Violation Details: 00376330-AP-326734

Records Request Print Provider Details
Date
1/7/2025
Report number
00376330-AP-326734
Type
Licensing Violation
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to follow care plan
Result
Substantiated
Rule(s) Violated
411-054-0025(1)(a) and (b)
411-054-0027(1)(g) and (s)
411-054-0028(2)
411-054-0036(2)(g)
Findings
The Alleged Victim (AV) is care planned to be toileted three to four times per shift. AV will tear up his/her brief if it becomes wet and try to flush it down the toilet. Alleged Perpetrator #2 (AP2) was working swing shift on January 7, 2025 and responsible for resident cares. Oncoming night shift staff found AV in his/her room, without a brief on, and pieces of brief on the floor, along with water and/or urine on the floor, causing a tripping / fall hazard. AP2 failed to follow AV's care plan to ensure he/she was dry, which is a violation of resident rights, is considered neglect of care and constitutes abuse. Alleged Perpetrator #3 (AP3) allegations were found to be inconclusive in this case. The facility's failure to ensure AV's care plan was followed is a violation of Oregon Administrative Rules.