- Date
- 2/17/2025
- Report number
- CALMS - 00083162
- Type
- Licensing Violation
- Level
- 3 - Moderate harm or potential for serious harm
- Allegation
- Failed to staff as indicated by ABST
- Result
- Substantiated
- Findings
- Based on observation, interview, and record review, conducted during a site visit on 04/24/25, the facility’s failure to provide qualified awake direct care staff sufficient in number to meet the 24-hour scheduled and unscheduled needs of each resident was substantiated. The facility’s census for the residential care facility was 52, including 15 residents served by the specific needs contract. The facility’s census for the memory care was 30. The facility’s posted staffing schedule indicated: For the residential care facility, for day and evening shifts, there were 2.5 caregivers and one medication aide, and for night shift, one caregiver and one medication aide; For the memory care, for day and evening shifts, there were 2.5 caregivers and one medication aide, and for night shift, one caregiver and one medication aide; For specific needs contract residents, for day and evening shifts, the ratio was one staff for four residents, and for night shift, the ratio was one staff for six residents. A review of the specific needs contract, dated 05/06/24, indicated for day and evening shifts, the facility must have four direct care staff while at full contract capacity (15 residents), and for night shift, the facility must have three direct care staff when at full contract capacity. On 02/24/25, the facility was at capacity for specific needs contract residents. A review of the staff schedule, dated 02/18/25 through 02/24/25, indicated: For the resident care facility, the facility was not staffed to their posted staffing plan for 14 of 21 reviewed shifts. For the memory care, the facility was not staffed to their posting staffing plan for three of 21 reviewed shifts. For the specific needs contract, the facility was not staffed to their posted staffing plan or contract for five of 21 reviewed shifts. It was determined the facility’s failure to provide qualified awake direct care staff sufficient in number to meet the 24-hour scheduled and unscheduled needs of each resident was substantiated. An investigation determined this is a violation of Oregon Administrative Rules.