Print Violation: 00443552-AP-395518

Provider Information

Washington Gardens Memory Care

9000 SW 91ST AVENUE
Tigard, OR 97223

Date: 12/4/2025
Report number: 00443552-AP-395518
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to properly plan care
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: 411-054-0036(2)(g)
Findings: The Alleged Victim (AV) is a known fall risk and has suffered falls at least three times during the month of November. AV's last service plan update was on October 30, 2025. On or about December 4, 2025, AV was found on the floor in his/her room from a fall. AV suffered bleeding to both sides of his/her forehead. AV complained of pain and emergency services were called to assess AV. Respondent failed to ensure proper care planning to reduce the risk of falls. This constitutes abuse by neglect, as outlined in OAR 411-020-0002(1)(b)(A)(i).
Sanction: RCFCP26-00422 $375.00 fine assessed