immediately notify authorities about multiple instances of abuse and unwitnessed injury falls.
Licensing—Failed to report potential or suspected abuse
25 Dec 2023Inspection
25 Dec 2023Inspection
Investigated a failure to provide relevant information to an outside provider and found that only a face sheet was printed for responders while MARs could not be printed for a resident.
Licensing—Failed to provide social services
25 Dec 2023Inspection
25 Dec 2023Inspection
Investigated and found deficiencies in medication administration for two residents, including failures to give prescribed doses and falsified records.
Licensing—Failed to administer medication as ordered
22 Dec 2023Inspection
22 Dec 2023Inspection
Confirmed the failure to immediately notify local SPD or AAA about suspected abuse involving a resident. This involved one sampled resident.
Licensing—Failed to report potential or suspected abuse
01 Dec 2023Inspection
01 Dec 2023Inspection
Found insufficient awake direct care staff to meet 24-hour needs, leaving units unstaffed and creating poor visibility between wings at night.
Licensing—Failed to meet the scheduled and unscheduled needs of residents
11 Sept 2023Inspection
11 Sept 2023Inspection
Found insufficient awake direct care staff to meet 24-hour needs, leaving units unattended.
Licensing—Failed to meet the scheduled and unscheduled needs of residents
11 Sept 2023Inspection
11 Sept 2023Inspection
Investigated a staffing-related allegation and found the acuity-based staffing tool was not updated to reflect resident acuity.
Licensing—Failed to update staffing plan based on ABST
08 Aug 2023Inspection
08 Aug 2023Inspection
Found a failure to provide a safe medication administration system and adequate administrator oversight.
Licensing—Failed to provide a safe medication administration system
27 Jul 2023License Condition
27 Jul 2023License Condition
Found that the staffing plan was not updated to reflect ABST requirements.
Regulatory Action—Failed to update staffing plan based on ABST
27 Jul 2023Inspection
27 Jul 2023Inspection
Investigated and found failures to immediately notify local SPD/AAA about abuse and to investigate and notify the local department office about an unwitnessed fall for a sampled resident.
Licensing—Failed to report potential or suspected abuse
27 Jul 2023License Condition
27 Jul 2023License Condition
Identified failure to use an ABST to develop a staffing plan based on care minutes. The finding cites noncompliance with ABST-related staffing requirements.
Regulatory Action—Failed to use an ABST
25 Jul 2023Abuse: Neglect
25 Jul 2023Abuse: Neglect
Found that a safe environment was not provided, resulting in abuse and neglect with minor harm.
Abuse—Failed to provide safe environment
25 Jul 2023Complaint
25 Jul 2023Complaint
Identified deficiencies in several areas with potential for moderate harm. Deficiencies affected resident rights, abuse reporting, laundry, service planning, treatment orders, psychotropic medications, and staffing.
Deficiency—Licensing Complaint Investigation
Deficiency—Resident Rights and Protection: Personal Rela
Deficiency—Staffing Requirements and Training: Staffing
19 Jul 2023Inspection
19 Jul 2023Inspection
Found that records were not provided to the Department upon request in relation to an allegation of failing to cooperate with an investigation.
Licensing—Failed to cooperate with an investigation
15 May 2023Validation
15 May 2023Validation
Found deficiencies in resident activities, move-in evaluations, and service plans. Also found lapses in infection control, medication management, and safety procedures.
Deficiency—Comment
Deficiency—Resident Services: Activities
Deficiency—Resident Move-In and Eval: Res Evaluation
Deficiency—Service Plan: General
Deficiency—Infection Prevention & Control
Deficiency—Systems: Treatment Orders
Deficiency—Acuity-Based Staffing Tool
Deficiency—Fire and Life Safety: Safety
Deficiency—Inspections and Investigation: Insp Interval
Deficiency—General Building Exterior
Deficiency—Doors, Walls, Elevators, Odors
Deficiency—Housekeeping and Laundry
Deficiency—Heating and Ventilation
Deficiency—Call Sys, Exit Dr Alarm, Phones, Tv, Or Cable
Deficiency—Administration Compliance
Deficiency—Staff Training Requirements
Deficiency—Compliance With Rules Health Care
Deficiency—Activities
Deficiency—Behavior
Deficiency—Outside Area
Deficiency—Secure Outdoor Recreation Area
12 May 2023Inspection
12 May 2023Inspection
Determined that there was a deficiency in responding to and resolving resident complaints. The deficiency affected resident rights.
Licensing—Failed to assure resident rights
08 May 2023Validation
08 May 2023Validation
Investigated deficiencies across multiple operations, resident rights, care planning, medication management, staffing, and safety during relicensure; numerous citations issued for notable lapses.
Found a medication administration deficiency that resulted in missed doses of quetiapine fumarate between 1/16/2023 and 1/26/2023.
Licensing—Failed to administer medication as ordered
21 Apr 2023Inspection
21 Apr 2023Inspection
Investigated an allegation that staff acted as a resident's guardian or attorney-in-fact and obtained power of attorney from memory care residents. Found a rights violation.
Licensing—Failed to assure resident rights
19 Apr 2023Licensure
19 Apr 2023Licensure
Determined substantial compliance with applicable meal service and sanitation requirements after a kitchen review.
Deficiency—Comment
19 Apr 2023Licensure
19 Apr 2023Licensure
Determined substantial compliance with applicable meal service and sanitation requirements.
Deficiency—Comment
13 Apr 2023Inspection
13 Apr 2023Inspection
Found that residents' medical and other records were not kept confidential as required by law. The finding identified a licensing rule violation related to resident rights.
Licensing—Failed to assure resident rights
07 Apr 2023Inspection
07 Apr 2023Inspection
Investigated and found failure to fully implement and update an Acuity Based Staffing Tool.
Licensing—Failed to use an ABST
25 Mar 2023Inspection
25 Mar 2023Inspection
Determined that resident complaints were not effectively responded to or resolved, and outsiders approached residents at the smoking area.
Licensing—Failed to assure resident rights
22 Mar 2023Inspection
22 Mar 2023Inspection
Found a deficiency in storage and handling of soiled linens and clothing due to the absence of a separate closed-container area and one-way flow from soiled to clean areas.
Licensing—Failed to provide service
20 Jan 2023Inspection
20 Jan 2023Inspection
Investigated and found a failure to report potential or suspected abuse, resulting in unexplainable injuries and an ER visit.
Licensing—Failed to report potential or suspected abuse
15 Jan 2023Abuse: Neglect
15 Jan 2023Abuse: Neglect
Investigated a care plan violation and found that staff did not follow the plan, resulting in neglect and abuse with potential for moderate harm; a fine was assessed.
Abuse—Failed to follow care plan
25 Dec 2022Inspection
25 Dec 2022Inspection
Identified a violation for not using ABST; an ABST condition was imposed and later closed.
Licensing—Failed to use an ABST
12 Sept 2022Inspection
12 Sept 2022Inspection
Investigated the abuse reporting process and found a failure to promptly investigate all reports of abuse and suspected abuse and to take measures to protect residents from re-occurrence.
Licensing—Failed to report potential or suspected abuse
12 Sept 2022Inspection
12 Sept 2022Inspection
Investigated the allegation of failing to report potential or suspected abuse and determined that no licensing violation or abuse occurred.
Licensing—Failed to report potential or suspected abuse
02 Sept 2022Abuse: Neglect
02 Sept 2022Abuse: Neglect
Found a failure to provide a safe environment that resulted in injury and constitutes abuse. The incident involved an altercation and harm to a resident.
Abuse—Failed to provide safe environment
29 Aug 2022Abuse: Neglect
29 Aug 2022Abuse: Neglect
Found a failure to provide a safe environment when a courtyard door was propped open on a hot day, resulting in a resident being found outside and unable to stand.
Abuse—Failed to provide safe environment
14 Aug 2022Abuse: Neglect
14 Aug 2022Abuse: Neglect
Investigated and found neglect and abuse stemming from failure to locate a resident's belt buckles, which led to theft. A $250 fine was assessed.
Abuse—Failed to protect resident from financial exploitation
19 May 2022Inspection
19 May 2022Inspection
Found a violation for failing to provide a safe and homelike environment.
Licensing—Failed to provide a homelike environment
18 May 2022Inspection
18 May 2022Inspection
Investigated and found a safety deficiency due to a door that did not latch and open areas that allowed memory care residents to access cabinets.
Licensing—Failed to provide safe environment
18 May 2022Inspection
18 May 2022Inspection
Investigated the allegation that medications were not kept secure between setup and administration and found a deficiency.
Licensing—Failed to properly secure or store medication
18 May 2022Inspection
18 May 2022Inspection
Investigated the medication administration oversight allegation and verified inadequate professional oversight of the medication and treatment administration system.
Licensing—Failed to administer medication as ordered
18 May 2022Inspection
18 May 2022Inspection
Investigated and verified a failure to keep medical and other records confidential as required by law.
Licensing—Failed to assure resident rights
18 May 2022Inspection
18 May 2022Inspection
Investigated an allegation of failing to administer medication as ordered and identified a deficiency for not carrying out medication and treatment orders.
Licensing—Failed to administer medication as ordered
10 Mar 2022Abuse: Neglect
10 Mar 2022Abuse: Neglect
Found that a resident was not provided a safe environment, resulting in abuse and neglect findings and a $250 fine assessed.
Abuse—Failed to provide safe environment
26 Jan 2022Inspection
26 Jan 2022Inspection
Investigated a complaint and found a deficiency in providing a safe environment, including inadequate PPE usage during the COVID outbreak.
Licensing—Failed to provide safe environment
18 Jan 2022Abuse: Neglect
18 Jan 2022Abuse: Neglect
Investigated and found neglect and abuse due to failure to provide proper care, with a resident found in urine-soaked clothing and a room smelling of urine and rotten food.
Abuse—
02 Nov 2021Inspection
02 Nov 2021Inspection
Investigated a staffing allegation and verified that staffing levels were not adequate.
Licensing—Failed to provide appropriate staffing
08 Jun 2021Inspection
08 Jun 2021Inspection
Investigated the allegation and found housekeeping services were not provided as required.
Licensing—Failed to provide appropriate housekeeping services
08 Jun 2021Inspection
08 Jun 2021Inspection
Investigated a falsified records allegation and found the alleged victim's record was not current or accurate.
Licensing—Falsified records
08 Jun 2021Inspection
08 Jun 2021Inspection
Found a deficiency in providing or assisting with hygiene. The allegation was verified.
Licensing—Failed to provide or assist with hygiene
08 Jun 2021Inspection
08 Jun 2021Inspection
Found inadequate staffing. The staffing allegation was verified.
Licensing—Failed to provide appropriate staffing
18 May 2021Inspection
18 May 2021Inspection
Found a deficiency in providing a safe environment for residents.
Licensing—Failed to provide safe environment
18 May 2021Inspection
18 May 2021Inspection
Investigated and determined equipment was not kept in good repair.
Licensing—Failed to provide service
31 Mar 2021Inspection
31 Mar 2021Inspection
Investigated and verified a failure to provide three daily nutritious, palatable meals.
Licensing—Failed to provide proper food/nutrition
31 Mar 2021Inspection
31 Mar 2021Inspection
Investigated the infection control allegation and verified that reasonable precautions to protect residents' health, safety, or welfare were not provided.
Licensing—Failed to provide infection control
10 Mar 2021Inspection
10 Mar 2021Inspection
Identified a violation for failing to administer medication as ordered.
Licensing—Failed to administer medication as ordered
12 Aug 2020Inspection
12 Aug 2020Inspection
Found insufficient staff to meet residents' scheduled and unscheduled needs; the related call-light response allegation was confirmed.
Licensing—Failed to answer call light in a timely manner
12 Aug 2020Inspection
12 Aug 2020Inspection
Investigated the allegation that resident rights were not assured and found a deficiency in responding to and resolving resident complaints.
Licensing—Failed to assure resident rights
23 Jun 2020Abuse: Neglect
23 Jun 2020Abuse: Neglect
Investigated a complaint and found neglect of care and abuse for failing to respond to a resident's significant change in condition.
Abuse—Failed to intervene when resident's condition changed
22 Oct 2019Inspection
22 Oct 2019Inspection
Investigated an allegation of failing to provide proper food and nutrition and found a deficiency.
Licensing—Failed to provide proper food/nutrition
20 Aug 2019Abuse: Neglect
20 Aug 2019Abuse: Neglect
Found a violation for failing to provide a safe environment, risking serious harm to a resident during an exit-seeking incident in a secured memory care unit.
Abuse—Failed to provide safe environment
29 Jul 2019Abuse: Neglect
29 Jul 2019Abuse: Neglect
Identified neglect of care and assessed a $375 fine.
Abuse—Failed to follow care plan
10 Jul 2019Abuse: Financial abuse
10 Jul 2019Abuse: Financial abuse
Investigated an allegation of financial exploitation and identified a failure to protect a resident from financial exploitation.
Abuse—Failed to protect resident from financial exploitation
07 Jul 2019Abuse: Neglect
07 Jul 2019Abuse: Neglect
Identified neglect involving a resident found with a head injury.
Abuse—Failed to follow care plan
16 Apr 2019Abuse: Financial abuse
16 Apr 2019Abuse: Financial abuse
Investigated a report of missing funds and identified theft/financial exploitation; an allegation of unsafe environment was noted.
Abuse—Failed to provide safe environment
09 Apr 2019Inspection
09 Apr 2019Inspection
Found a deficiency in the safe medication administration system.
Licensing—Failed to provide a safe medication administration system
09 Apr 2019Inspection
09 Apr 2019Inspection
Found that a resident did not receive medication as prescribed.
Licensing—Failed to administer medication as ordered
04 Apr 2019Abuse: Neglect
04 Apr 2019Abuse: Neglect
Found neglect related to medication administration that prevented proper delivery of prescribed medications. A $500 fine was assessed.
Abuse—Failed to provide a safe medication administration system
04 Apr 2019Inspection
04 Apr 2019Inspection
Found failure to report suspected abuse and assessed a $750 fine.
Licensing—Failed to report potential or suspected abuse
05 Dec 2018Abuse: Neglect
05 Dec 2018Abuse: Neglect
Found neglect due to failure to provide a safe environment, creating risk of serious harm.
Abuse—Failed to provide safe environment
01 Dec 2018Abuse: Neglect
01 Dec 2018Abuse: Neglect
Found neglect of care due to failing to provide a safe environment and safe medication administration, creating risk of serious harm.
Abuse—Failed to provide a safe medication administration system
25 Nov 2018Abuse: Neglect
25 Nov 2018Abuse: Neglect
Investigated and found neglect due to failure to assure resident safety after a fall during care; the resident sustained a leg injury.
Abuse—Failed to assure resident was safe
22 Oct 2018Inspection
22 Oct 2018Inspection
Investigated the allegation and substantiated a licensing violation.
Licensing—Failed to provide service
11 Aug 2018Inspection
11 Aug 2018Inspection
Found that a safe environment was not provided to residents.
Licensing—Failed to provide safe environment
02 Aug 2018Abuse: Neglect
02 Aug 2018Abuse: Neglect
Investigated an abuse/neglect allegation and found a failure to maintain a safe environment, with a $375 fine assessed.
Abuse—Failed to follow care plan
26 Mar 2018Abuse: Financial abuse
26 Mar 2018Abuse: Financial abuse
Investigated an allegation of financial exploitation and found a failure to protect a resident from theft.
Abuse—Failed to protect resident from financial exploitation
22 Sept 2016Inspection
22 Sept 2016Inspection
Found a safety deficiency due to failure to provide a safe environment.
Licensing—Failed to follow care plan
19 Sept 2016Inspection
19 Sept 2016Inspection
Investigated and found a failure to provide a safe environment.
Licensing—Failed to provide safe environment
11 Dec 2015Inspection
11 Dec 2015Inspection
Identified a failure to carry out medication orders as prescribed, a Level 1 licensing violation with no harm or potential for minor harm.
Licensing—Failed to administer medication as ordered
08 Jul 2014Abuse: Financial abuse
08 Jul 2014Abuse: Financial abuse
Investigated an allegation of financial abuse and found a deficiency in protecting a resident from theft.
Abuse—Failed to provide safe environment
16 Dec 2013Abuse: Restraints
16 Dec 2013Abuse: Restraints
Found a failure to provide a safe environment related to a restraint allegation.
Abuse—Failed to provide safe environment
26 Jul 2013Abuse: Physical Abuse
26 Jul 2013Abuse: Physical Abuse
Investigated a report of abuse and found a safe environment was not provided.
Abuse—Failed to provide safe environment
02 Jul 2013Abuse: Financial abuse
02 Jul 2013Abuse: Financial abuse
Identified a deficiency for failing to provide a safe environment, resulting in property theft.
Abuse—Failed to provide safe environment
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Mirador Living is not affiliated with the owner or operator(s) of Pacific Grove Senior Living. The information above has not been verified or approved by the owner or operator. For exact information, please contact Pacific Grove Senior Living directly. There is no cost for this service. We are compensated by the community you select.
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