Trustwell Living at Evergreen Place

Facility failed to provide quarterly inspection reports, annual forward flow reports, and 5-year FDC hydrostatic inspection reports.

Incomplete fire alarm testing records.

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

Kitchen M/C cable found broken at ceiling.

Facility failed to provide annual emergency light testing.

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

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

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

Changed fusible link selection without heat survey; lack of employee training records; flammable materials on hood.

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

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 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).

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

Deficiencies for this regulation were corrected.

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

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

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

The licensee failed to ensure a Medicaid policy was completed and/or documented for 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 ensure the nurse delegator had delegated five Medication Aids prior to administering medications to one resident.

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

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

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

Two sampled Family Medication Plans were not up to date.

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

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

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

Facility failed to provide annual emergency light testing.

Semi-annual fire alarm testing required.

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

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

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

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

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.

The facility failed to provide an annual inspection of fire-resistance-rated construction, and holes were found in the kitchen mechanical room.

The facility failed to make required corrections identified during the fire damper inspection.

The facility lacked strain protection for kitchen cooking appliances when in use.

During the June 9 inspection, the facility failed to have the kitchen exhaust fan operating while cooking.