Aging and People with Disabilities
Safety, Oversight and Quality
Print Violation: 00391132-AP-341696
Provider Information
Crystal Terrace Memory Care
320 JADE TERRACE
Klamath Falls, OR 97601
- Provider ID
- 50M300
- Administrator
- Rachel Vandusen
- Phone
- (541) 273-7336
- rachelvandusen@mbk.com
Violation Details
- Date
- 3/25/2025
- Report number
- 00391132-AP-341696
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to properly plan care
- Result
- Substantiated
- Rule(s) Violated
-
411-054-0025(1)(a) and (b)
411-054-0027(1)(g) and (s)
411-054-0028(2)
411-054-0036(2)(g)
- Findings
- The Alleged Victim (AV) requires assistance with transfers, repositioning and ambulation, and is to be checked on every 15-30 minutes for safety. AV suffered two falls within a little over a week, causing unreasonable discomfort to AV. The facility failed to ensure staff understood AV's needs and ensure AV's care plan was updated with interventions to ensure AV's safety. The facility's actions constitute abuse by neglect, as outlined in OAR 411-020-0002(1)(b)(A)(i).
- Sanction
- RCFCP26-00011 $1313.00 fine assessed