Print Violation: 00303394-AP-256556

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 12/4/2023
Report number: 00303394-AP-256556
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: 411-054-0030(1)(e)(I)
External site: 411-054-0036(2)(g)
Findings: The facility failed to implement interventions and appropriately monitor Witness 1 (W1) according to his/her known behavior and prior altercations. On or about December 4, 2023, W1 became agitated and pulled Alleged Victim's (AV) wrist. W1 is known to be aggressive and erratic, without visible triggers to his/her behavior. Based on facility documentation and interviews, the facility failed to enforce a previous intervention to redirect W1 away from AV which resulted in the physical altercation, causing unreasonable discomfort to the Alleged Victim, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP24-00293 $375.00 fine assessed