Print Violation: 00339804-AP-290653

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 6/29/2024
Report number: 00339804-AP-290653
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)
Findings: The Alleged Victim (AV) has a history of aggression towards staff and residents. On or about June 29, 2024, Witness #1 (W1) was standing in the hallway talking to another resident and called AV stupid. AV's one to one caregiver got in between AV and W1 but could not separate the two. W1 kicked AV and AV scratched W1's arm and knocked his/her glasses off. W1 and AV suffered a skin tear during the altercation. The facility's failure to provide a safe environment is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP24-01046 $375.00 fine assessed