Be sure to review the recently Frequently Cited Violations Report from the State for the first quarter of 2023. This information is important to understand to help you focus on common areas that can be problematic, and to help you avoid violations and improve your compliance. 

The top violations are related to staffing records and medication administration.​

Staffing Records

Licensees must maintain accurate and complete staff records.

• Background checks: All subject individuals (licensee, staff, occupants over 16, etc.) must have approved background checks with verification records kept in the facility records.
• Caregiver workbook: Before providing direct care to residents, caregivers must have completed the  caregiver preparatory workbook  (using the study guide) without assistance. This must be reviewed by the licensee and the certificate of completion must be signed by the licensee and maintained in the staffing records.
• Pre-Service Dementia Training: Before providing direct care to residents, caregivers must have completed the mandatory dementia training and have verification of completion in the staffing records.
  • Note: see our approved dementia training option here
• CPR & first aid certification [repeat from last report]: Both CPR and First Aid training must be completed for substitute caregivers (these are all of your day-to-day care staff) within 30 calendar days of hire and kept on file. 
  • Note: In comparison, licensees, co-licensees, administrators and resident managers must have their certification prior to providing care. 

Facility Records

• Fire Evacuation Drills: These drills are required to be conducted at least every 90 calendar days and at least one drill must be conducted annually during sleeping hours. Documentation must be kept in the facility records.
  • Note: this means licensees can, and should, conduct drills more often than 90 days (e.g. 60 days, 75 days, etc.) but no less than once every 90 days.
    
  • Additional Note: the first-year fire drill requirement for Multnomah County ONLY is at least once every 60 days.
    

Resident Records

• Resident records (narratives) [repeat from last report]: narratives must be documented at least weekly and be signed and dated by the person writing the narratives.
• Residency Agreement: a residency agreement must detail rates, care, and services to be provided. It must also be reviewed by the local licensing office before being used. The written agreement must be signed by all parties before a resident can be admitted.
  

Medication Administration Record (MAR)

Note: We encourage new licensees to take the required Six Rights of Safe Medication Administration training within the first few months of being licensed [this applies to counties outside of Multnomah Co.].

• Missed or Refused Medications: This needs to be documented correctly on the MAR each time a resident misses or "refuses" (declines) a medication. The person administering the medication must initial the MAR and circle their initial. On the back of the MAR, the person administering the medications must note the date/time, medication and a description of what happened with the medication dose (e.g. the medication was missed or declined and what was the outcome).
  

Other

• Variance requests: If a licensee wishes to admit a resident whose needs exceed the license classification, or they have a current resident whose care now exceeds the license classification (i.e. class 3 level of care in a class 2 home), the licensee must request a variance from the local licensing office. A variance is required for the licensee to continue to provide care in this case. 
  
• Staffing Coverage: Licensees must staff the care home according to Oregon Administrative Rule (OAR) and ensure qualified caregivers are always available to meet the needs of residents.