Print Violation: 00421025-AP-372420

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 8/17/2025
Report number: 00421025-AP-372420
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to provide safe environment
Result: Substantiated
Rule(s) Violated: External site: 411-054-0027(1)(g) and (s)
External site: 411-054-0028(2)
External site: 411-054-0030(1)(e)(I)
Findings: Witness #1 (W1) is known to engage in altercations with other residents. On or about August 17, 2025, W1 attempted to stab the Alleged Victim (AV) in the forearm with a fork. AV suffered pink discoloration to his/her forearm, which dissipated after a short time. W1 had previously been agitated and had two other altercations that same day. Interventions in place for W1 were not successful. The facility's failure to provide a safe environment is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP25-01223 $375.00 fine assessed