Cheerful Adult Homes LLC

Adult Foster Home (Class 3)
6282 SW 154TH PL, BEAVERTON, OR 97007

Facility Information

Facility ID 6730399492
Status Active
County Washington
Licensed Beds 5
Phone 503-747-3143
Administrator Teresa Muchai
Active Date Feb 20, 2024
Funding Medicaid
Services:

No special services listed

2
Total Surveys
7
Total Deficiencies
0
Abuse Violations
1
Licensing Violations
0
Notices

Violations

Licensing: CALMS - 00075601

Survey History

Survey RL002880

7 Deficiencies
Date: 2/19/2025
Type: Re-Licensure

Citations: 7

Citation #1: V5665 - Background Check Documentation

Visit History:
t Visit: 2/19/2025 | Corrected: 3/21/2025
Regulation:
OAR 411-049-0120(1)(a) Background Check Documentation

(1) All subject individuals (SI) must have an approved background check, which for non-licensees or non-licensee applicants, may include an approved preliminary fitness determination, prior to operating, working in, training in, or living in an AFH. (a) Licensees must maintain documentation of preliminary and final fitness determinations with the home's facility records in accordance with these rules and the background check rules.
Inspection Findings:
During scheduled renewal inspection it was found that substitute caregiver #1 did not have the correct position on the approved background check.
Plan of Correction:
Statement of Correction Written as Received:

Correction done. SI matches the job deseription. More attention will be taken when doing the Background of SI.

Citation #2: V5738 - Training within First Year

Visit History:
t Visit: 2/19/2025 | Corrected: 3/16/2025
Regulation:
OAR 411-049-0125(7) Training within First Year

(7) TRAINING WITHIN FIRST YEAR OF INITIAL LICENSURE OR APPROVAL. Within the first year of obtaining an initial license or approval, the licensee, administrator, resident manager, floating resident manager, and shift caregivers must complete the "DHS Six Rights of Safe Medication Administration" and a Fire and Life Safety training as available. The Department or LLA and the Office of the State Fire Marshal or the local fire prevention authority may coordinate the Fire and Life Safety training program.
Inspection Findings:
During scheduled renewal inspection it was found that administrator did not complete the correct Fire and Life Safety Training.
Plan of Correction:
Statement of Correction Written as Received:

The training was done in the Care Partners site while the requirement is on Workday. This has been noted and acted upon. We'll be careful to not the Required Training Sites.

(C02865)) Class unavailable for year 2024 after completing the preliquisites.

Citation #3: V6316 - Fac Standards: Screens

Visit History:
t Visit: 2/19/2025 | Corrected: 3/6/2025
Regulation:
OAR 411-050-0715(3)(c) Fac Standards: Screens

(c) All doors and windows that are used for ventilation must have screens in good condition.
Inspection Findings:
During scheduled renewal if was found that the front windows open outward. However, they did not have screens.
Plan of Correction:
Technical Assistance Provided. Written plan of correction not required.

Citation #4: V6420 - Facility: First Aid

Visit History:
t Visit: 2/19/2025 | Corrected: 3/6/2025
Regulation:
OAR 411-050-0720(12) Facility: First Aid

(12) FIRST AID. Current, basic first-aid supplies and a first-aid manual must be readily available in the home.
Inspection Findings:
During scheduled renewal inspection it was found that there was no first aid manual available in the home.
Plan of Correction:
Technical Assistance Provided. Written plan of correction not required.

Citation #5: V6468 - Safety: Emergency Plan

Visit History:
t Visit: 2/19/2025 | Corrected: 3/6/2025
Regulation:
OAR 411-050-0725(7)(a)(A)(i-vi) Safety: Emergency Plan

(7) EMERGENCY PREPAREDNESS PLAN. A licensee or administrator must develop and maintain a written emergency preparedness plan for the protection of all occupants in the home in the event of an emergency or disaster.(a) The written emergency plan must:(A) Include an evaluation of potential emergency hazards including, but not limited to:(i) Prolonged power failure or water or sewer loss.(ii) Fire, smoke, or explosion.(iii) Structural damage.(iv) Hurricane, tornado, tsunami, volcanic eruption, flood, or earthquake.(v) Chemical spill or leak.(vi) Pandemic.
Inspection Findings:
During scheduled renewal inspection it was found that the emergency preparedness plan had not been annually reviewed.
Plan of Correction:
Technical Assistance Provided. Written plan of correction not required.

Citation #6: V6564 - Facility Records: Verification Exclusion Lis

Visit History:
t Visit: 2/19/2025 | Corrected: 3/16/2025
Regulation:
OAR 411-050-0735(3)(b) Facility Records: Verification Exclusion Lis

(b) Verification of checking the Exclusion Lists must be clearly documented in the facility records.
Inspection Findings:
During scheduled renewal inspection it was found that caregiver #2 did not have proof in records that the SAM and OIG exclusions search were done.
Plan of Correction:
Statement of Correction Written as Received:

Issue Rectified and forwarded to the inspector on 02/19/2025.

Will be careful to follow through the Requirements

Citation #7: V6565 - Employment Applications: Abuse

Visit History:
t Visit: 2/19/2025 | Corrected: 3/6/2025
Regulation:
OAR 411-050-0735(4) Employment Applications: Abuse

(4) EMPLOYMENT APPLICATION. An application for employment in any capacity in an AFH must include a question asking whether the person applying for employment has been found to have committed abuse. Employment applications must be retained for at least three years.
Inspection Findings:
During scheduled renewal inspection it was found that caregiver #2 and #3's employment application did not include the required abuse question.
Plan of Correction:
Technical Assistance Provided. Written plan of correction not required.

Survey HXEJ

0 Deficiencies
Date: 11/15/2023
Type: Initial Licensure

Citations: 1

Citation #1: V0000 - Initial Comments

Visit History:
1 Visit: 11/15/2023 | Not Corrected
Inspection Findings:
Adult Foster Homes must operate and provide services in compliance with all applicable State and local laws, regulations and codes. This report reflects the findings of the announced on-site initial licensure visit conducted 11/15/2023. The adult foster home was evaluated for compliance with Oregon Administrative Rule 411, Division 50. The adult foster home was found to be in substantial compliance.