Print Violation: 00257936-AP-213254

Provider Information

Waterford Grand Memory Care

600 WATERFORD WAY
Eugene, OR 97401

Date: 4/14/2023
Report number: 00257936-AP-213254
Type: Licensing Violation
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to provide safe environment
Result: Substantiated
Rule(s) Violated: 411-054-0025(1)(a) and (b)
411-054-0027(1)(r)
Findings: The Alleged Perpetrator 2 failed to follow the Alleged Victim's (AV) care plan to ensure s/he does not receive plastic silverware with meals due to a history of chewing and ingesting them. On or about April 14, 2023, AP2 gave AV breakfast with a plastic spoon, which was later discovered be partially missing causing AV to be transferred to the hospital for assessment. AP2's failure placed AV at risk of harm, which is a violation of resident rights, is considered neglect of care and constitutes abuse. The facility failed to assure AV's safety, which is a violation of Oregon Administrative Rules.