Inspection Reports for Clearwater Springs Assisted Living

201 NW 78th St, Vancouver, WA 98665, United States, WA, 98665

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Inspection Report Enforcement Deficiencies: 1 Oct 17, 2025
Visit Reason
The Department of Social and Health Services completed a follow-up visit to Clearwater Springs Assisted Living to address previously cited deficiencies and enforce compliance, resulting in the imposition of a civil fine.
Findings
The licensee failed to provide timely refunds to resident representatives for 13 residents within 30 days after discharge, placing residents at risk for financial exploitation. This was a recurring and uncorrected deficiency previously cited multiple times.
Deficiencies (1)
Description
Failure to provide a timely refund to a resident representative for 13 residents within 30 days after discharge.
Report Facts
Civil fine amount: 1200 Number of residents affected: 13
Employees Mentioned
NameTitleContext
Clinton FridleyRN, Field ManagerContact person for plan of correction and follow-up
Matt HauserCompliance SpecialistSigned the enforcement letter
Notice Deficiencies: 0 Oct 6, 2025
Visit Reason
The Department of Social and Health Services issued a Stop Placement Order based on a Statement of Deficiencies dated September 24, 2025.
Findings
A Stop Placement Order was imposed on the license of Clearwater Springs Assisted Living effective October 6, 2025, and remains in effect until formally lifted.
Report Facts
License number: 2579
Employees Mentioned
NameTitleContext
Matt HauserCompliance SpecialistSigned the Stop Placement Order notice
Inspection Report Enforcement Deficiencies: 1 Sep 24, 2025
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to Clearwater Springs Assisted Living to address ongoing deficiencies, resulting in a stop placement order prohibiting admissions due to failure to comply with fire safety ordinances.
Findings
The facility failed to comply with local and state fire ordinances, placing residents, visitors, and staff at risk of injury or harm in the event of a fire. This deficiency was repeated and uncorrected despite previous citations, leading to the issuance of a stop placement order prohibiting admissions effective October 6, 2025.
Deficiencies (1)
Description
Failure to stay in compliance with local and state fire ordinances placing all residents, visitors, and staff at risk of injury and harm in the event of a fire.
Report Facts
Dates of previous citations: Repeated deficiency previously cited on August 1, 2025, July 26, 2024, June 16, 2025, and April 29, 2025
Employees Mentioned
NameTitleContext
Clinton FridleyField ManagerContact person for approval requests and plan of correction submission
Matt HauserCompliance SpecialistSigned the enforcement letter
Inspection Report Follow-Up Deficiencies: 1 Aug 1, 2025
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to Clearwater Springs Assisted Living to verify correction of previously cited deficiencies.
Findings
The facility failed to comply with local and state fire ordinances, resulting in a recurring deficiency that placed residents, visitors, and staff at risk of injury or harm in the event of a fire. This deficiency was previously cited on June 16, 2025, and April 29, 2025, and remains uncorrected.
Deficiencies (1)
Description
Failure to stay in compliance with local and state fire ordinances for the assisted living facility.
Report Facts
Civil fine amount: 2000
Employees Mentioned
NameTitleContext
Clinton FridleyRN, Field ManagerContact person for plan of correction and follow-up
Matt HauserCompliance SpecialistSigned the imposition of civil fines letter
Inspection Report Enforcement Deficiencies: 1 Jul 8, 2025
Visit Reason
The Department of Social and Health Services completed a follow-up visit to Clearwater Springs Assisted Living to address previously cited deficiencies and to impose a civil fine related to resident rights violations.
Findings
The facility failed to provide timely refunds to resident representatives within 30 days after resident discharge for three residents, resulting in a civil fine of $600. This deficiency was previously cited and remains uncorrected.
Deficiencies (1)
Description
Failure to provide a timely refund to a resident representative for three residents within 30 days after discharge.
Report Facts
Civil fine amount: 600 Residents reviewed for refund: 3 Previous citation date: Apr 30, 2025
Employees Mentioned
NameTitleContext
Clinton FridleyRN, Field ManagerContact person for plan of correction and follow-up.
Matt HauserCompliance SpecialistSigned the enforcement letter.
Inspection Report Enforcement Census: 71 Deficiencies: 1 Jun 16, 2025
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to Clearwater Springs Assisted Living to assess compliance with previous deficiencies and to impose a civil fine for uncorrected violations.
Findings
The facility failed to comply with local and state fire ordinances, placing 71 residents at risk in the event of a fire. This deficiency was uncorrected from a prior inspection on April 29, 2025, resulting in a civil fine of $1,500.
Deficiencies (1)
Description
Failure to stay in compliance with local and state fire ordinances, placing residents' lives and safety at risk.
Report Facts
Civil fine amount: 1500 Residents at risk: 71
Employees Mentioned
NameTitleContext
Clinton FridleyRN, Field ManagerContact person for plan of correction and appeals
Matt HauserCompliance SpecialistSigned the enforcement letter
Inspection Report Follow-Up Census: 77 Deficiencies: 12 Mar 5, 2025
Visit Reason
The Department completed a follow-up inspection of Clearwater Springs Assisted Living Facility on 03/05/2025 to verify correction of previously cited deficiencies.
Findings
The follow-up inspection found no deficiencies and confirmed that the facility meets Assisted Living Facility licensing requirements. Previous deficiencies related to intermittent nursing services and nurse delegation were corrected.
Deficiencies (12)
Description
Facility failed to ensure a registered nurse had delegated nursing tasks to staff and supervised and evaluated at least every two weeks for the first four weeks of insulin administration to sampled residents, resulting in untrained and unsupervised care staff administering insulin injections placing residents at risk for harm.
Facility failed to ensure nurse delegation core training and diabetes specific training was completed by medication technicians and failed to ensure nurse delegation consent and documentation for residents.
Facility failed to ensure all staff received required training and orientation including long-term care worker training, specialty training for mental health and dementia, and CPR certification.
Facility failed to properly secure chemicals in laundry rooms, posing health and safety risk to residents and staff.
Facility failed to ensure negotiated service agreements were signed by responsible parties for sampled residents within a reasonable timeframe.
Facility failed to ensure Medicaid policy was signed and maintained for sampled residents.
Facility failed to ensure fire extinguishers were inspected monthly and maintained in working order.
Facility failed to ensure tuberculosis testing was completed timely for sampled staff.
Facility failed to ensure ongoing assessments were completed by qualified assessors for sampled residents.
Facility failed to ensure medication carts were locked and accessible only to designated staff, posing risk of adverse reactions.
Facility failed to ensure resident rights related to Medicaid policy disclosure and signature were met for sampled residents.
Facility failed to ensure combined utility area for laundry services was properly provided with necessary space to maintain infection control and properly store cleaning agents.
Report Facts
Sampled residents: 77 Sampled residents: 2 Sampled staff: 17 Sampled staff: 5 Sampled residents: 12 Sampled residents: 9 Sampled residents: 8 Sampled staff: 5 Sampled residents: 5 Sampled residents: 4
Employees Mentioned
NameTitleContext
Kyle GehlenALF Licensor - LTCDepartment staff who inspected the Assisted Living Facility
Jennifer SiharathALF LicensorDepartment staff who inspected the Assisted Living Facility
Richard WestomNCI, ALF Complaint InvestigatorDepartment staff who inspected the Assisted Living Facility
Staff AExecutive DirectorAcknowledged department findings and interviewed during inspections
Staff BHealth Services DirectorInterviewed and discussed preliminary findings; reviewed staff records
Staff DMedication TechnicianReviewed for training and tuberculosis testing documentation
Staff EMedication TechnicianReviewed for training documentation
Staff FMedication TechnicianReviewed for training documentation
Staff GMedication TechnicianReviewed for nurse delegation training and background check
Staff HMedication TechnicianReviewed for nurse delegation training and background check
Staff JMedication TechnicianReviewed for nurse delegation training
Staff CResident Care CoordinatorCompleted ongoing assessments and involved in care planning
Staff IEnvironmental Services DirectorAcknowledged fire marshal requirements and inspection tags
Staff PMedication TechnicianReviewed for tuberculosis testing documentation
Staff QCaregiverReviewed for tuberculosis testing documentation
Staff KHousekeeperInterviewed regarding laundry services and infection control
Inspection Report Enforcement Deficiencies: 1 Jan 14, 2025
Visit Reason
The Department of Social and Health Services completed a follow-up visit to Clearwater Springs Assisted Living to assess compliance with previously cited deficiencies and imposed a civil fine based on violations found during the visit.
Findings
The facility failed to ensure that a registered nurse delegated nursing tasks and supervised staff administering insulin injections to two residents, resulting in untrained and unsupervised care staff administering insulin injections, placing residents at risk for harm. This deficiency was uncorrected and recurring from previous citations.
Deficiencies (1)
Description
Failure to ensure a registered nurse delegated nursing tasks and supervised staff administering insulin injections to two residents.
Report Facts
Civil fine amount: 1000 Previous citation dates: 3
Employees Mentioned
NameTitleContext
Michael BurdickField ManagerContact person for submission of Plan of Correction and inquiries.
Matt HauserCompliance SpecialistSigned the enforcement letter.
Inspection Report Enforcement Deficiencies: 1 Nov 20, 2024
Visit Reason
The Department of Social and Health Services completed a follow-up visit to Clearwater Springs Assisted Living to assess compliance and impose a civil fine based on violations found during the inspection.
Findings
The facility failed to ensure that a registered nurse delegated required nursing tasks and supervised staff administering insulin injections to two residents, resulting in an uncorrected and recurring deficiency that placed residents at risk of harm.
Deficiencies (1)
Description
Failure to ensure a registered nurse delegated required nursing tasks and supervised staff administering insulin injections to two residents.
Report Facts
Civil fine amount: 600 Previous citation dates: 2
Employees Mentioned
NameTitleContext
Matt HauserCompliance SpecialistSigned the enforcement letter.
Michael BurdickField ManagerContact person for plan of correction and inquiries.
Inspection Report Follow-Up Census: 85 Deficiencies: 6 Sep 19, 2024
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to Clearwater Springs Assisted Living to assess correction of previously cited deficiencies.
Findings
Multiple uncorrected deficiencies were found, including failures in nursing supervision of insulin administration, staff training documentation, signing of negotiated service agreements, tuberculosis testing, securing chemicals, and fire extinguisher inspections. Civil fines totaling $1,200 were imposed based on these violations.
Deficiencies (6)
Description
Failure to ensure a registered nurse delegated nursing tasks and supervised staff administering insulin injections to one resident at least every two weeks for the first four weeks.
Failure to ensure five staff had completed and/or had documentation of required training to work as long-term care workers.
Failure to ensure the Negotiated Service Agreement was agreed to and signed by the responsible party at least annually and/or within a reasonable timeframe for five residents.
Failure to complete the first step of tuberculosis testing within three days of hire for three staff.
Failure to properly secure chemicals for carpet cleaning in one laundry room accessed by residents.
Failure to ensure one fire extinguisher had been inspected monthly to verify proper operation.
Report Facts
Civil fines total: 1200 Residents at risk: 85 Staff without required training: 5 Residents without signed negotiated service agreement: 5 Staff without timely tuberculosis testing: 3 Fire extinguishers not inspected monthly: 1
Employees Mentioned
NameTitleContext
Michael BurdickField ManagerContact person for submission of Plan of Correction and inquiries.
Matt HauserCompliance SpecialistSigned the letter imposing civil fines.
Inspection Report Complaint Investigation Census: 73 Deficiencies: 1 Feb 16, 2024
Visit Reason
The inspection was conducted as an unannounced on-site complaint investigation triggered by allegations regarding a resident's death and failure to provide facility intervention.
Findings
The investigation found failed provider practices including failure to provide cardiopulmonary resuscitation (CPR) to a resident who passed away, violating facility policies and procedures. Citations were issued for these deficiencies.
Complaint Details
The complaint involved allegations of a resident's death with no facility intervention and failure to follow policy and procedures for cardiopulmonary resuscitation. The complaint was substantiated with failed provider practices identified and citations written.
Deficiencies (1)
Description
Facility staff failed to provide cardiopulmonary resuscitation (CPR) to 1 of 3 residents reviewed during a medical emergency, placing the resident at risk of harm.
Report Facts
Total residents: 73 Resident sample size: 3 Closed records sample size: 1
Employees Mentioned
NameTitleContext
Richard WestomNCI, ALF Complaint InvestigatorInvestigator who conducted the complaint investigation
Bret LeagueAdministratorNamed in interviews related to CPR policy and plan of correction
Inspection Report Re-Inspection Deficiencies: 7 Dec 28, 2022
Visit Reason
The Office of the State Fire Marshal conducted a re-inspection at the facility to verify correction of previously identified fire safety violations.
Findings
The facility was found to have multiple unresolved fire safety violations including failure to provide smoke detector sensitivity testing, failure to provide a 5-year fire department connection hydro test, failure to provide a 4-year fire damper inspection report, failure to repair fire sprinkler system deficiencies, and failure to conduct required fire drills.
Deficiencies (7)
Description
Facility failed to provide sensitivity testing of the fire alarm system
Facility failed to provide 5 year FDC hydro test
Med room door that was replaced failed to have fire rating in compliance with NFPA 80. Door frame listed for 1 1/2 hour
Facility failed to provide 4 year fire damper inspection report
Facility failed to conduct repairs of the fire sprinkler system deficiencies listed in the annual fire sprinkler report
Storage in room 210 found to be blocking exiting
Facility failed to conduct fire drills as required; missing shifts in all four quarters
Report Facts
Next inspection scheduled date: Jan 27, 2023 Next inspection scheduled date: Dec 22, 2022 Fire drills required: 12
Employees Mentioned
NameTitleContext
Nicholas WaldenDeputy State Fire MarshalSigned as Deputy State Fire Marshal on the inspection report
Inspection Report Complaint Investigation Census: 80 Deficiencies: 1 Dec 9, 2022
Visit Reason
The inspection was conducted as a complaint investigation based on complaints numbered 57231 and 57502, including allegations of fraud/false billing and failure to notify the case manager of resident hospitalization in a timely manner.
Findings
The investigation found no failed practice regarding fraud/false billing, with the family credited for services not received. However, the facility failed to notify the case manager of hospitalization in a timely manner, which was identified as a failed practice with citation(s) written.
Complaint Details
Complaint investigation included allegations of fraud/false billing and failure to notify case manager of hospitalization. The notification failure was substantiated as a failed practice; fraud/false billing was not substantiated.
Deficiencies (1)
Description
Facility failed to notify case manager of resident hospitalization in a timely manner.
Report Facts
Total residents: 80 Resident sample size: 3 Closed records sample size: 0 Days late notification: 51
Employees Mentioned
NameTitleContext
Richard WestomALF Complaint InvestigatorInvestigator who conducted the complaint investigation
Cory CisnerosField ManagerField Manager who signed the follow-up letter

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