Violation Details: 00438167-AP-390000

Records Request Print
Date
11/8/2025
Report number
00438167-AP-390000
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide safe environment
Result
Substantiated
Rule(s) Violated
411-054-0025(1)(a) and (b)
411-054-0027(1)(g) and (s)
411-054-0028(2)
411-054-0030(1)(e)(H) and (I)
411-054-0036(2)(g)
Findings
The Alleged Victim (AV) and Witness 1 (W1) reside in the Respondent’s facility and depend on facility staff for assistance with daily needs and safety. W1 has a known history of involvement in resident-to-resident altercations, including three prior incidents occurring in the dining room. W1’s service plan reflects that W1 wishes to continue assisting with dining room cleanup; staff are directed to guide W1 to an empty table away from other residents during these activities. On or about November 8, 2025, W1 was cleaning the dining room after a meal when W1 began walking toward AV. AV attempted to shoo W1 away using a fly swatter. W1 became upset and threw a glass of apple juice at AV. The Respondent failed to provide adequate supervision and ensure a safe environment. This constitutes abuse by neglect as defined in OAR 411-020-0002(1)(b)(A)(ii).
Sanction
RCFCP26-00589 $375.00 fine assessed