Print Violation: 00300698-AP-254006

Provider Information

South Beach Manor

411 SE 35TH ST
South Beach, OR 97366

Date: 12/8/2023
Report number: 00300698-AP-254006
Type: Abuse: Neglect
Level: 3 - Moderate harm or potential for serious harm
Allegation: Failed to provide appropriate staffing
Result: Substantiated
Rule(s) Violated: 411-054-0025(1)(a) and (b)
411-054-0027(1)(f) and (r)
411-054-0028(2)
411-054-0036(2)(g)
411-054-0070(1)
Findings: The Alleged Victim (AV) has a history of falls. AV is known to wander the halls during typical sleeping hours in the facility, and during this time is when AV has his/her falls. One of the fall prevention's put into place was to increase staff to monitor AV while he/she was wandering during the night. On or about December 8, 2023, another resident alerted staff that AV had fallen. AV was found in the dining room, face down with a cut over his/her left eyelid and swelling to his/her face. AV was sent to the emergency room where he/she received laceration repair to his/her eyelid and was diagnosed with a head injury. The facility failed to implement interventions to reduce AV's known fall history and ensure enough staff were working to ensure monitoring and supervision of AV to ensure his/her safety. The facility's failure is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP24-00620 $375.00 fine assessed