Inspection Reports for
Evergreen Court
900 124TH AVENUE NE, BELLEVUE, WA, 98005
Back to Facility Profile7 Reports
Inspection Report — Dec 9, 2025
Re-Inspection
Date: Dec 9, 2025
Visit Reason
An unannounced Fire and Life Safety Code re-inspection was conducted at Evergreen Court by a representative of the Washington State Patrol, State Fire Marshal's Office to determine compliance with all applicable codes.
Findings
The facility was found non-compliant and disapproved due to multiple deficiencies related to fire safety equipment documentation and fire drill participation. Several violations were corrected on site, but the facility was unable to provide required documentation for monthly smoke detector testing and fire drill participation.
Deficiencies (10)
IFC 603.5 (2021) - Relocatable power taps and current taps must comply with NFPA 70 and this code. The facility corrected this issue.
IFC 603.6 (2021) - Extension cords must not substitute permanent wiring and must be listed and labeled per UL 817. The facility corrected this issue.
IFC 607.3.1 (2018) - Ventilation systems with hoods must operate at required air movement rates and have grease filters listed and labeled per UL 1046. The facility corrected this issue.
IFC 903.3.1.1 (2012, 2015) - Buildings requiring automatic sprinkler systems must have sprinklers installed per NFPA 13 sections 903.3.1.1.1 and 903.3.1.1.2. The facility corrected this issue.
IFC 903.5 (2021) - Sprinkler systems must be tested and maintained per Section 901. The facility corrected this issue.
IFC 906.2 (2021) - Portable fire extinguishers must be selected, installed, and maintained per this section and NFPA 10. The facility corrected this issue.
IFC 906.6 (2021) - Portable fire extinguishers must not be obstructed or obscured and means must be provided to indicate their locations. The facility corrected this issue.
IFC 907.8 (2021) - The facility failed to provide documentation for monthly smoke detector testing and inspection reports verifying no deficiencies or correction of deficiencies.
IFC 1013.1 (2021) - Exit signs and exit access doors must be marked by approved exit signs visible from any direction of egress travel. The facility corrected this issue.
WAC 212-12-044 - The facility failed to provide documentation that at least twelve planned and unannounced fire drills were held yearly, including quarterly drills for all shifts in the third quarter of 2025.
Report Facts
Fire drills required: 12
Fire drills participation period: 2025
Inspection Report — Dec 9, 2025
Life Safety
Date: Dec 9, 2025
Visit Reason
An unannounced Fire and Life Safety Code re-inspection was conducted at Evergreen Court by a representative of the Washington State Patrol, State Fire Marshal's Office to determine compliance with applicable codes.
Findings
The facility was found non-compliant and disapproved due to missing documentation for monthly smoke detector testing, fire alarm and detection system maintenance records, and fire drill participation. All other cited fire safety deficiencies were corrected on site.
Deficiencies (10)
IFC 603.5 (2021) - Relocatable power taps and current taps must be constructed and used in accordance with NFPA 70. The facility corrected this issue.
IFC 603.6 (2021) - Extension cords must not substitute permanent wiring and must be listed and labeled per UL 817. The facility corrected this issue.
IFC 607.3.1 (2018) - Ventilation systems with hoods must operate at required air movement rates and have grease filters listed and labeled per UL 1046. The facility corrected this issue.
IFC 903.3.1.1 (2012, 2015) - Buildings requiring automatic sprinkler systems must have sprinklers installed per NFPA 13. The facility corrected this issue.
IFC 903.5 (2021) - Sprinkler systems must be tested and maintained per Section 901. The facility corrected this issue.
IFC 906.2 (2021) - Portable fire extinguishers must be selected, installed, and maintained per NFPA 10. The facility corrected this issue.
IFC 906.6 (2021) - Portable fire extinguishers must not be obstructed or obscured and must have means to indicate their location. The facility corrected this issue.
IFC 907.8 (2021) - Fire alarm and detection systems must have maintenance and testing schedules per Sections 907.8.1 through 907.8.5 and NFPA 72, with records maintained. The facility was unable to provide documentation verifying monthly smoke detector testing and inspection reports confirming no deficiencies.
IFC 1013.1 (2021) - Exit signs and exit access doors must be marked by approved exit signs visible from any direction of egress travel. The facility corrected this issue.
WAC 212-12-044 - Group I, E, and R2 occupancies must conduct at least twelve planned and unannounced fire drills annually, with quarterly drills on each shift in Group I and R2. The facility was unable to provide documentation that all shifts participated in third quarter 2025 fire drills.
Inspection Report — Aug 11, 2025
Follow-Up
Date: Aug 11, 2025
Visit Reason
The Department of Social and Health Services conducted a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies.
Complaint Details
The complaint investigation involved an allegation of respiratory illness found in 22 residents and five staff. The investigation found infection prevention control failures and cited WAC 388-78A-2610.
Findings
The follow-up inspection on 08/11/2025 found no deficiencies and confirmed that previously cited deficiencies were corrected.
Deficiencies (4)
WAC 388-78A-2100 Ongoing assessments. The facility failed to complete 1 of 7 sampled resident assessments that included the required full assessment components, placing a resident at risk of harm from unidentified care needs.
WAC 388-78A-2150 Signing negotiated service agreement. The facility failed to ensure 1 of 7 sampled residents or their representatives signed their Service Plan Report at least annually, placing a resident at risk of unmet care needs.
WAC 388-78A-2810 Criteria for increasing licensed bed capacity. The facility failed to notify and receive approval from the Department of Social and Health Services Construction Review Services for the addition of 3 rooms and approval for occupancy, placing 3 residents at risk of injury from residing in unapproved apartments.
WAC 388-78A-3090 Maintenance and housekeeping. The facility failed to provide ventilation fans in 5 rooms that operated to provide proper air flow and ventilation to the outside, placing all 37 residents at risk of diminished quality of life from improper air circulation.
Report Facts
Sampled residents: 11
Current residents: 37
Resident sample size: 7
Total residents: 36
Staff screened for TB: 3
Residents at risk: 40
Staff respirators available: 0
Residents at risk: 36
Residents at risk: 40
Staff without background check: 1
Days without background check: 238
Inspection Report — Apr 23, 2025
Enforcement
Date: Apr 23, 2025
Visit Reason
This document is a formal notice of civil fines imposed on the assisted living facility EVERGREEN COURT following a follow-up visit conducted by the Department of Social and Health Services on April 23, 2025. The fines are based on multiple uncorrected deficiencies previously cited on February 26, 2025.
Findings
The report identifies multiple uncorrected deficiencies related to resident assessments, service agreement signing, unauthorized increase in licensed bed capacity, maintenance and housekeeping issues, and service agreement planning. These deficiencies placed residents at risk of harm or unmet care needs and resulted in civil fines totaling $1,500.
Deficiencies (5)
WAC 388-78A-2100 (2)(a)(b)(i)(ii) Ongoing assessments. The licensee failed to complete one resident’s assessments including required full components, placing the resident at risk of harm from unidentified care needs.
WAC 388-78A-2150 (1)(2) Signing negotiated service agreement. The licensee failed to ensure one resident or their representative and a facility representative signed their Service Plan Report at least annually, placing the resident at risk of unmet care needs.
WAC 388-78A-2810 (1)(2)(3) Criteria for increasing licensed bed capacity. The licensee failed to notify and receive approval for the addition of three rooms and occupancy approval, placing three residents at risk of injury from residing in unapproved apartments.
WAC 388-78A-3090 (1)(a)(2)(c)(iv) Maintenance and housekeeping. The licensee failed to provide ventilation fans in four rooms that operated properly, placing all 37 residents at risk of diminished quality of life from improper air circulation.
WAC 388-78A-2130 (1)(b)9c)(3)(a)(b)(4) Service agreement planning. The licensee failed to document in one resident’s service agreements a plan to monitor and address interventions required to meet current needs, placing the resident at risk for unmet care needs and potential harm.
Report Facts
Civil fines total: 1500
Residents at risk: 37
Rooms added without approval: 3
Inspection Report — Oct 2, 2024
Life Safety
Date: Oct 2, 2024
Visit Reason
The Office of the State Fire Marshal conducted a scheduled fire safety inspection at the Evergreen Court residential care facility.
Findings
All violations noted during previous related inspections have been corrected. The current inspection found no outstanding deficiencies and the facility was approved.
Deficiencies (18)
IFC 315.2.1 2021 - Storage shall be maintained 2 feet or more below the ceiling in nonsprinklered areas or not less than 18 inches below sprinkler heads. Exceptions apply for certain areas. This was corrected.
IFC 315.3.2 2021 - Combustible materials shall not be stored in exits or enclosures for stairways and ramps. This was corrected.
IFC 315.2.3 2021 - Combustible material shall not be stored in boiler rooms, mechanical rooms, electrical equipment rooms or fire command centers. This was corrected.
IFC 405.2 2021 - Drills shall be held at unexpected times and under varying conditions to simulate fire conditions. Documentation for twelve planned and unannounced fire drills in the previous 12 months was missing. Facility will need to perform one fire drill per shift in the next 30 days.
IFC 603.2.2 2021 - Open junction boxes and open-wiring splices are prohibited. Approved covers shall be provided for all switch and electrical outlet boxes. This was corrected.
IFC 606.3.3 2021 - Hoods, grease-removal devices, fans, ducts and other appurtenances shall be cleaned at required intervals. Documentation for first and second semi-annual hood cleaning was missing.
IFC 701.6 2021 - Owner shall maintain inventory and visually inspect fire-resistance-rated construction annually. Facility needs to identify and establish a schedule for inspection of fire-rated construction. Annual inspection will need to be performed and completed.
IFC 705.2.4 2021 - Swinging fire doors shall close from full-open position and latch automatically. Room 163 door and PPE door will not latch.
IFC 903.5 2021 - Sprinkler systems shall be tested and maintained per Section 901. Documentation for annual report, 5-year internal pipe testing, 3-year dry system full flow trip test, annual trip test, annual forward flow test, 5-year FDC hydro testing, and quarterly inspections was missing.
IFC 904.13.5.2 2021 - Automatic fire-extinguishing systems shall be serviced at least every six months. Documentation for first and second semi-annual servicing was missing.
IFC 907.8 2021 - Fire alarm and detection systems shall be maintained and tested per NFPA 72. Documentation for annual report, sensitivity testing, and monthly single and multiple station alarms test was missing.
IFC 0915.1 2021 WAC 51-54A - Carbon monoxide detection shall be installed and maintained. Documentation for testing, maintenance, and monthly schedule was missing.
IFC 1013.1 2021 - Exits and exit access doors shall be marked by approved exit signs visible from any direction of egress travel. Exit sign not working on main floor by room 95.
IFC 1032.10 2021 - Emergency lighting shall be maintained and inspected. Emergency lights not working by rooms 221 and 227 and in stairwells.
IFC 1032.10.1 2021 - Emergency lighting equipment shall be tested monthly for at least 30 seconds. Monthly activation testing had not been performed or documented.
IFC 1031.10.2 2021 - Battery-powered emergency lighting equipment shall be tested annually for at least 90 minutes. Annual 90-minute power test had not been performed or documented.
NFPA 80 Fire/Smoke Dampers Inspection and Testing - Dampers shall be inspected and tested 1 year after installation and every 4 years thereafter. Fire/smoke damper inspection will need to be performed and documented.
NFPA 80 Fire Door Inspection and Testing - Fire doors shall be inspected and tested annually with records maintained. Facility needs to identify and establish a schedule for inspection of fire doors. Annual inspection will need to be performed and completed.
Report Facts
Missing fire drills: 12
Missing fire drill shifts: 3
Deficiencies cited: 18
Inspection Report — Jul 29, 2024
Life Safety
Date: Jul 29, 2024
Visit Reason
The Office of the State Fire Marshal conducted a scheduled fire safety inspection at the Evergreen Court residential care facility to assess compliance with fire and life safety codes.
Findings
The inspection found multiple deficiencies related to fire safety including missing documentation for required fire drills, incomplete maintenance and testing records for fire and safety equipment, and physical issues such as combustible materials stored improperly and malfunctioning fire doors and emergency lighting. None of the deficiencies were corrected at the time of inspection, resulting in a disapproved status.
Deficiencies (18)
IFC 315.2.1 (2021) - Storage shall be maintained 2 feet below ceiling in nonsprinklered areas or 18 inches below sprinkler heads. Storage in the 1st floor PPE room was within 18 inches of sprinkler heads.
IFC 315.3.2 (2021) - Combustible materials shall not be stored in exits or enclosures for stairways and ramps. Combustible materials were found on the 3rd floor stairwell.
IFC 315.2.3 (2021) - Combustible materials shall not be stored in boiler, mechanical, electrical equipment rooms or fire command centers. Combustible materials were found in the electrical room on the bottom floor.
IFC 405.2 (2021) - Drills shall be held at unexpected times and under varying conditions. Facility could not provide documentation for twelve planned and unannounced fire drills in the previous 12 months for all shifts.
IFC 603.2.2 (2021) - Open junction boxes and open wiring splices are prohibited. An open junction box was found on the 3rd floor in the electrical room outside the meeting room/restroom.
IFC 606.3.3 (2021) - Hoods, grease-removal devices, fans, ducts and other appurtenances shall be cleaned at required intervals. Facility lacked documentation for first and second semi-annual hood cleaning.
IFC 701.6 (2021) - Owner shall maintain inventory and inspection schedule for fire-resistance-rated construction. Facility lacked documentation for inspection schedule and annual inspection of fire-rated construction.
IFC 705.2.4 (2021) - Swinging fire doors shall close from full-open position and latch automatically. Room 163 and PPE door will not latch.
IFC 903.5 (2021) - Sprinkler systems shall be tested and maintained per Section 901. Facility lacked documentation for annual report, 5-year internal pipe testing, 3-year dry system full flow trip test, annual trip test, annual forward flow test, 5-year FDC hydro testing, and quarterly inspections.
IFC 904.13.5.2 (2021) - Automatic fire-extinguishing systems shall be serviced at least every six months. Facility lacked documentation for first and second semi-annual servicing.
IFC 907.8 (2021) - Fire alarm and detection systems shall be maintained and tested per NFPA 72. Facility lacked documentation for annual report, sensitivity testing, and monthly single and multiple station alarms test.
IFC 0915.1 (2021) WAC 51-54A - Carbon monoxide detection shall be installed and maintained. Facility lacked documentation for monthly testing and maintenance of carbon monoxide alarms and detectors.
IFC 1013.1 (2021) - Exits and exit access doors shall be marked by approved exit signs. Exit sign on main floor by room 95 was not working when tested.
IFC 1032.10 (2021) - Emergency lighting shall be maintained and tested. Emergency lights were not working by rooms 221, 227, and in stairwells.
IFC 1032.10.1 (2021) - Emergency lighting equipment shall be tested monthly for at least 30 seconds. Facility lacked documentation for monthly activation testing.
IFC 1031.10.2 (2021) - Battery-powered emergency lighting equipment shall be tested annually for 90 minutes. Facility lacked documentation for annual 90-minute power test.
NFPA 80 (2021) - Fire/smoke dampers shall be inspected and tested periodically. Facility lacked documentation for fire/smoke damper inspection.
NFPA 80 (2021) - Fire doors shall be inspected and tested annually with records maintained. Facility lacked documentation for annual inspection of fire doors and several fire doors had operational issues.
Report Facts
Missing fire drills: 12
Missing fire drill quarters: 12
Inspection Report — Jul 6, 2023
Life Safety
Date: Jul 6, 2023
Visit Reason
The Office of the State Fire Marshal conducted a scheduled fire safety inspection at Evergreen Court to verify compliance with fire protection codes.
Findings
All violations noted during previous related inspections have been corrected. The current inspection resulted in an Approved status with no open deficiencies.
Viewing
Loading inspection reports...
