Print Violation: 00308916-AP-261679

Provider Information

Friendsview Retirement Community

1301 E FULTON ST
Newberg, OR 97132

Date: 12/23/2023
Report number: 00308916-AP-261679
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to follow care plan
Result: Substantiated
Rule(s) Violated: External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0027(1)(g) and (s)
External site: 411-054-0028(2)
External site: 411-054-0030(1)(e)(A)
External site: 411-054-0036(2)(g)
Findings: Alleged Victim (AV) has history of multiple falls. AV is a two-person transfer with a Hoyer. AV attempts to self-transfer. After a fall on September 18, 2023 the intervention in place was a motion mat and for that mat to move with AV between surfaces. On or about December 23, 2023 AV was found after a fall. Investigation found the care plan was not being followed as the motion mat was not under AV. There is an intervention checklist for AV, caregivers check off that they ensured that AV's motion mat moves with AV every two hours. It is marked that this was done on December 23, 2023 but the mat was not in place when AV fell. The facility failed to follow the care plan which is a violation of resident’s rights is neglect of care and constitutes abuse.
Sanction: RCFCP24-01005 $500.00 fine assessed