Violation Details: 00358040-AP-308399

Records Request Print
Date
9/21/2021
Report number
00358040-AP-308399
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide safe environment
Result
Substantiated
Rule(s) Violated
411-054-0025(1)(a) and (b)
411-054-0027(1)(g) and (s)
411-054-0028(2)
411-054-0030(1)(e)(A)
411-054-0070(1)
Findings
The Alleged Victim (AV) is care planned as a two person assist with transfers. On or about September 21, 2024, AV had a witnessed assisted fall in his/her room. Alleged Perpetrator #2 (AP2) was assisting AV with a transfer by him/herself, due to the facility not having enough staff to ensure two staff were available to assist with the transfer. AP2 was not able to complete the transfer by themselves and ended up assisting AV to the floor. AV was not injured. The Respondents failure to ensure proper staffing placed AV at risk for harm. This constitutes abuse by neglect, as outlined in OAR 411-020-0002(1)(b)(A)(i).
Sanction
RCFCP26-00028 $250.00 fine assessed