Print Violation: 00295712-AP-249428

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 11/4/2023
Report number: 00295712-AP-249428
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: 411-054-0027(1)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0036(2)(g)
Findings: Alleged Victim (AV) relies on the facility for a safe environment. Witness #1 (W1) has a history of agitation, aggression, and physical behaviors towards other residents. On or about November 04, 2023, W1 had aggressive behavior towards AV, which lead to a resident-to-resident altercation. W1 yelled at AV to stop moving chairs and then kicked AV. The facility failed to provide a safe environment, properly plan care, and provided interventions appropriate to mitigate W1 continued aggressive behaviors towards other residents which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP23-01522 $375.00 fine assessed