Violation Details: 00167510-AP-132858

Records Request Print
Date
10/24/2021
Report number
00167510-AP-132858
Type
Licensing Violation
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to follow care plan
Result
Substantiated
Rule(s) Violated
External site: 411-045-0027(1)(f) and (r)
External site: 411-054-0036(2)(g)
Findings
Alleged Victim (AV) relies on the facility for assistance with mobility, which includes two-person transfers and use of a gait belt. On or about October 24, 2021, the Alleged Perpetrator 2 (AP2) did not follow AV's care plan and transferred AV by themselves without a gait belt resulting in AV falling. AP2's actions are considered neglect and constitutes abuse. The facility failed to ensure care plans were followed which is a violation of Oregon Administrative Rules.