- Date
- 3/25/2025
- Report number
- 00391116-AP-341677
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to properly plan care
- Result
- Substantiated
- Findings
- The Alleged Victim (AV) is dependent on the facility to meet his/her safety needs and has a history of falls. According to an investigation, on or about March 21, 2025, AV was found on the floor in AV's room. AV's service planned fall interventions were for staff to provide hourly safety checks and provide standby assistance with mobility and escorts to/from activities and dining room. Prior to the fall, AV was seen in the dining room. The frequency of safety checks provided was not clear to staff interviewed and AV had not been escorted to AV's room by staff, resulting in AV's fall with injury. The facility failed to properly care plan, which is a violation of resident rights, is considered neglect of care which constitutes abuse.
- Sanction
- RCFCP25-00989 $250.00 fine assessed