Print Violation: 00331820-AP-283103

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 5/11/2024
Report number: 00331820-AP-283103
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: 411-054-0025(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)(I)
External site: 411-054-0036(2)(g)
Findings: Witness #1 (W1) has a history of agitation and alterations. On May 11, 2024, W1 was observed by a staff member to be agitated. The staff member did not notify other staff that W1 was agitated. Later, W1 was observed pulling AV by his/her sweatshirt from the dining area and shoved into his/her room by W1. The facility's failure to ensure the safety of residents is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP24-01037 $375.00 fine assessed