Print Violation: 00359376-AP-309718

Provider Information

Rackleff Place

655 SW 13TH AVE
Canby, OR 97013

Date: 10/9/2024
Report number: 00359376-AP-309718
Type: Licensing Violation
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to provide inservice
Result: Substantiated
Rule(s) Violated: External site: 411-054-0025(1)(a) and (b), 411-054-0027(1)(g) and (s), 411-054-0028(2)
External site: 411-054-0055(1)(a) and (f)
Findings: The Alleged Victim (AV) relies on the facility to administer his/her medications. According to an investigation, on or about October 9, 2024, the Alleged Perpetrator 2 (AP2) failed to administer medication as ordered when he/she administered another resident's Gabapentin to AV in error. AV is allergic to Gabapentin. This exposed AV to potential risk of serious harm. AP2's actions are considered neglect and constitutes abuse. The facility failed to ensure medications were administered as ordered, which violates Oregon Administrative Rules.