Inspection Reports for Canterbury Inn Assisted Living Community
1324 3rd Ave, Longview, WA 98632, United States, WA, 98632
Back to Facility ProfileDeficiencies per Year
16
12
8
4
0
Severe
High
Moderate
Low
Unclassified
Inspection Report
Follow-Up
Deficiencies: 0
Nov 13, 2024
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previous deficiencies.
Findings
The follow-up inspection found no deficiencies and confirmed that the facility meets Assisted Living Facility licensing requirements. Previously cited deficiencies were corrected.
Report Facts
Residents sampled: 12
Total residents: 97
Deficiencies cited: 14
Staff continuing education hours missing: 2
Residents missing negotiated service agreements: 6
Residents missing Medicaid policy signature on or before admission: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kyle Gehlen | ALF Licensor - LTC | Department staff who did the on-site verification |
| Jennifer Siharath | ALF Licensor | Department staff who did the on-site verification |
| Michael Burdick | Field Manager | Signed enforcement letter and correspondence |
| Staff A | Executive Director | Acknowledged findings and deficiencies during exit interviews |
| Staff C | Director of Nursing | Confirmed resident use of transfer pole |
| Staff G | Certified Nursing Assistant/Medication Technician | Had incomplete continuing education hours |
| Staff H | Licensed Practical Nurse/Assistant Director of Resident Services | Had incomplete continuing education hours |
Inspection Report
Re-Inspection
Deficiencies: 15
Jul 30, 2024
Visit Reason
The Office of the State Fire Marshal conducted a re-inspection at Canterbury Retirement Inn to verify correction of previously identified fire and safety violations.
Findings
The facility was found to have multiple unresolved fire and safety violations including missing electrical covers, blocked electrical panels, noncompliant fire doors, missing fire drill records for 2023 and 2024, and failure to secure oxygen tanks. Several reports required for compliance were not provided.
Deficiencies (15)
| Description |
|---|
| Electrical cover missing in maintenance office and room 313 |
| Annual fire door inspection report not provided; multiple fire doors out of compliance (attic access door not self-closing, cross corridor door by room 601 side gap, door 605 bottom gap) |
| Cigarette found in garbage can; no ashtray present in smoking area |
| Electrical cover missing in boiler room, laundry room, maintenance office, and room 313; broken electrical flex conduit in culinary manager area |
| Electrical panel blocked by item near room 122 |
| Extension cord found as permanent wiring in laundry room |
| Kitchen appliance not restrained from movement |
| Boiler room has holes in wall; hole in stairwell by room 608; hole in wall trash by room 508 |
| Fire damper fusible link painted in storage room by rooms 508 or 608 |
| Multiple fire doors found wedged open during inspection (rooms 101, 103, 104, 105, 106, 118, 124) |
| Annual trip test and 3 year trip test for sprinkler system not documented; facility in process of replacing dry pendant fire sprinkler heads |
| Carbon monoxide detector in room 148 is in trouble |
| Annual emergency light testing not provided; exit sign by dining room failed to be illuminated |
| Oxygen tank in room 124 not secured; repair made during inspection |
| Fire drills missing for 2023 and 2024 |
Report Facts
Fire doors wedged open: 7
Fire drills missing years: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nicholas Wolden | Deputy State Fire Marshal | Signed inspection report |
Inspection Report
Life Safety
Deficiencies: 7
Jun 12, 2023
Visit Reason
The Office of the State Fire Marshal conducted a fire safety inspection at Canterbury Retirement Inn on June 12, 2023.
Findings
The facility was found to have multiple fire safety violations including failure to maintain fire resistance rated construction, inadequate inspection and maintenance of fire protection systems, missing fire sprinkler components, lack of required fire drills, and failure to provide necessary inspection reports and testing.
Deficiencies (7)
| Description |
|---|
| Facility failed to maintain fire resistance rated construction in boiler room around fire sprinkler piping |
| Facility failed to maintain/provide fire rated door/hatch in mechanical room by 608 and 142 |
| Facility failed to provide quarterly fire sprinkler inspection reports and annual forward flow testing; fire sprinkler trim ring missing from fire sprinkler head by room 151 |
| Facility failed to provide heat survey results and proper fusible link selection for kitchen hood suppression system |
| Facility failed to provide sensitivity testing of the fire alarm smoke detectors |
| Facility failed to provide 5 year hydro testing of fire department connection (FDC) |
| Facility failed to provide the third quarter swing shift and night shift fire drills |
Report Facts
Inspection date: Jun 12, 2023
Next inspection scheduled: Jul 12, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nicholas D. Wolden | Deputy State Fire Marshal | Conducted the fire safety inspection |
| Raymond Sabino | Area Director | Authorized Facility Representative signing the report |
Report
File
R_CANTERBURY_RETIREMENT_INN_Inspection_08-25-2022_-_AH.pdf
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