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Residential Provider Compliance Status Report Respect & DD HCBS Provider Status Legal / Corporate Control of Freedom from Privacy (including Choice of Furnishing & Residency Name Setting Name County Integration Choices Schedule Coercion/ locking door) Roommate Decorating Access to Food Visitors Agreement Current Status Information Source HCBS Setting Type ABEBE, HUNDE OATFIELD CLACKAMAS COMPLIANT NEW SITE / INITIAL FOSTER CARE - REVIEW ADULT ABEBE, YESHIHAREG FARGO MULTNOMAH PENDING INCOMPLETE SURVEY FOSTER CARE - REGULATORY ADULT ONSITE REVIEW ABRAHAM, GEMECHU FOREST GALE WASHINGTON PENDING COMPLIANT NEW SITE / INITIAL FOSTER CARE - REGULATORY REVIEW ADULT ONSITE REVIEW ADAIR, DAVID OAK HILL DOUGLAS PENDING COMPLIANT SURVEY FOSTER CARE - REGULATORY ADULT ONSITE REVIEW ADAIR, DAVID OAK HILL DOUGLAS COMPLIANT COMPLIANT ON-SITE REVIEW FOSTER CARE - 09/29/2016 ADULT ADAMS, SHARON L WHISTLE DESCHUTES PENDING INCOMPLETE SURVEY FOSTER CARE - REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 111TH MULTNOMAH DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 111TH MULTNOMAH COMPLIANT COMPLIANT ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC 10/18/2016 ADULT ADULT LEARNING 120TH MULTNOMAH DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 120TH MULTNOMAH DOES NOT MEET COMPLIANT REMEDIATION ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC EXPECTATION 05/27/2016 ADULT ADULT LEARNING 143RD MULTNOMAH DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 143RD MULTNOMAH COMPLIANT COMPLIANT ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC 09/21/2016 ADULT ADULT LEARNING 145TH MULTNOMAH DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION EXPECTATION EXPECTATION EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 145TH MULTNOMAH COMPLIANT COMPLIANT ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC 10/18/2016 ADULT ADULT LEARNING 205TH MULTNOMAH DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 205TH MULTNOMAH DOES NOT MEET REMEDIATION ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC EXPECTATION 03/08/2016 ADULT ADULT LEARNING 214TH MULTNOMAH DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 22ND MULTNOMAH PENDING INCOMPLETE SURVEY RESIDENTIAL - SYSTEMS OR INC REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 22ND MULTNOMAH COMPLIANT COMPLIANT ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC 03/08/2017 ADULT ADULT LEARNING 231ST 1611 MULTNOMAH DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 231ST 1611 MULTNOMAH COMPLIANT COMPLIANT ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC 03/08/2017 ADULT ADULT LEARNING 236TH MULTNOMAH DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION REGULATORY ADULT ONSITE REVIEW 1 of 159 As of 10/14/2016 Respect & DD HCBS Provider Status Legal / Corporate Control of Freedom from Privacy (including Choice of Furnishing & Residency Name Setting Name County Integration Choices Schedule Coercion/ locking door) Roommate Decorating Access to Food Visitors Agreement Current Status Information Source HCBS Setting Type ADULT LEARNING 236TH MULTNOMAH DOES NOT MEET COMPLIANT REMEDIATION ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC EXPECTATION 07/27/2016 ADULT ADULT LEARNING 238TH MULTNOMAH DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 238TH MULTNOMAH DOES NOT MEET REMEDIATION ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC EXPECTATION 03/18/2016 ADULT ADULT LEARNING 29TH CLACKAMAS PENDING INCOMPLETE SURVEY RESIDENTIAL - SYSTEMS OR INC REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 97TH MULTNOMAH DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING 97TH MULTNOMAH COMPLIANT COMPLIANT ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC 10/19/2016 ADULT ADULT LEARNING 9TH JACKSON PENDING INCOMPLETE SURVEY RESIDENTIAL - SYSTEMS OR INC REGULATORY ADULT ONSITE REVIEW ADULT LEARNING FLEMING MULTNOMAH DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING GLISAN MULTNOMAH DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING GLISAN *10/*14 MULTNOMAH DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING GLISAN *10/*14 MULTNOMAH DOES NOT MEET COMPLIANT REMEDIATION ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC EXPECTATION 05/04/2016 ADULT ADULT LEARNING JOHN QUINCY CLACKAMAS DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC ADAMS EXPECTATION EXPECTATION EXPECTATION EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING JOHN QUINCY CLACKAMAS DOES NOT MEET COMPLIANT REMEDIATION ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC ADAMS EXPECTATION 02/15/2017 ADULT ADULT LEARNING KNIGHT MULTNOMAH DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION EXPECTATION EXPECTATION EXPECTATION EXPECTATION EXPECTATION EXPECTATION EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING KNIGHT MULTNOMAH COMPLIANT COMPLIANT ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC 02/15/2017 ADULT ADULT LEARNING MAIN WASHINGTON PENDING INCOMPLETE SURVEY RESIDENTIAL - SYSTEMS OR INC REGULATORY ADULT ONSITE REVIEW ADULT LEARNING MULTNOMAH MULTNOMAH DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY SUPPORTED LIVING SYSTEMS OR INC EXPECTATION EXPECTATION REGULATORY ONSITE REVIEW ADULT LEARNING OREGON MULTNOMAH PENDING COMPLIANT SURVEY RESIDENTIAL - SYSTEMS OR INC REGULATORY ADULT ONSITE REVIEW ADULT LEARNING OREGON MULTNOMAH COMPLIANT COMPLIANT ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC 01/20/2017 ADULT ADULT LEARNING RAYMOND MULTNOMAH DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - SYSTEMS OR INC EXPECTATION REGULATORY ADULT ONSITE REVIEW ADULT LEARNING RAYMOND MULTNOMAH DOES NOT MEET COMPLIANT REMEDIATION ON-SITE REVIEW RESIDENTIAL - SYSTEMS OR INC EXPECTATION 07/27/2016 ADULT 2 of 159 As of 10/14/2016 Respect & DD HCBS Provider Status Legal / Corporate Control of Freedom from Privacy (including Choice of Furnishing & Residency Name Setting Name County Integration Choices Schedule Coercion/ locking door) Roommate Decorating Access to Food Visitors Agreement Current Status Information Source HCBS Setting Type AGBONZE, PRINCE 156TH MULTNOMAH PENDING INCOMPLETE SURVEY FOSTER CARE - REGULATORY ADULT ONSITE REVIEW AHMED BENNOUR PARKER WASHINGTON DOES NOT MEET DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY FOSTER CARE - EXPECTATION EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW AHMED BENNOUR PARKER WASHINGTON DOES NOT MEET REMEDIATION ON-SITE REVIEW FOSTER CARE - EXPECTATION 04/04/2017 ADULT AIMRO, FEKERTE T 167TH WASHINGTON DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY FOSTER CARE - EXPECTATION EXPECTATION REGULATORY ADULT ONSITE REVIEW ALBERTINA KERR 10TH WASHINGTON DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - CENTERS EXPECTATION REGULATORY CHILD ONSITE REVIEW ALBERTINA KERR 10TH WASHINGTON DOES NOT MEET COMPLIANT REMEDIATION ON-SITE REVIEW RESIDENTIAL - CENTERS EXPECTATION 02/17/2017 CHILD ALBERTINA KERR 159TH MULTNOMAH COMPLIANT NEW SITE / INITIAL RESIDENTIAL - CENTERS REVIEW ADULT ALBERTINA KERR 164TH MULTNOMAH PENDING INCOMPLETE SURVEY RESIDENTIAL - CENTERS REGULATORY CHILD ONSITE REVIEW ALBERTINA KERR 165TH MULTNOMAH DOES NOT MEET DOES NOT MEET DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - CENTERS EXPECTATION EXPECTATION EXPECTATION REGULATORY CHILD ONSITE REVIEW ALBERTINA KERR 165TH MULTNOMAH DOES NOT MEET REMEDIATION ON-SITE REVIEW RESIDENTIAL - CENTERS EXPECTATION 08/11/2016 CHILD ALBERTINA KERR 16TH WASHINGTON DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - CENTERS EXPECTATION REGULATORY CHILD ONSITE REVIEW ALBERTINA KERR 16TH WASHINGTON DOES NOT MEET REMEDIATION ON-SITE REVIEW RESIDENTIAL - CENTERS EXPECTATION 02/11/2016 CHILD ALBERTINA KERR 181ST WASHINGTON PENDING INCOMPLETE SURVEY RESIDENTIAL - CENTERS REGULATORY ADULT ONSITE REVIEW ALBERTINA KERR 190TH MULTNOMAH DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - CENTERS EXPECTATION REGULATORY ADULT ONSITE REVIEW ALBERTINA KERR 190TH MULTNOMAH DOES NOT MEET COMPLIANT REMEDIATION ON-SITE REVIEW RESIDENTIAL - CENTERS EXPECTATION 03/29/2017 ADULT ALBERTINA KERR 196TH MULTNOMAH DOES NOT MEET PENDING REMEDIATION SURVEY RESIDENTIAL - CENTERS EXPECTATION REGULATORY CHILD ONSITE REVIEW ALBERTINA KERR 40TH MARION DOES NOT MEET DOES NOT MEET PENDING REMEDIATION
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