Brookdale Montclair Poulsbo

Facility failed to complete a required Washington State name and date of birth background check for 1 of 5 staff (Staff D) prior to employment.

Staff D did not complete required 70-hour basic training, specialty training for dementia and mental health, 12 hours of continuing education, or obtain Home Care Aide (HCA) certification.

Failed to provide report showing testing and maintenance of CO detectors.

Kitchen oven is plugged into a power strip.

Failed to provide annual fire resistance-rated construction inspection report; missing fire rated caulking in back wall of 1st communications room.

Missing five-year internal pipe inspection, three-year dry system full flow trip test, and five-year fire department connection hydrostatic test; fire sprinkler head outside room 18 is loaded with debris.

Failed to provide documents showing kitchen hood is being cleaned twice a year.

Fire/smoke damper report from 9/7/22 shows failures; no proof of repair.

Failed to provide fire alarm sensitivity test report and monthly inspection logs with batteries.

Failed to provide documentation showing annual 1.5 hrs test of exits and emergency lights.

Failed to provide annual inspection report for fire doors; double doors by puzzle table on 3rd floor failed to latch.

Failed to provide documentation showing monthly 30 second test of exits and emergency lights.

Deficiency previously cited and corrected.

Facility failed to provide documentation showing annual inspection of all fire-resistance-rated construction (fire wall inspection).

Facility failed to maintain fire sprinkler system: room 115 has painted sprinkler head; dry system has accelerator deficiency; no annual fire pump inspection; missing escutcheon rings in coffee shop and back closet; blocked sprinkler head in dry storage.

Facility failed to provide documentation showing monthly 30 second inspection of all emergency lights and exit signs.

Facility failed to provide documentation showing kitchen hood is being cleaned twice a year.

Damper report states failed dampers, facility shall provide documentation that dampers were fixed.

Facility failed to provide documentation showing monthly inspection of single and multiple station smoke alarms.

Facility failed to provide documentation showing annual inspection of all fire doors. Second floor, elevator #2 fire door does not latch.

The facility maintained two separate sets of service plans. Direct care staff had access to a set that was not updated with the newest resident care information or interventions, leaving them without necessary information for providing care.

Facility failed to maintain power strips in maintenance shop; power strips connected to other power strips.

Facility failed to maintain sprinkler head located in physical therapy room; sprinkler head was recessed.

Facility failed to provide documentation showing monthly inspection of smoke alarms and failed to maintain fire alarm system (system in trouble mode).

Facility failed to provide documentation for generator: annual servicing, weekly inspection log, and monthly 30-minute full load test log.

Facility failed to maintain extension cords in maintenance shop; extension cords being used as permanent wiring.

Facility failed to provide documentation showing 2nd semi-annual servicing of kitchen suppression system.

Facility failed to provide documentation showing sensitivity test has been conducted on fire alarm system.

Facility failed to provide documentation showing carbon monoxide alarms are being tested or maintained.

Facility failed to provide documentation showing 30-second monthly activation test of exit signs and emergency lighting.