Aging and People with Disabilities
Safety, Oversight and Quality
Print Violation: 00390849-AP-341394
Provider Information
Avamere at Sandy
17727 SE LANGENSAND RD
Sandy, OR 97055
- Provider ID
- 5MA249
- Administrator
- Madison Tritico
- Phone
- (503) 668-4199
- malmodovar@avamerecommunities.com
Violation Details
- Date
- 3/24/2025
- Report number
- 00390849-AP-341394
- Type
- Abuse: Neglect
- Level
- 3 - Moderate harm or potential for serious 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)
External site: 411-054-0036(2)(g)
- Findings
- On or about March 24, 2025, the facility failed to provide appropriate supervision to the Alleged Victim (AV) according to his/her care needs. Based on facility documentation and interviews, AV was last seen by facility staff at around midnight. According to facility records, at 2:11am the facility door alarm went off and staff did not check the door. AV was later found by the LEA a quarter of a mile away from the facility. LEA brought AV back to the facility and staff did not know that AV had left the facility. Alleged Perpetrator 2 (AP2) failed to provide proper supervision and oversight result in AV exiting the facility. Prior to incident, AP2 knew AV had been riding the elevator for hours and AP2 did not redirect AV. AP2 was trained to intervene when AV is exhibiting exit seeking behaviors; however, AP2 failed to intervene when AP2 saw that AV was having behaviors. AP2 did not follow any of AV's interventions as detailed in AV's service plan. AP2's actions is considered neglect of care which constitutes abuse. The facility's failure resulted in AV leaving the facility, without staff knowledge, placing him/her at risk of harm due to AV having to cross a busy highway before AV was found by LEA, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
- Sanction
- RCFCP25-00849 $1125.00 fine assessed