Print Violation: 00223076-AP-181690

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 9/2/2022
Report number: 00223076-AP-181690
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: 411-054-0030(1)(e)(I)
External site: 411-054-0036(2)(g)
Findings: The facility failed to follow the care plan and provide a safe environment for Alleged Victim (AV). Witness 1 (W1) has history of wandering into other residents’ rooms and resident to resident altercations. W1 is care planned to have frequent checks and to keep W1 away from other residents. On or about, September 09, 2022, W1 wandered into AV room. W1 and AV had a verbal confrontation that turned physical. W1 grabbed AVs arm and pushed him/her to the ground resulting in a skin tear to AV. This failure is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP22-01742 $500.00 fine assessed