State assisted-living licensing record · Oregon ODHS · record as pulled September 18, 2026· Not the federal nursing home survey

Pacific Grove Memory Care

3334 22nd Ave, Forest Grove, OR 97116 · Washington County · 56 licensed beds

ODHS facility ID 5MA242 · licensed, active · first licensed April 2000

The licence

Licensed by ODHS · Residential Care Facility · managed by Forest Grove Senior Living LLC

Licence details, as listed by ODHS
Licensed as
Residential Care Facility
Memory care endorsement
Yes
Accepts Medicaid
No
Current licensee since
February 1, 2021
65
Citations on file
Since September 2021
7
ODHS visits
3 routine inspections
4
Level 3 or 4
The serious level
15
Building-related
Physical plant · emergency

Position within Oregon

65 citations — more than 97% of the 572 licensed assisted living facilities in Oregon. Compared only within Oregon: a citation from ODHS means what it means in Oregon, and there is no national assisted living record to compare to. Counted over 5 years, which holds two or three routine inspections. How this is calculated

Not in this record

Fire and life safety inspection, and enforcement. The fire inspection of an Oregon assisted living or residential care facility is the State Fire Marshal's or the local fire authority's and is not published; what ODHS itself cites about the building — its fire and life safety rule, emergency and disaster planning, and the building requirements — is here. ODHS also publishes substantiated abuse and licensing complaint findings, licence conditions and civil penalties for each facility; none of that is republished. This record is the survey citations only. Adult foster homes, which Oregon licenses separately and which are mostly licensed to an individual, are not included.

Get an email about Pacific Grove Memory Care

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Which alerts

This is the state licensing record, not the federal nursing home survey. Your address is used for these alerts and nothing else.

Building-related citations

The citations about the building itself — physical plant and emergency management. Usually the maintenance side’s to fix.

  • C0420 Fire and Life Safety: SafetyJuly 2, 2026 · Level 2
  • C0422 Fire and Life Safety: Training For ResidentsJuly 2, 2026 · Level 2
  • C0510 General Building ExteriorJuly 2, 2026 · Level 2
  • C0513 Doors, Walls, Elevators, OdorsJuly 2, 2026 · Level 2
  • C0555 Call System, Exit Door Alarm, Phones, TV or CableJuly 2, 2026 · Level 2
  • Z0173 Secure Outdoor Recreation AreaJuly 2, 2026 · Level 2
  • C0241 Resident Services: LaundryJuly 25, 2023 · Level 2
  • C0420 Fire and Life Safety: SafetyMay 15, 2023 · Level 2 · corrected July 17, 2023
  • C0510 General Building ExteriorMay 15, 2023 · Level 2 · corrected July 17, 2023
  • C0513 Doors, Walls, Elevators, OdorsMay 15, 2023 · Level 2 · corrected December 23, 2023
  • C0530 Housekeeping and LaundryMay 15, 2023 · Level 2 · corrected July 17, 2023
  • C0540 Heating and VentilationMay 15, 2023 · Level 2 · corrected July 17, 2023
  • C0555 Call System, Exit Door Alarm, Phones, TV or CableMay 15, 2023 · Level 2 · corrected July 17, 2023
  • Z0168 Outside AreaMay 15, 2023 · Level 2 · corrected July 17, 2023
  • Z0173 Secure Outdoor Recreation AreaMay 15, 2023 · Level 2 · corrected July 17, 2023

How that compares

Citations on file over 5 years

Compared with the median licensed assisted living facility in Oregon. Within-state only.

This facility65Oregon median21
Citations on file over 5 years, compared
MeasureCitations
This facility65
Median facility in Oregon21

Visit history

Citations at each ODHS visit
02023-04202023-0582023-0782024-0272024-0422024-10202026-07
Citations at each ODHS visit
VisitTypeCitations
April 19, 2023state licensure survey0
May 15, 2023validation survey20
July 25, 2023complaint investigation8
February 7, 2024complaint investigation8
April 16, 2024complaint investigation7
October 21, 2024complaint investigation2
July 2, 2026re-licensure survey20

What the citations cover

Citations by category (TagProof's grouping)
  • Resident care 27
  • Physical plant 10
  • Medication 9
  • Staffing and training 7
  • Other 12
Citations by category
CategoryCitations
Resident care27
Physical plant10
Medication9
Staffing and training7
Records and administration7
Life safety5

Every visit on file since September 2021

As published by ODHS, newest first, including visits that cited nothing. The wording and the classes are ODHS’s own.

July 2, 2026 — re-licensure survey, 20 citations

Citations from the re-licensure survey on July 2, 2026
TagWhat ODHS checksSeverity levelCorrected
C0152Facility Administration: Required PostingsLevel 2—
C0200Resident Rights and Protection - GeneralLevel 2—
C0231Reporting & Investigating Abuse-Other ActionLevel 2—
C0260Service Plan: GeneralLevel 2—
C0270Change of Condition and MonitoringLevel 2—
C0280Resident Health ServicesLevel 2—
C0295Infection Prevention & ControlLevel 2—
C0305Systems: Resident Right to RefuseLevel 2—
C0310Systems: Medication AdministrationLevel 2—
C0362Acuity Based Staffing Tool - ABST TimeLevel 2—
C0420Fire and Life Safety: SafetyLevel 2—
C0422Fire and Life Safety: Training For ResidentsLevel 2—
C0510General Building ExteriorLevel 2—
C0513Doors, Walls, Elevators, OdorsLevel 2—
C0555Call System, Exit Door Alarm, Phones, TV or CableLevel 2—
H1510Individual Rights Settings: Privacy, DignityLevel 2—
H1517Individual Privacy: Own UnitLevel 2—
Z0142Administration ComplianceLevel 2—
Z0162Compliance with Rules: Health CareLevel 2—
Z0173Secure Outdoor Recreation AreaLevel 2—

October 21, 2024 — complaint investigation, 2 citations

Citations from the complaint investigation on October 21, 2024
TagWhat ODHS checksSeverity levelCorrected
C0303Systems: Treatment OrdersLevel 2—
C0361Acuity-Based Staffing ToolLevel 2—

April 16, 2024 — complaint investigation, 7 citations

Citations from the complaint investigation on April 16, 2024
TagWhat ODHS checksSeverity levelCorrected
C0200Resident Rights and Protection - GeneralLevel 2—
C0231Reporting & Investigating Abuse-Other ActionLevel 2—
C0270Change of Condition and MonitoringLevel 2—
C0280Resident Health ServicesLevel 2—
C0303Systems: Treatment OrdersLevel 2—
C0310Systems: Medication AdministrationLevel 2—
Z0165BehaviorLevel 2—

February 7, 2024 — complaint investigation, 8 citations

Citations from the complaint investigation on February 7, 2024
TagWhat ODHS checksSeverity levelCorrected
C0154Facility Administration: Policy & ProcedureLevel 4October 21, 2024
C0155Facility Administration: RecordsLevel 4October 21, 2024
C0231Reporting & Investigating Abuse-Other ActionLevel 4October 21, 2024
C0260Service Plan: GeneralLevel 3—
C0295Infection Prevention & ControlLevel 2October 21, 2024
C0302Systems: Tracking Control SubstancesLevel 2—
C0360Staffing Requirements and Training: StaffingLevel 2October 21, 2024
C0361Acuity-Based Staffing ToolLevel 2—

July 25, 2023 — complaint investigation, 8 citations

Citations from the complaint investigation on July 25, 2023
TagWhat ODHS checksSeverity levelCorrected
C0010Licensing Complaint InvestigationLevel 2—
C0210Resident Rights and Protection: Personal RelationshipsLevel 2—
C0231Reporting & Investigating Abuse-Other ActionLevel 2—
C0241Resident Services: LaundryLevel 2—
C0260Service Plan: GeneralLevel 2—
C0303Systems: Treatment OrdersLevel 2—
C0330Systems: Psychotropic MedicationLevel 2—
C0360Staffing Requirements and Training: StaffingLevel 2—

May 15, 2023 — validation survey, 20 citations

Citations from the validation survey on May 15, 2023
TagWhat ODHS checksSeverity levelCorrected
C0242Resident Services: ActivitiesLevel 2July 17, 2023
C0252Resident Move-In and Eval: Res EvaluationLevel 2July 17, 2023
C0260Service Plan: GeneralLevel 2July 17, 2023
C0295Infection Prevention & ControlLevel 2July 17, 2023
C0303Systems: Treatment OrdersLevel 2December 23, 2023
C0361Acuity-Based Staffing ToolLevel 2July 17, 2023
C0420Fire and Life Safety: SafetyLevel 2July 17, 2023
C0455Inspections and Investigation: Insp IntervalLevel 2December 23, 2023
C0510General Building ExteriorLevel 2July 17, 2023
C0513Doors, Walls, Elevators, OdorsLevel 2December 23, 2023
C0530Housekeeping and LaundryLevel 2July 17, 2023
C0540Heating and VentilationLevel 2July 17, 2023
C0555Call System, Exit Door Alarm, Phones, TV or CableLevel 2July 17, 2023
Z0142Administration ComplianceLevel 2December 23, 2023
Z0155Staff Training RequirementsLevel 2July 17, 2023
Z0162Compliance with Rules: Health CareLevel 2December 23, 2023
Z0164ActivitiesLevel 2July 17, 2023
Z0165BehaviorLevel 2July 17, 2023
Z0168Outside AreaLevel 2July 17, 2023
Z0173Secure Outdoor Recreation AreaLevel 2July 17, 2023

April 19, 2023 — state licensure survey, nothing cited

Reflects the ODHS record as pulled September 18, 2026. A recent visit may not appear yet. This is the Oregon state licensing record; it is not the federal nursing home survey and the two are never combined.