Print Violation: 00359003-AP-309338

Provider Information

Redwood Heights Retirement and Assisted Living Community

4050 12TH ST CUTOFF SE
Salem, OR 97302

Date: 10/6/2024
Report number: 00359003-AP-309338
Type: Licensing Violation
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to provide a safe medication administration system
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: 411-054-0055(1)(a) and (f)
Findings: On or about October 6, 2024, Alleged Perpetrator #3 (AP3) was training Alleged Perpetrator #2 (AP2) to pass medication to residents. AP3 instructed AP2 to give the Alleged Victim (AV) his/her medication. AP3 provided AP2 with three cups of pre-popped medication, however, did not tell AP2 which medication was for which resident. AP2 gave incorrect medication to AV, causing AV to feel dizzy. AP2's actions were found to be not substantiated. AP3's failure to ensure proper oversight of medication training, and allowing AP2 to provide incorrect medication to AV is a violation of resident rights, is considered neglect of care and constitutes abuse. The facility failure to provide a safe medication administration system is a violation of Oregon Administrative Rules.