Print Violation: 00294717-AP-248481

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 10/29/2023
Report number: 00294717-AP-248481
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: 411-054-0025(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: Alleged Victim (AV) and Witness #1’s (W1) have a history of resident-to-resident altercations with other residents and each other. W1 has a history of wandering the community and into other residents’ rooms. W1 requires frequent checks on whereabouts and redirection for safety. On or about October 29, 2023, W1 was trying to get into AV's room, which led to a physical altercation. W1 pushed AV down and then hit AV on the left side of head, resulting in AV having back pain. W1 was seen a few minutes prior to the altercation trying doors and wandering the halls alone. The facility failed to follow care plan, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP23-01519 $375.00 fine assessed