Print Violation: 00339807-AP-290629

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 6/29/2024
Report number: 00339807-AP-290629
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: Witness #1 (W1) has a history of aggression towards staff and residents. On or about June 29, 2024, the Alleged Victim (AV) was standing in the hallway talking to another resident and called W1 stupid. W1's one to one caregiver got in between W1 and AV but could not separate the two. AV kicked W1 and W1 scratched AV's arm and knocked his/her glasses off. AV and W1 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: RCFCP24-01047 $375.00 fine assessed