Print Violation: 00385765-AP-336237

Provider Information

The Arbor at Avamere Court

450 CLAGGETT COURT N
Keizer, OR 97303

Date: 2/17/2025
Report number: 00385765-AP-336237
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to follow care plan
Result: Substantiated
Rule(s) Violated: External site: 411-054-0025(10(a) and (b)
External site: 411-054-0027(1)(g) and (s)
External site: 411-054-0028(2)
External site: 411-054-0036(2)(g)
Findings: According to the documentation, the facility failed to follow Witness 1’s (W1) service plan by not redirecting them away from another resident’s room. W1 has a known behavior of wandering in and around other resident rooms. W1 is service planned to be redirected away from other resident rooms when exhibiting this behavior. On or about February 17, 2025, the AV was seen in the doorway of the Alleged Victim’s (AV) doorway. Staff walked by W1 and did not redirect them. Approximately five minutes later, staff went into AV’s room and found the AV laying on the ground with a skin tear and a bump on their head. The failure to follow the care plan to redirect W1 away from AV lead to a resident to resident altercation causing harm to the AV, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP25-00325 $500.00 fine assessed