I moved my mom here and we're very pleased - the bright, spotless campus and spacious, well-maintained apartments feel luxurious, the staff are consistently warm, attentive and professional, and the dining is delicious. There's a lively schedule of activities, welcoming residents, and a real sense of community, so I'd recommend it for active older adults.
Loved one of resident
Jul 2026
Pricing
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
Coordination with health care providers
Hospice waiver
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
Dementia waiver
Mild cognitive impairment
Specialized memory care programming
Transportation
Community operated transportation
Transportation arrangement
Transportation arrangement (medical)
Transportation arrangement (non-medical)
Transportation to doctors appointments
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
3.27·(84)
Overall rating
5
4
3
2
1
Care
2.9
Staff
3.2
Meals
2.6
Amenities
4.1
Value
2.4
Pros
Modern, attractive new campus
Spacious apartments with balconies and full kitchens
Wide range of on-site amenities (theater, library, cafe, game rooms, salon, fitness)
Robust activity program with frequent outings
Friendly and compassionate direct care staff
Housekeeping and routine maintenance services
Assistance with transportation and medical appointments
Move-in and transfer support (suite preparation, equipment provision)
Meal-choice options and some higher-quality meal periods
Pet-friendly unit options and outdoor access
Accessible common areas and safety features (handrails, seating)
Positive value and satisfaction reported by some families
Cons
Inconsistent staffing levels and high turnover
Gaps in clinical staffing and limited full-time nursing coverage
Medication-administration delays and inventory management issues
Unreliable meal service and variable food quality
Weak management follow-through and inconsistent communication
Insufficient staff training and readiness for complex care needs
Post-incident response and family-notification gaps
Maintenance follow-through delays and inconsistent unit repairs
Laundry handling and personal-property management errors
Billing, refund, and unexpected charge disputes
Variable memory-care management and oversight
Perceived corporate-priority pressures affecting local operations
Summary of reviews
Bonaventure of Gresham presents as a largely new, well-appointed senior living campus with many physical strengths: modern architecture, spacious apartments (including some with full kitchens and balconies), and an extensive set of common areas and amenities such as a theater, library, cafe, game rooms, salon and fitness spaces. The community offers a busy activities calendar and regular outings, and several reviewers praised the move-in process and on-site supports like transportation to appointments.
Direct care staff receive frequent positive remarks for compassion, personal attention and responsiveness; families described caregivers who build rapport and coordinate complex transfers at move-in. That said, a recurrent operational pattern is inconsistent staffing levels and turnover. Multiple reviews point to gaps in clinical coverage (including absence of a full-time RN at times), limited training for some care staff, and resulting delays in medication administration and other clinical tasks. There are also reports of missed or late medications and medication-supply lapses, which create a material risk for residents who require close clinical oversight.
Dining and dining-service reliability are notable areas of variability. Some reviewers praised certain meals and the availability of meal choices, but many described long service delays, meals arriving cold, limited lighter or diet-specific options, removal of salad/soup bar offerings, and occasional concerns about dish cleanliness and utensil availability. These comments suggest fluctuating kitchen staffing or service processes that affect consistency.
Activity programming is a clear strength: reviewers consistently describe a broad variety of scheduled activities, resident inclusion in planning, and frequent outings that contribute to a strong sense of community. The built environment supports social engagement with ample seating in corridors, multiple activity rooms, and outdoor access.
Operational weaknesses extend beyond staffing and dining. Families raised issues with management responsiveness and follow-through on promised services, inconsistent maintenance completion timelines, laundry and personal-property handling errors, and billing or refund disputes. A subset of reviews referenced regulatory citations and allegations of theft and other serious concerns; these comments, while not uniform across all feedback, indicate the need to review past survey history and specific incident resolution when evaluating the community.
Taken together, Bonaventure of Gresham offers many of the physical and programmatic attributes prospective residents and families seek in a new campus—strong amenities, active programming, and many attentive caregivers. However, reviewers also identify operational risks around clinical staffing, medication management, dining consistency, and management reliability. Prospective families should verify current clinical staffing levels (RN coverage and medication administration procedures), ask for recent state survey results, clarify meal and dietary accommodations, review billing and pet policies in writing, and request examples of how the community addresses staff turnover and incident communication before making a placement decision.
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Location
Bonaventure of Gresham is located at 22514 SE Stark St, Gresham, OR, 97030.
About Bonaventure of Gresham
Bonaventure of Gresham Assisted Living is a senior living community in Oregon with services for independent living, assisted living, and memory care. The building has a classic craftsman look on the outside and a cozy, traditional feel inside, with big windows that let in lots of light. Seniors live in suites that can be small studios or bigger spaces, with sizes ranging from 341 to 1,103 square feet, so there's something for folks who want more room or something simpler. Memory care suites come in both private and shared options, even with space for couples. All the suites have full kitchens or kitchenettes, and everyone can control the temperature to fit what they like.
Seniors can bring their pets, which is nice for animal lovers, and the grounds have tree-lined walking paths, gardens, and patios. There are activity rooms, an exercise center, a theater room, a café with coffee and snacks, a beauty and barber salon, library, billiards room, and spots to gather or sit by the fireplace. Folks can also find a game room, hospitality suite, puzzle room, wash-and-dry rooms, and a dedicated dining space for private meals. The building is three stories high and has about 57 beds, so it's not a huge place but not too small either, with enough people to keep things lively.
Residents get three meals every day served in a restaurant-style dining room, plus snacks, and there's an anytime dining option for those who don't want to eat at regular times. Activities are set up every day of the week, and transportation can be arranged for trips or errands. The staff is always there-day or night-to give help and check on folks. People who need more help, like assistance getting dressed or reminders for medication, have trained staff around to lend a hand. For those who need a nurse, skilled care is available right in the building.
The community makes it easy for people to feel comfortable, with clean, well-kept suites and weekly housekeeping with fresh linens, handy maintenance, and laundry rooms that don't cost extra to use, plus WiFi and cable. Safety is important here, so there are nurse call systems, enhanced security at the front door, and the bathrooms are designed to be easy to use if anyone has trouble getting around. People with Alzheimer's or dementia have their own spaces and support, with activities and areas meant to fit their needs.
Bonaventure of Gresham isn't far from Portland-just about a half-hour drive-so people can get to the city if needed but still live in a quieter, peaceful spot. The place is set up so folks can choose how active they want to be, with lots of options for socializing, relaxing, making friends, or doing hobbies. There's a focus on happiness, well-being, and making sure everyone gets the help they need to enjoy life. The community has a website for families and residents to stay updated, and has spaces and events that make it easy to keep in touch or gather with friends. All in all, it's a well-kept, friendly spot for seniors looking for support, comfort, and a home where they can live at their own pace.
Founded in 1999 and headquartered in Salem, Oregon, Bonaventure Senior Living is a family-owned company operating 28 communities across Washington, Oregon, and Colorado. They offer independent living, assisted living, and memory care services with their "Retirement Perfected™" philosophy.
People often ask...
Bonaventure of Gresham offers competitive pricing, with rates starting at a cost of $6,591 per month.
Bonaventure of Gresham offers independent living, assisted living, and memory care.
There are 42 photos of Bonaventure of Gresham on Mirador.
Yes, Bonaventure of Gresham allows residents to age in place and adjust their level of care as needed.
The full address for this community is 22514 SE Stark St, Gresham, OR 97030.
No, Bonaventure of Gresham 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.
Regulatory Action—Failed to provide safe environment
30 Mar 2026Inspection
30 Mar 2026Inspection
Identified a deficiency for failing to provide a secured outdoor recreation area.
Licensing—Failed to provide safe environment
22 Mar 2026Inspection
22 Mar 2026Inspection
Found failure to ensure the implementation of required services.
Licensing—Failed to provide service
22 Mar 2026Inspection
22 Mar 2026Inspection
Determined that required awake direct-care staffing levels and quarterly ABST evaluations were not met.
Licensing—Failed to provide service
22 Mar 2026Abuse: Neglect
22 Mar 2026Abuse: Neglect
Investigated an abuse by neglect allegation and found that safety measures were inadequate, leading to elopement and injury.
Abuse—Failed to provide safe environment
22 Mar 2026Inspection
22 Mar 2026Inspection
Identified a failure to provide a safe environment that could threaten residents' health and safety.
Licensing—Failed to provide safe environment
19 Feb 2026Inspection
19 Feb 2026Inspection
Investigated a complaint alleging staff photographed a resident during care and mocked them, finding failure to protect the resident from emotional abuse.
Licensing—Failed to protect resident from mental or emotional abuse
25 Oct 2025Inspection
25 Oct 2025Inspection
Investigated and concluded a violation for failing to provide records to the Department upon request.
Licensing—Failed to make facility or resident records accessible
27 Aug 2025Inspection
27 Aug 2025Inspection
Found that quarterly ABST evaluations for residents were not completed or reviewed as required.
Licensing—Failed to provide service
05 Aug 2025Inspection
05 Aug 2025Inspection
Found that records were not provided to the Department upon request, violating Oregon Administrative Rules.
Licensing—Failed to cooperate with an investigation
05 Aug 2025Complaint
05 Aug 2025Complaint
Identified deficiencies in service plan documentation and acuity-based staffing data, showing incomplete and inconsistent care time and tasks for residents.
Deficiency—Licensing Complaint Investigation
Deficiency—Service Plan: General
Deficiency—Staffing Requirements and Training: Staffing
Deficiency—Acuity Based Staffing Tool - Abst Time
21 Jul 2025Inspection
21 Jul 2025Inspection
Found that a resident was financially exploited by a staff member and the provider failed to protect the resident, constituting abuse by neglect.
Licensing—Failed to protect resident from financial exploitation
15 Jul 2025Inspection
15 Jul 2025Inspection
Found that a resident was financially exploited and protection from exploitation failed.
Licensing—Failed to protect resident from financial exploitation
10 Jul 2025Inspection
10 Jul 2025Inspection
Determined that the provider failed to ensure the implementation of services for sampled residents.
Licensing—Failed to provide service
08 Jul 2025Inspection
08 Jul 2025Inspection
Found failure to provide records to the Department upon request, violating Oregon administrative rules.
Licensing—Failed to make facility or resident records accessible
18 Jun 2025Kitchen
18 Jun 2025Kitchen
Identified deficiencies in kitchen sanitation, food-handling practices, and staff training. Violations cited across multiple areas.
Deficiency—Staffing Requirements and Training – Pre-service
Deficiency—Inspections and Investigations
Deficiency—Inspections and Investigation: Insp Interval
Deficiency—Administration Compliance
Deficiency—Staff Training Requirements
18 Jun 2025Kitchen
18 Jun 2025Kitchen
Identified serious kitchen sanitation and storage deficiencies and a staff member lacking an active food handler's certificate. Cited for failing to implement relicensing follow-up plans.
Deficiency—Staffing Requirements and Training – Pre-service
Deficiency—Inspections and Investigations
Deficiency—Inspections and Investigation: Insp Interval
23 May 2025Inspection
23 May 2025Inspection
Found that quarterly service plans were not completed after a resident moved in.
Licensing—Failed to properly plan care
23 May 2025Inspection
23 May 2025Inspection
Investigated a complaint and found a deficiency for failing to provide a safe environment due to missing written policies and procedures that promote high-quality services, health, and safety.
Licensing—Failed to provide safe environment
23 May 2025Inspection
23 May 2025Inspection
Found failure to immediately notify the local Department office of any incident of abuse or suspected abuse.
Licensing—Failed to provide safe environment
23 May 2025Complaint
23 May 2025Complaint
Identified deficiencies in staffing requirements and in the use of acuity-based staffing tools. Also found issues related to inspections and investigations.
Deficiency—Licensing Complaint Investigation
Deficiency—Staffing Requirements and Training: Staffing
Deficiency—Acuity Based Staffing Tool - Abst Time
Deficiency—Acuity Based Staffing Tool - Updates & Plan
Deficiency—Inspections and Investigations
23 May 2025Inspection
23 May 2025Inspection
Concluded that oversight and monitoring of a resident's short-term change in condition was not provided. Found that a 24-hour resident monitoring and reporting system was not implemented.
Licensing—Failed to provide oversight and monitoring of change of condition
19 May 2025Abuse: Neglect
19 May 2025Abuse: Neglect
Found abuse by neglect due to inadequate monitoring and lack of progressive interventions to prevent bruising from falls, posing safety risk, with a fine assessed.
Abuse—Failed to properly plan care
16 May 2025Inspection
16 May 2025Inspection
Investigated an allegation of failing to provide a safe environment and found that required records were not provided to the Department on request.
Licensing—Failed to provide safe environment
29 Apr 2025Inspection
29 Apr 2025Inspection
Investigated an allegation that records were not accessible; found that records were not provided to the Department upon request.
Licensing—Failed to make facility or resident records accessible
14 Apr 2025Inspection
14 Apr 2025Inspection
Concluded that records were not provided to the department upon request. This finding identified a licensing violation for failing to make records accessible.
Licensing—Failed to make facility or resident records accessible
26 Mar 2025Abuse: Neglect
26 Mar 2025Abuse: Neglect
Found violations for failing to plan care and mitigate fall risk, resulting in multiple falls and related injuries.
Abuse—Failed to properly plan care
19 Mar 2025Inspection
19 Mar 2025Inspection
Found a violation for failing to provide records upon request.
Licensing—Failed to make facility or resident records accessible
05 Mar 2025Abuse: Neglect
05 Mar 2025Abuse: Neglect
Concluded that a safe environment was not provided and abuse/neglect occurred, with a monetary penalty assessed.
Abuse—Failed to provide safe environment
28 Feb 2025Abuse: Neglect
28 Feb 2025Abuse: Neglect
Found neglect and abuse due to the failure to perform nightly checks required by the care plan, leaving a resident on the floor for hours.
Abuse—Failed to follow care plan
28 Feb 2025Inspection
28 Feb 2025Inspection
Found insufficient qualified awake direct care staff to meet the 24-hour schedule.
Licensing—Failed to provide service
27 Feb 2025Inspection
27 Feb 2025Inspection
Identified that quarterly ABST evaluations for residents were not completed or updated as required.
Licensing—Failed to provide service
09 Jan 2025Inspection
09 Jan 2025Inspection
Investigated a records access allegation and found a deficiency for failing to provide records upon request.
Licensing—Failed to make facility or resident records accessible
03 Jan 2025Inspection
03 Jan 2025Inspection
Investigated the allegation and identified deficiencies in awake direct care staffing and quarterly ABST evaluations.
Licensing—Failed to provide service
18 Nov 2024Inspection
18 Nov 2024Inspection
Investigated and found that records were not provided to the Department upon request.
Licensing—Failed to make facility or resident records accessible
05 Nov 2024Inspection
05 Nov 2024Inspection
Investigated the allegation of failing to provide service; found that required actions for a resident's short-term change of condition were not determined or documented, and written communications of the change and needed interventions to direct care staff on each shift were not provided.
Licensing—Failed to provide service
15 Aug 2024Abuse: Neglect
15 Aug 2024Abuse: Neglect
Found violations for failing to provide a safe medication administration system, resulting in pain for a resident who relies on staff to administer medications.
Abuse—Failed to provide a safe medication administration system
13 Aug 2024Licensure
13 Aug 2024Licensure
Investigated multiple deficiencies across abuse reporting, resident services, care planning, staffing, infection control, and training; substantial compliance was reached after follow-up.
Deficiency—Resident Move-In and Eval: Res Evaluation
Deficiency—Service Plan: General
Deficiency—Change of Condition and Monitoring
Deficiency—Resident Health Services
Deficiency—Infection Prevention & Control
Deficiency—Systems: Psychotropic Medication
Deficiency—Restraints and Supportive Devices
Deficiency—Staffing Requirements and Training: Staffing
Deficiency—Acuity-Based Staffing Tool
Deficiency—Fire and Life Safety: Training For Residents
Deficiency—Inspections and Investigation: Insp Interval
Deficiency—Doors, Walls, Elevators, Odors
Deficiency—Individual Door Locks: Key Access
Deficiency—Administration Compliance
Deficiency—Staff Training Requirements
Deficiency—Compliance With Rules Health Care
12 Aug 2024Licensure
12 Aug 2024Licensure
Identified widespread deficiencies in quality improvement, resident rights, service planning, medication management, infection control, staffing, and fire safety during a re-licensure process, with multiple violations cited.
Identified sanitation and food handling deficiencies during the initial kitchen review, including dirty surfaces, improper storage, uncovered ice cream, and improper glove use. A follow-up visit later found substantial compliance with the applicable rules.
Investigated a neglect allegation and found the resident did not receive basic care. The injury worsened to a stage 3 pressure ulcer, and a $250 fine was assessed.
Abuse—Failed to provide service
16 Jan 2024Inspection
16 Jan 2024Inspection
Found that records were not made available to the Department upon request, following an allegation of failing to provide a safe environment.
Licensing—Failed to provide safe environment
13 Jan 2024Abuse: Neglect
13 Jan 2024Abuse: Neglect
Found a failure to provide a safe medication administration system, resulting in significant pain and hospital transport. A $250 fine was assessed.
Abuse—Failed to provide a safe medication administration system
05 Jan 2024Abuse: Neglect
05 Jan 2024Abuse: Neglect
Found abuse and neglect due to failure to provide a safe environment after escalating aggression toward residents, including an assault.
Abuse—Failed to provide safe environment
23 Nov 2023Abuse: Neglect
23 Nov 2023Abuse: Neglect
Found violations of neglect and abuse for failing to follow the care plan and assist with a one-person transfer, which contributed to a resident fall.
Abuse—Failed to follow care plan
17 Aug 2023Inspection
17 Aug 2023Inspection
Investigated and found that records were not provided to the Department upon request, violating state rules.
Licensing—Failed to provide safe environment
10 Aug 2023Inspection
10 Aug 2023Inspection
Investigated a complaint and found that a staff member failed to protect a resident from verbal abuse. The facility also failed to protect the resident from verbal abuse, resulting in identified violations.
Licensing—Failed to protect resident from verbal abuse
10 Aug 2023Inspection
10 Aug 2023Inspection
Investigated an incident involving physical abuse. Found that a staff member grabbed a resident's wrist and elbow and failed to protect the resident from abuse, constituting abuse and neglect.
Licensing—Failed to protect resident from physical abuse
10 Aug 2023Inspection
10 Aug 2023Inspection
Investigated an allegation of physical abuse and found that staff failed to protect a resident from abuse and neglect.
Licensing—Failed to protect resident from physical abuse
19 Jul 2023Abuse: Neglect
19 Jul 2023Abuse: Neglect
Identified insufficient safety planning and care planning for a resident's known behaviors, with potential for harm.
Abuse—Failed to properly plan care
04 Jul 2023Abuse: Neglect
04 Jul 2023Abuse: Neglect
Found a failure to provide a safe medication administration system that caused distress and led to the resident's death.
Abuse—Failed to provide a safe medication administration system
25 May 2023Inspection
25 May 2023Inspection
Found a violation for failing to provide records to the Department upon request.
Licensing—Failed to provide safe environment
25 Apr 2023Licensure
25 Apr 2023Licensure
Identified deficiencies in kitchen cleanliness and cross-contamination prevention; a follow-up review determined compliance with applicable rules.
Found deficiencies in kitchen cleanliness and cross-contamination controls, and administration rule noncompliance. The issues were observed during two visits.
Investigated an abuse/neglect allegation and found a failure to provide a safe environment, resulting in injuries.
Abuse—Failed to provide safe environment
21 Mar 2023Abuse: Verbal Abuse
21 Mar 2023Abuse: Verbal Abuse
Found that a staff member failed to protect a resident from verbal abuse, with a $500 fine assessed.
Abuse—Failed to protect resident from verbal abuse
21 Mar 2023Abuse: Neglect
21 Mar 2023Abuse: Neglect
Investigated an incident of abuse and neglect, finding that a staff member failed to protect a resident from physical abuse and protection was not assured, with a $500 fine assessed.
Abuse—Failed to protect resident from physical abuse
01 Mar 2023Abuse: Neglect
01 Mar 2023Abuse: Neglect
Found a failure to provide a safe environment that put a resident at risk of harm, constituting neglect and abuse.
Abuse—Failed to provide safe environment
01 Mar 2023Inspection
01 Mar 2023Inspection
Investigated an allegation of failing to provide a safe environment and identified a records-availability violation for not making documents available to the Department as required.
Licensing—Failed to provide safe environment
26 Feb 2023Abuse: Neglect
26 Feb 2023Abuse: Neglect
Found a failure to provide a safe environment resulting in abuse/neglect and risk of harm to a resident. A $500 fine was assessed.
Abuse—Failed to provide safe environment
11 Feb 2023Abuse: Neglect
11 Feb 2023Abuse: Neglect
Investigated and found a failure to provide a safe environment for a resident given known aggressive behavior, leading to violations cited and a monetary penalty. A $500 fine was assessed.
Abuse—Failed to provide safe environment
05 Feb 2023Abuse: Neglect
05 Feb 2023Abuse: Neglect
Identified a safety deficiency after a resident-to-resident altercation left a resident exposed to risk of harm due to inadequate supervision; a fine was assessed.
Abuse—Failed to provide safe environment
20 Jan 2023Abuse: Neglect
20 Jan 2023Abuse: Neglect
Investigated a complaint about transportation safety; found staff failure to safeguard a resident during pickup, allowing the resident to be driven to a bank while confused.
Abuse—Failed to provide service
08 Jan 2023Abuse: Neglect
08 Jan 2023Abuse: Neglect
Found violations of the service plan leading to neglect and abuse; a fine was assessed.
Abuse—Failed to follow care plan
14 Dec 2022Abuse: Neglect
14 Dec 2022Abuse: Neglect
Found violations related to safe medication administration that could put a resident at risk, with a $250 fine assessed.
Abuse—Failed to provide a safe medication administration system
10 Dec 2022Abuse: Neglect
10 Dec 2022Abuse: Neglect
Investigated an allegation of neglect and found a failure to provide a safe medication administration system, resulting in shortages of anxiety and blood pressure medications.
Abuse—Failed to provide a safe medication administration system
07 Dec 2022Abuse: Neglect
07 Dec 2022Abuse: Neglect
Found failures to provide incontinence and catheter care and to reposition a resident as required, risking potential harm.
Abuse—Failed to provide service
26 Oct 2022Complaint
26 Oct 2022Complaint
Identified deficiencies in abuse reporting, activities, staffing, and staff training, indicating noncompliance with applicable rules.
Deficiency—Staffing Requirements and Training: Staffing
Deficiency—Annual and Biennial Inservice For All Staff
22 Sept 2022Abuse: Neglect
22 Sept 2022Abuse: Neglect
Found that the provider failed to provide a safe environment, resulting in a resident's fall and injuries. A $500 fine was assessed.
Abuse—Failed to provide safe environment
13 Sept 2022Inspection
13 Sept 2022Inspection
Found a licensing violation for failure to provide a safe medication administration system.
Licensing—Failed to provide a safe medication administration system
13 Sept 2022Inspection
13 Sept 2022Inspection
Investigated an allegation of failure to report potential or suspected abuse and found that there was a failure to immediately notify the local Department office and to require all staff to immediately report abuse and suspected abuse.
Licensing—Failed to report potential or suspected abuse
12 Sept 2022Inspection
12 Sept 2022Inspection
Found violations for failing to protect a resident from verbal abuse.
Licensing—Failed to protect resident from verbal abuse
25 Aug 2022Complaint
25 Aug 2022Complaint
Identified deficiencies in incident response and notification practices; failed to notify the resident's physician and family for an incident.
Found neglect of care and abuse due to failure to revise the care plan and document safety measures after multiple falls. This resulted in injuries to the resident.
Abuse—Failed to properly plan care
14 Aug 2022Inspection
14 Aug 2022Inspection
Identified a deficiency in incident prevention and response policies and procedures, including for incidents not involving abuse.
Licensing—Failed to provide safe environment
12 Jun 2022Abuse: Neglect
12 Jun 2022Abuse: Neglect
Investigated a resident safety violation after a resident was punched by a staff member, causing injuries, and a fine was assessed.
Abuse—Failed to provide safe environment
05 Jun 2022Abuse: Neglect
05 Jun 2022Abuse: Neglect
Investigated the allegation of neglect and abuse and found a failure to provide a safe environment, constituting abuse and neglect.
Abuse—Failed to provide safe environment
05 Jun 2022Abuse: Neglect
05 Jun 2022Abuse: Neglect
Investigated and found a failure to provide a safe environment, resulting in abuse/neglect concerns and a fine was assessed.
Abuse—Failed to provide safe environment
31 May 2022Abuse: Neglect
31 May 2022Abuse: Neglect
Found violations of resident rights due to failure to provide a safe environment, constituting abuse and neglect.
Abuse—
05 May 2022Inspection
05 May 2022Inspection
Found insufficient staffing to meet residents' needs, violating Oregon Administrative Rules.
Licensing—Failed to provide appropriate staffing
25 Mar 2022Abuse: Neglect
25 Mar 2022Abuse: Neglect
Observed neglect and abuse due to failing to respond to a call light promptly, leaving a resident on the bathroom floor for over an hour; a $250 fine was assessed.
Abuse—Failed to answer call light in a timely manner
15 Mar 2022Inspection
15 Mar 2022Inspection
Investigated an allegation that a safe environment was not provided and identified a deficiency in training staff to determine direct care competency through evaluation, observation, or written testing.
Licensing—Failed to provide safe environment
09 Mar 2022Inspection
09 Mar 2022Inspection
Investigated a financial exploitation incident and found the resident was not adequately protected from exploitation.
Licensing—Failed to protect resident from financial exploitation
23 Feb 2022Abuse: Neglect
23 Feb 2022Abuse: Neglect
Found deficiencies in care involving wound prevention, oral hygiene, and compression sock management, with a $250 fine assessed.
Abuse—Failed to provide service
18 Jan 2022Inspection
18 Jan 2022Inspection
Identified insufficient awake direct care staffing to meet 24-hour needs, violating Oregon Administrative Rules.
Licensing—Failed to provide appropriate staffing
18 Jan 2022Inspection
18 Jan 2022Inspection
Found failure to provide a daily program of social and recreational activities, which violated Oregon Administrative Rules.
Licensing—Failed to provide appropriate activities
01 Jul 2021Inspection
01 Jul 2021Inspection
Investigated a complaint of mental/emotional abuse and found that a staff member admitted to throwing water on a resident to prompt a shower, with protections against abuse not ensured.
Licensing—Failed to protect resident from mental or emotional abuse
21 May 2021License Condition
21 May 2021License Condition
Found deficiencies in providing needed/necessary services.
Regulatory Action—Failed to provide service
16 Mar 2021Inspection
16 Mar 2021Inspection
Found that service plans were not readily available to staff and lacked clear direction for delivering services.
Licensing—Failed to communicate necessary information
16 Mar 2021Inspection
16 Mar 2021Inspection
Investigated and verified a failure to provide infection control.
Licensing—Failed to provide infection control
16 Mar 2021Inspection
16 Mar 2021Inspection
Investigated the allegation of failing to provide a safe medication administration system and found inadequate professional oversight of the medication and treatment administration system.
Licensing—Failed to provide a safe medication administration system
18 Feb 2021Inspection
18 Feb 2021Inspection
Identified a deficiency in oversight of the medication administration system that resulted in a resident not receiving medication for two days.
Licensing—Failed to provide a safe medication administration system
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated and found inadequate oversight of the medication administration system due to lost emergency room paperwork.
Licensing—Failed to provide a safe medication administration system
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated an allegation of failing to assure resident rights and identified a deficiency for not providing residents with a menu one week in advance.
Licensing—Failed to assure resident rights
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated a complaint alleging an unsafe environment and found that interior materials and surfaces were not kept clean per the applicable rule.
Licensing—Failed to provide safe environment
18 Feb 2021Abuse: Neglect
18 Feb 2021Abuse: Neglect
Found a failure to provide a safe medication administration system, causing inconsistent medication delivery and failure to notify a doctor about dangerously high blood glucose readings.
Abuse—Failed to provide a safe medication administration system
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated a complaint and found deficiencies in infection prevention and control, including feces-covered clothing and bed sheets in the bath tub and on residents' beds.
Licensing—Failed to provide safe environment
18 Feb 2021Inspection
18 Feb 2021Inspection
Found insufficient staff to meet residents' scheduled and unscheduled needs, including supervision and dressing assistance.
Licensing—Failed to provide appropriate staffing
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated and identified that medications were not kept secure between setup and administration, violating state regulatory requirements.
Licensing—Failed to provide a safe medication administration system
18 Feb 2021Inspection
18 Feb 2021Inspection
Found deficiencies in personal care assistance, including bathing and dressing, with a resident reportedly wearing only a shirt and having greasy hair.
Licensing—Failed to provide service
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated the complaint and found a deficiency in medication administration, resulting in residents not receiving prescribed medications for two days.
Licensing—Failed to provide a safe medication administration system
18 Feb 2021Inspection
18 Feb 2021Inspection
Found residents lacked access to a secure outdoor recreation area.
Licensing—Failed to provide safe environment
18 Feb 2021Inspection
18 Feb 2021Inspection
Found a failure to provide a safe and homelike environment, resulting in a substantiated licensing violation.
Licensing—Failed to provide safe environment
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated an allegation of a safe medication administration system and found a failure to maintain an accurate MAR.
Licensing—Failed to provide a safe medication administration system
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated the medication administration practice and found a deficiency in ensuring that medications are set up, poured, and documented by the same person who administers them. This created a safety risk.
Licensing—Failed to provide a safe medication administration system
18 Feb 2021Inspection
18 Feb 2021Inspection
Concluded that memory care was not kept separate from other housing and staff crossed between units on the same shift.
Licensing—Failed to provide safe environment
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated a complaint about resident rights and identified deficiencies in responding to and resolving resident complaints.
Licensing—Failed to assure resident rights
18 Feb 2021Inspection
18 Feb 2021Inspection
Found a deficiency in the system for disposing unused, outdated, or discontinued medications.
Licensing—Failed to provide a safe medication administration system
18 Feb 2021Inspection
18 Feb 2021Inspection
Investigated allegation found a failure to provide a safe environment, including service plans not completed before move-in and not updated as required.
Licensing—Failed to provide safe environment
26 Jan 2021Inspection
26 Jan 2021Inspection
Investigated an allegation that there was no system to prevent theft or misuse of medication; verified failure to track controlled substances and dispose of unused, outdated, or discontinued medications.
Licensing—Failure to provide a system that prevents theft or misuse of medication
15 Jan 2021Inspection
15 Jan 2021Inspection
Investigated a licensing violation and found that medication orders were not carried out as prescribed.
Licensing—Failed to administer medication as ordered
04 Jan 2021Abuse: Neglect
04 Jan 2021Abuse: Neglect
Found neglect and abuse for failing to administer prescribed medications in a timely manner, risking serious harm to a resident.
Abuse—Failed to provide a safe medication administration system
29 Dec 2020Inspection
29 Dec 2020Inspection
Verified that there was a failure to provide a daily program of social and recreational activities based on individuals' and groups' interests and needs, with opportunities for community participation.
Licensing—Failed to provide appropriate activities
29 Dec 2020Inspection
29 Dec 2020Inspection
Found deficiencies related to meal planning and communication about meals. The findings verified that menus weren't prepared in advance or available to all residents, substitutions must be nutritionally similar, and residents must be informed of changes.
Licensing—Failed to communicate necessary information
29 Dec 2020Inspection
29 Dec 2020Inspection
Found that there was no training program to determine direct care staff competency through evaluation, observation, or written testing.
Licensing—Failed to provide appropriate staffing
29 Dec 2020Inspection
29 Dec 2020Inspection
Investigated and found a failure to have written policies and procedures on medical emergency response for all shifts.
Licensing—Failed to communicate necessary information
29 Dec 2020Inspection
29 Dec 2020Inspection
Concluded that qualified awake direct care staffing was insufficient to meet 24-hour needs.
Licensing—Failed to assure a qualified caregiver was present
27 Nov 2020Abuse: Neglect
27 Nov 2020Abuse: Neglect
Found that interventions were not implemented and monitoring was inadequate, leading to a physical altercation and discomfort.
Abuse—Failed to provide safe environment
28 Oct 2020License Condition
28 Oct 2020License Condition
Found deficiencies related to infection control due to failure to provide it.
Regulatory Action—Failed to provide infection control
29 Sept 2020Abuse: Neglect
29 Sept 2020Abuse: Neglect
Identified neglect and abuse for failing to follow the Alleged Victim's care plan to reposition with two staff, resulting in open sores.
Abuse—Failed to follow care plan
29 Sept 2020Inspection
29 Sept 2020Inspection
Investigated and found that services were not implemented per the resident service plan and that care plans were not readily available to staff.
Licensing—Failed to follow care plan
29 Sept 2020Inspection
29 Sept 2020Inspection
Investigated a complaint and found insufficient awake qualified direct care staff to meet scheduled and unscheduled resident needs, including safe transfers.
Licensing—Failed to assist with transfer
29 Sept 2020Inspection
29 Sept 2020Inspection
Investigated the staffing concern and identified a deficiency in awake qualified direct care staff. Found that untrained staff were involved in training Med Techs.
Licensing—Failed to provide appropriate staffing
26 Sept 2020Inspection
26 Sept 2020Inspection
Found a deficiency in the medication administration system that allowed a resident to receive another resident's medication, creating risk of harm.
Licensing—Failed to provide a safe medication administration system
22 Sept 2020Inspection
22 Sept 2020Inspection
Concluded that there was a failure to document and monitor change of condition and needed interventions, risking harm from an untreated infected skin tear.
Licensing—Failed to provide oversight and monitoring of change of condition
22 Sept 2020Inspection
22 Sept 2020Inspection
Investigated and found failure to report potential or suspected abuse to required authorities, including failure to report an unknown-cause injury.
Licensing—Failed to report potential or suspected abuse
22 Sept 2020Inspection
22 Sept 2020Inspection
Found deficiencies in safekeeping of residents possessions; missing pants and socks were reported.
Licensing—Failed to protect resident from financial exploitation
20 Sept 2020Abuse: Neglect
20 Sept 2020Abuse: Neglect
Identified neglect and abuse due to failure to provide required services, causing the victim's skin condition to worsen and severe pain; a $500 fine was assessed.
Abuse—Failed to provide service
19 Jul 2020Inspection
19 Jul 2020Inspection
Investigated an allegation of verbal abuse toward a resident and found that a staff member yelled at the resident and shoved them back into bed, and protections against verbal abuse were not provided.
Licensing—Failed to protect resident from verbal abuse
19 Jul 2020Inspection
19 Jul 2020Inspection
Found that a staff member verbally abused a resident and that protection from verbal/emotional abuse was lacking. This violated state administrative rules.
Licensing—Failed to protect resident from verbal abuse
19 Jul 2020Inspection
19 Jul 2020Inspection
Determined the allegation substantiated due to insufficient qualified awake staff to meet residents' scheduled and unscheduled needs.
Licensing—Failed to assure a qualified caregiver was present
19 Jul 2020Inspection
19 Jul 2020Inspection
Found medication records were not kept current or accurate, and resident records lacked accuracy.
Licensing—Failed to keep medication record current or accurate
19 Jul 2020Inspection
19 Jul 2020Inspection
Investigated and found a staff member verbally abused a resident and the provider failed to protect the resident from verbal abuse.
Licensing—Failed to protect resident from verbal abuse
19 Jul 2020Inspection
19 Jul 2020Inspection
Investigated the allegation and identified failure to perform 2-hour night checks as stated in the service plan.
Licensing—Failed to follow care plan
19 Jul 2020Inspection
19 Jul 2020Inspection
Investigated a licensing violation alleging failure to administer medication as ordered.
Licensing—Failed to administer medication as ordered
19 Jul 2020Inspection
19 Jul 2020Inspection
Investigated and found that a resident was subjected to physical abuse and the facility failed to protect the resident.
Licensing—Failed to protect resident from physical abuse
19 Jul 2020Inspection
19 Jul 2020Inspection
Found that a staff member dragged a resident by the knees during care, constituting physical abuse, and the provider failed to protect the resident from abuse.
Licensing—Failed to protect resident from physical abuse
15 Jun 2020Inspection
15 Jun 2020Inspection
Investigated allegations of physical abuse; found that a staff member rotated a resident during care causing pain and protection from abuse was not ensured.
Licensing—Failed to protect resident from physical abuse
09 May 2020Inspection
09 May 2020Inspection
Investigated a financial exploitation allegation and determined that a resident was exploited and protections against exploitation were inadequate.
Licensing—Failed to protect resident from financial exploitation
04 Feb 2020Abuse: Neglect
04 Feb 2020Abuse: Neglect
Investigated a complaint and found neglect and abuse due to failing to assure resident safety, resulting in an unwitnessed fall with injury; a $375 fine was assessed.
Abuse—Failed to assure resident was safe
09 Dec 2019Abuse: Neglect
09 Dec 2019Abuse: Neglect
Investigated and found that staff rushed care causing bruising to a resident and documenting concerns about care was neglected, resulting in substantiated violations and a fine.
Abuse—Failed to provide service
30 Sept 2019Abuse: Neglect
30 Sept 2019Abuse: Neglect
Investigated an allegation of failing to provide a safe environment; found elopement led to a fall and hospital transport, constituting neglect and abuse.
Abuse—Failed to provide safe environment
30 Aug 2019Abuse: Neglect
30 Aug 2019Abuse: Neglect
Investigated the neglect allegation; found failure to provide medical treatment as ordered, resulting in physical harm, and assessed a $500 fine.
Abuse—Failed to provide medical treatment as ordered
30 Aug 2019Inspection
30 Aug 2019Inspection
Found failure to report suspected abuse and assessed a $750 fine.
Licensing—Failed to report potential or suspected abuse
17 Jul 2019Abuse: Financial abuse
17 Jul 2019Abuse: Financial abuse
Investigated a financial exploitation allegation and found failure to protect the resident, resulting in loss of medication.
Abuse—Failed to protect resident from financial exploitation
05 Jun 2019Abuse: Neglect
05 Jun 2019Abuse: Neglect
Investigated and found neglect that led to a resident drinking bathroom cleaner, vomiting, and hospitalization; a $375 fine was assessed.
Abuse—Failed to provide safe environment
02 Jun 2019Abuse: Financial abuse
02 Jun 2019Abuse: Financial abuse
Investigated a financial exploitation allegation and found neglect resulting in financial loss.
Abuse—Failed to protect resident from financial exploitation
03 May 2019Abuse: Neglect
03 May 2019Abuse: Neglect
Concluded neglect related to medication safety and the environment, causing unreasonable discomfort.
Abuse—Failed to provide a safe medication administration system
30 Jun 2018Abuse: Financial abuse
30 Jun 2018Abuse: Financial abuse
Investigated a financial abuse allegation and determined property belonging to RV was not adequately protected.
Abuse—Failed to provide safe environment
08 May 2018Inspection
08 May 2018Inspection
Determined the licensee failed to report potential or suspected abuse, and assessed a civil penalty of $750.
Licensing—Failed to report potential or suspected abuse
08 May 2018Abuse: Neglect
08 May 2018Abuse: Neglect
Investigated an allegation of abuse/neglect and found that a safe environment was not maintained.
Abuse—Failed to assure resident was safe
17 Dec 2017Abuse: Neglect
17 Dec 2017Abuse: Neglect
Found neglect due to failure to provide appropriate care.
Abuse—Failed to provide service
10 Jun 2017Abuse: Neglect
10 Jun 2017Abuse: Neglect
Investigated an abuse/neglect allegation and found failure to follow the victim's care plan, resulting in a $300 fine.
Abuse—Failed to follow care plan
18 May 2017Abuse: Verbal/Mental abuse
18 May 2017Abuse: Verbal/Mental abuse
Determined that residents were subjected to threats of punishment, humiliation, and harassment, and a deficiency was identified.
Abuse—Failed to protect resident from mental or emotional abuse
20 Apr 2017Inspection
20 Apr 2017Inspection
Found deficiencies in food sanitation related to how food was prepared, stored, and served.
Licensing—Failed to provide sanitary food service conditions
06 Apr 2017Abuse: Financial abuse
06 Apr 2017Abuse: Financial abuse
Investigated the allegation of financial abuse and found that a resident's personal property was not protected from theft.
Abuse—Failed to provide safe environment
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Mirador Living is not affiliated with the owner or operator(s) of Bonaventure of Gresham. The information above has not been verified or approved by the owner or operator. For exact information, please contact Bonaventure of Gresham directly. There is no cost for this service. We are compensated by the community you select.
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