Print Violation: 00445233-AP-397215

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 12/15/2025
Report number: 00445233-AP-397215
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: 411-054-0025(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)
Findings: On or about December 15, 2025, the Alleged Victim (AV) was standing in the hall a few rooms away from Witness #1's (W1) room. W1 told AV that he/she was going to "karate chop" AV and then W1 threw his/her hands towards AV's face and made contact when AV brought his/her hands up to defend him/herself. W1 has had similar incidents, as W1 gets agitated by others being in or around W1's apartment. AV was not injured; however, AV was placed at risk for harm. Respondent failed to provide a safe environment for AV. This constitutes abuse by neglect, as outlined in OAR 411-020-0002(1)(b)(A)(i).
Sanction: RCFCP26-00255 $375.00 fine assessed