Print Violation: 00033087-AP-023341

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 5/21/2019
Report number: 00033087-AP-023341
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: 411-054-0027(1)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0030(1)(e)(I)
External site: 411-054-0036(2)(g)
Findings: Witness 1 (W1) was care planned for aggressive behaviors and frequent agitation, and had an increase of altercations. On or about May 21, 2019, W1 and Alleged Victim (AV) had an altercation in which W1 was the aggressor and caused harm to AV. The facility failed to provide a safe environment for AV which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP20-00766 $188.00 fine assessed