Violation Details: 00430025-AP-381781

Records Request Print
Date
4/3/2025
Report number
00430025-AP-381781
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide safe environment
Result
Substantiated
Rule(s) Violated
External site: 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) relies on the facility to provide care and a safe environment. According to an investigation, on or about 04/03/2025 AV suffered an unwitnessed fall that resulted in a traumatic head injury. AV had a history of falls prior to the fall on 04/03/2025 and the facility failed to implement progressive interventions to mitigate AV from falling, which is a violation of Oregon Administrative Rule, is considered neglect which constitutes abuse.
Sanction
RCFCP26-00064 $500.00 fine assessed