Aegis of Queen Anne at Rodgers Park

Facility failed to provide 5 year FDC hydro static inspection report and quarterly fire sprinkler inspection reports; existing reports identified deficiencies

Electrical cover missing in telco room on second floor across from room 234

Facility failed to provide annual generator inspection report

Sprinkler riser room lacks required signage

Fire extinguishers were inaccessible (locked) during inspection

Holes found in fire rated construction in lobby level director office and loading dock area laundry room

Facility failed to provide semi annual hood system inspection report

Facility failed to provide signage for kitchen cooking appliances

Facility failed to provide fire drill report for the 4th quarter night shift

3rd floor double doors by 350, 1st floor double doors by room 130, and P1 sprinkler room door will not close/latch.

3rd floor Electrical room penetration across The Belfry; Telco room across room 334 has penetration.

K fire extinguisher damaged/leaking; fire extinguisher in lobby blocked for second year.

Fuel test and Load test documentation not provided.

Missing annual forward flow test documentation; broken dry pipe on patio (yellow tag).

Blocked electrical panel found in kitchen.

Dryer vents need to be cleaned.

Loose tank found in room 350 and Activities office back room.

P1 Activity closet has combustible material inside the 18 inch sprinkler clearance.

Door wedge found holding door in soiled linen room.

Documentation not provided; last tested 3/21/2019.

The licensee failed to monitor and evaluate one resident’s pain issue, placing the resident at risk for diminished quality of life.

Staff failed to wash hands during food preparation and before serving meals, placing 12 residents at risk of foodborne illness.

Negotiated Service Agreements (NSA) for Residents 5 and 10 were incomplete. Resident 5's NSA lacked information on private caregiver roles and shower assistance. Resident 10 lacked a required behavior intervention plan.

Facility failed to implement systems to support safe medication services for Residents 1 and 5, resulting in residents not receiving medications as prescribed.

Facility failed to monitor and evaluate a resident's pain issue, placing the resident at risk of diminished quality of life.

Facility failed to update assessment for Resident 5 to include safety considerations and proper usage for installed mobility devices (transfer poles).

Facility failed to implement skin management policies for Resident 1 (resulting in a pressure sore) and failed to monitor/document food temperatures for 12 residents in the Memory Care Unit.

Facility failed to notify physician or evaluate negative outcomes when 3 of 3 sampled residents (5, 8, and 10) refused medication.

Facility failed to follow criteria for nurse delegation for Resident 1, allowing non-licensed staff to administer medications without proper delegation.

Facility failed to secure toxic chemicals in an area accessible to residents, placing 34 residents at risk of ingestion.

Facility failed to ensure prescribed medications were available for 3 of 10 sampled residents, placing them at risk of medical complications.

Facility failed to secure toxic chemicals in an area accessible to residents, placing 34 of 34 residents at risk.

The facility failed to document repeated attempts to refill medications in the resident's record when medication ran out, leaving them unable to provide proof of ensuring necessary refills.

The facility failed to ensure a staff caregiver completed the required 70 hours of DSHS approved basic training within 120 days of hire, allowing them to provide care while untrained.

Failed to implement policies regarding skin management and reporting changes of condition, contributing to a resident developing a large, infected unstageable wound without necessary care.

Failed to identify, monitor, evaluate and take action in response to changes in skin condition, resulting in a resident developing a large, infected unstageable wound.

Failed to report the recurrence of a pressure ulcer to the Primary Care Physician and Resident Representative, resulting in a resident developing a large, infected unstageable wound without medical intervention.

The facility failed to implement their policies regarding skin management and reporting changes of condition for a resident, resulting in a lack of necessary care.

The facility failed to report the recurrence and worsening of a resident's pressure ulcer to the primary care physician and resident representative.

The facility failed to identify, monitor, evaluate, and take action regarding a resident's worsening skin condition, leading to an infected, unstageable pressure wound.