Print Violation: 00218228-AP-177214

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 8/25/2022
Report number: 00218228-AP-177214
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to follow care plan
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: 411-054-0036(2)(g)
Findings: Witness 1 (W1) has history of wandering into other residents’ rooms, combative behaviors, and resident to resident altercations. W1 is care planned to keep h/h away from other residents. On or about August 25, 2022, Alleged Victim (AV) yelled at W1 and W1 hit AV on h/h right forearm. The facility failed to follow the care plan which is a violation of resident rights is neglect of care and constitutes abuse.
Sanction: RCFCP22-01724 $500.00 fine assessed