Print Violation: 00302502-AP-255788

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 11/30/2023
Report number: 00302502-AP-255788
Type: Abuse: Neglect
Level: 3 - Moderate harm or potential for serious 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: The facility failed to provide appropriate supervision to the Alleged Victim (AV) according to his/her care needs. The facility's failure resulted in AV attempting to elope from the secured building, without staff knowledge. On or about November 30, 2023, AV was found on the floor in the hallway with his/her foot caught in the doorway which leads outside of the facility. AV's nose was bleeding and AV was screaming "I broke my arm". Based on facility documentation and interviews, the door that AV attempted to leave from was left open because someone left a trash bag outside the door which prevented the door from closing securely. As a result of the incident, AV suffered a broken arm, causing unreasonable discomfort which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP24-00271 $1125.00 fine assessed