- Date
- 7/8/2022
- Report number
- 00211099-AP-170707
- Type
- Licensing Violation
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to follow care plan
- Result
- Substantiated
- Findings
- Alleged Victim (AV) is care planned to be a two person assist in transferring. On or about July 8, 2022, AV needed to be changed and Alleged Perpetrator 2 (AP2) decided to transfer AV by him/herself. As a result, during the transfer AV put his/her legs out and this caused AP2 to drop AV and hitting his/her head. AP2 failed to follow the care plan, which is neglect of care and constitutes abuse. The facility failed to assure AV’s care plan was being followed, which is a violation of Oregon Administrative Rules.