- Date
- 6/12/2025
- Report number
- 00408594-AP-359674
- Type
- Abuse: Neglect
- Level
- 3 - Moderate harm or potential for serious harm
- Allegation
- Failed to follow care plan
- Result
- Substantiated
- Findings
- The Alleged Victim (AV) is a known fall risk and has suffered falls prior to this incident. Interventions at the time of this incident were to ensure AV was in the center of his/her bed when resting, padded bed frame and to bring AV to the common area for increased supervision. On or about June 17, 2025, AV was found on the floor in the hallway with blood on his/her forehead. AV was transported to the hospital where he/she received stitches to his/her forehead, a pinky dislocation and it was discovered that AV also had a broken clavicle, which may have occurred from an earlier incident. The night of this incident, AV was higher energy, and rather than bringing AV to the common area for supervision, AV was re-directed to his/her room and the door closed. The facility's failure to follow the care plan is a violation of resident rights, is considered neglect of care and constitutes abuse.
- Sanction
- RCFCP25-00922 $375.00 fine assessed