Print Violation: 00400155-AP-350961

Provider Information

Carlty Gardens

2669 S CLOVERLEAF LOOP
Springfield, OR 97477

Date: 11/24/2024
Report number: 00400155-AP-350961
Type: Abuse: Neglect
Level: 3 - Moderate harm or potential for serious harm
Allegation: Failed to provide a safe medication administration system
Result: Substantiated
Rule(s) Violated: 411-054-0025(1)(a) and (b)
411-054-0027(1)(g) and (s)
411-054-0028(2)
411-054-0055(1)(a) and (f)
Findings: The Alleged Victim (AV) relies on the facility for their care, including medication management. From approximately November 3, 2024, to November 25, 2024, AV was not given several doses of his/her scheduled medications, as it was unavailable, which caused AV to experience pain and was unable to sleep. The facility failed to provide a safe medication administration system to ensure AV’s medication was available to be administered as ordered. The failure is a violation of resident rights, is considered neglect of care and constitutes abuse. The allegation that Alleged Perpetrator 2 (AP2) neglected AV was investigated and determined to be inconclusive.