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Source: WA Dept. of Social & Health Services
All violations noted during previous related inspection(s) have been corrected.
A separate document (the cover letter) indicates that on 11/19/2024, a follow-up inspection found no deficiencies and WAC 388-78A-2040-1, 2040-2, and 2040 were marked as corrected.
Facility failed to ensure compliance with the Washington State Patrol Office of State Fire Marshal (OSFM) regarding fire and life safety inspections, specifically regarding missing paperwork for sprinkler maintenance, carbon monoxide detection, and fire door inspections.
The facility was marked 'Disapproved' on the inspection form due to missing documentation, but subsequent notations indicate items were 'Corrected'.
Required inspection paperwork not provided.
Required inspection paperwork not provided.
Required inspection/maintenance paperwork not provided.
Missing annual report (2024), 5-year internal pipe testing, 5-year FDC hydro testing, and quarterly inspection reports.
Required inspection paperwork not provided.
Daisy chain found in kitchen.
12 planned and unannounced fire drills in previous 12 months; need to conform to shift times.
Multi-plug in use behind washing machine; appliances must be plugged directly into receptacles.
Missing annual report and sensitivity testing records.
Plug pulled from wall behind washing machine.
This document is a cover letter confirming that deficiencies previously identified under compliance determination 42996 (WAC 388-78A-3100-1 and WAC 388-78A-3100-2) were corrected as verified by an on-site inspection on 08/16/2024.
The inspection on 7/13/2023 resulted in a 'Disapproved' status. The follow-up inspection on 8/28/2023 confirmed that all violations noted during previous inspections have been corrected.
Fire extinguisher located by resident room 5 had the pin pulled.
Facility failed to provide documentation/paperwork showing smoke detector sensitivity testing has been performed.
Facility did not provide documentation for annual fire door inspection and lacked a schedule for such inspections.
A follow-up inspection occurred on 05/12/2023 which found that all deficiencies had been corrected and the facility met licensing requirements.
Failed to ensure 1 of 6 sampled staff (Staff A) maintained current Nursing Assistant Registration (NAR) certification.
Failed to ensure Washington State name and date of birth background inquiry (BGI) for 2 of 6 sampled staff were completed at time of hire.
Failed to protect the confidentiality and privacy of 5 of 5 residents by displaying a confidential list of resident names in a public location.
Failed to ensure 1 of 6 staff (Staff E) completed specialized training for dementia.
Failed to ensure 2 of 6 sample staff were screened for tuberculosis within three days of employment.
Failed to ensure national fingerprint background check (NFBC) for 3 of 6 sampled staff were completed.
Failed to follow a Respiratory Protection Program (RPP) by ensuring staff were fit-tested for respirator masks.
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WA DSHS — View Official Record
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