Violation Details: 00399602-AP-350357

Date
5/3/2025
Report number
00399602-AP-350357
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to follow care plan
Result
Substantiated
Findings
Facility staff were to provide Alleged Victim (AV) two-person assistance for all ambulation. On May 3, 2025, AV was in AV's wheelchair. An in-home agency (IHA) staff and facility staff walked with AV back to AV's room. The facility staff briefly left Witness 5 (W5) while W5 wheeled AV into AV's room and closed the room door. AV stood up from AV's wheelchair and grabbed the IHA staff by the shoulder. AV became dead weight and W5 assisted AV to the ground. AV’s care plan stated that staff were to be present at all times to ensure AV’s safety. The facility failed to follow the care plan around two-person assist for AV, which is a violation of resident rights, is neglect of care and constitutes abuse.
Sanction
RCFCP25-01272 $500.00 fine assessed