Print Violation: 00164709-AP-200796

Provider Information

Mountain Park Memory Care Community

13600 SE 122ND AVE
Clackamas, OR 97015

Date: 10/12/2021
Report number: 00164709-AP-200796
Type: Licensing Violation
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to provide a safe medication administration system
Result: Substantiated
Rule(s) Violated: External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0027(1)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0055(1)(a) and (f)
Findings: Alleged Perpetrator 2 (AP2) failed to provide a safe medication administration system to ensure the Alleged Victim's (AV) medications were administered as ordered. On or about October 12, 2021, AP2 administered AVs scheduled dose of medication at approximately 4:23 pm, AP2 then administer AVs PRN dose of the same medication at approximately 6:19 pm. AV’s PRN medication is not to be administer within four (4) hours of the scheduled dose of medication. AV appeared sedated, h/h gait and coordination was altered placing AV at risk of serious harm. AP2's actions are considered neglect of care and constitutes abuse. The facility failed to provide a safe medication administration system which is a violation of Oregon Administrative Rules.
Sanction: RCFCP23-00334 $375.00 fine assessed