Print Violation: 00380965-AP-331520

Provider Information

Crystal Terrace Memory Care

320 JADE TERRACE
Klamath Falls, OR 97601

Date: 1/26/2025
Report number: 00380965-AP-331520
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to properly plan care
Result: Substantiated
Rule(s) Violated: 411-054-0027(1)(g) and (s)
411-054-0028(2)
411-054-0036(2)(g)
Findings: Alleged Victim (AV) is known to be a high fall risk. Between January 28th and 29th, 2025, AV had two (2) falls. Witnesses were under the impression that AV was independent with his/her ambulation despite the frequent falls. AV’s 1-1 caregivers were not told that AV’s care consisted of or what care to provide to AV to prevent falls. The facility failed to put appropriate and/or sufficient interventions into place to address AV’s falls, which placed AV at risk of harm, which is a violation of resident rights, is neglect of care and constitutes abuse.
Sanction: RCFCP25-00708 $1501.00 fine assessed