Inspection Reports for Evergreen Estates

WA

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Deficiencies (last 3 years)

Deficiencies (over 3 years) 2.3 deficiencies/year

Deficiencies are regulatory violations found during state inspections.

63% better than Washington average
Washington average: 6.3 deficiencies/year

Deficiencies per year

8 6 4 2 0
2023
2024
2025

Inspection Report

Annual Inspection
Deficiencies: 0 Date: Jul 3, 2025

Visit Reason
The Department completed a full inspection of the Assisted Living Facility on 07/03/2025.

Findings
No deficiencies were found during the inspection.

Employees mentioned
NameTitleContext
Tethra WalesAssisted Living Facility LicensorDepartment staff who did the inspection
Brian ZbylskiALF LicensorDepartment staff who did the inspection
Veronica JacksonAssisted Living Facility LicensorDepartment staff who did the inspection

Inspection Report

Life Safety
Deficiencies: 6 Date: Sep 24, 2024

Visit Reason
The Office of the State Fire Marshal conducted a fire safety inspection at Evergreen Estates Ret & AL Community on 09/24/2024.

Findings
Multiple fire safety violations were observed including combustible materials stored improperly, electrical hazards from appliances plugged into multiplug adapters, fire doors not closing and latching automatically, sprinkler system tamper switches removed and not replaced, lack of annual fire extinguisher service, and missing instructions for exiting coded doors. All violations were marked as corrected during the inspection except for the sprinkler system tamper switches and coded exit door instructions.

Deficiencies (6)
Combustible materials stored in boiler rooms, mechanical rooms, electrical equipment rooms, or fire command centers.
Appliances plugged into multiplug adapters in multiple locations creating electrical hazards.
Fire doors did not close and latch automatically in several locations.
Sprinkler system tamper switches removed during backflow repair and not replaced.
Annual service of fire extinguisher in serving kitchen had not been performed.
Instructions for exiting coded doors were not posted within six feet of the door.
Report Facts
Next inspection scheduled date: Oct 24, 2024

Employees mentioned
NameTitleContext
Barbara A MaierDeputy State Fire MarshalSigned as the inspecting official
Fred J CancelloExecutive DirectorNamed as Owner or Authorized Representative

Inspection Report

Complaint Investigation
Census: 37 Deficiencies: 1 Date: Aug 22, 2023

Visit Reason
The inspection was conducted as a complaint investigation related to resident falls with injury, including one fall leading to death, to determine compliance with assisted living facility requirements.

Complaint Details
The complaint involved allegations of resident falls with injury, including one fall leading to death. The investigation substantiated failures in care planning and fall prevention.
Findings
The investigation found that sampled residents did not have updated care plans reflecting interventions for fall prevention, leading to multiple falls and injuries. The facility failed to meet service agreement planning requirements under WAC 388-78A-2130, resulting in citations.

Deficiencies (1)
Failure to update care plans reflecting interventions for residents with a history of falls, leading to multiple falls and injuries.
Report Facts
Total residents: 37 Resident sample size: 4 Closed records sample size: 1

Employees mentioned
NameTitleContext
Joy PipgrasLTC SurveyorInvestigator who conducted the complaint investigation
Mark SedhomAssisted Living Facility LicensorDepartment staff who did the inspection and provided consultation
Stephanie JenksField ManagerSigned letter regarding the complaint investigation

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