Trustwell Living at Evergreen Place

Facility failed to implement systems to support safe medication services for 1 of 7 residents (R6); topical medication not given and not documented.

Facility failed to complete the negotiated service agreement within 30 days of admission for 3 of 4 sampled residents (R3, R7, R9).

Facility failed to ensure a Medicaid policy was completed/documented for 3 of 7 sampled residents (R2, R5, and R6).

Facility failed to ensure 2 of 3 sampled staff (Staff C and D) had completed/documented required training, and staff credentials for Staff C and D were expired or missing.

Facility failed to complete a full assessment within 14 days of admission for 3 of 4 sampled residents (R3, R7, R9).

Facility failed to complete TB testing within three days of hire for 3 of 3 sampled staff (Staff A, C, and D).

Deficiencies for this regulation were corrected.

Facility failed to document identified care and service needs for 4 of 9 sampled residents (R1, R2, R4, R9) in the negotiated service agreement.

Facility failed to ensure the written plan for family assistance with medications included required minimum information for 3 of 3 residents (R1, R4, R9).

Facility failed to ensure a Washington state name and date of birth background check was completed for 1 of 5 staff (Staff E).

Facility failed to maintain an accurate resident characteristic roster for 2 of 9 sampled residents (R7 and R9).

The licensee failed to complete tuberculosis (TB) testing within three days of hire for one staff member.

Facility failed to provide quarterly fire sprinkler inspection report, annual forward flow of fire sprinkler system report, and 5 year FDC hydrostatic inspection report.

Facility failed to provide an annual fire door inspection report; resident room door 112 found to have excessive door gap.

The licensee failed to ensure the nurse delegator had delegated five Medication Aids prior to administering medications to one resident.

The licensee failed to document the plan to provide specific resident identified care and service needs in the negotiated service agreement for two residents.

The licensee failed to complete tuberculosis testing within three days of hire for one staff member.

The licensee failed to ensure a Medicaid policy was completed and/or documented for one resident.

Facility staff failed to follow established policies and procedures regarding written orders.

Two sampled Family Medication Plans were not up to date.

Staff member accidentally administered fast acting insulin instead of prescribed long acting insulin.

Facility failed to provide annual emergency light testing.

Dumpster found within 5 feet of building with no sprinkler protection.

Kitchen M/C cable found broken at ceiling (broken electrical wire).

Facility failed to provide annual fire resistance-rated construction inspection.

Facility failed to provide annual fire door inspection report; Resident room door 112 had excessive door gap.

Electrical room door failed to close automatically (propped open).

Failed to provide quarterly fire sprinkler inspection report, annual forward flow test, and 5-year FDC hydrostatic inspection; Sprinkler heads in laundry room had excessive dust.

Semi-annual fire alarm testing required.

Changed fusible link selection with no heat survey; missing instructions for new employees; flammable materials on top of hood suppression system.

Facility failed to conduct fire drills on night shift during second, third, and fourth quarter of 2024.