Inspection Report
Annual Inspection
Deficiencies: 0
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
| Name | Title | Context |
|---|---|---|
| Tethra Wales | Assisted Living Facility Licensor | Department staff who did the inspection |
| Brian Zbylski | ALF Licensor | Department staff who did the inspection |
| Veronica Jackson | Assisted Living Facility Licensor | Department staff who did the inspection |
Inspection Report
Life Safety
Deficiencies: 6
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)
| Description |
|---|
| 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
| Name | Title | Context |
|---|---|---|
| Barbara A Maier | Deputy State Fire Marshal | Signed as the inspecting official |
| Fred J Cancello | Executive Director | Named as Owner or Authorized Representative |
Inspection Report
Complaint Investigation
Census: 37
Deficiencies: 1
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.
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.
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.
Deficiencies (1)
| Description |
|---|
| 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
| Name | Title | Context |
|---|---|---|
| Joy Pipgras | LTC Surveyor | Investigator who conducted the complaint investigation |
| Mark Sedhom | Assisted Living Facility Licensor | Department staff who did the inspection and provided consultation |
| Stephanie Jenks | Field Manager | Signed letter regarding the complaint investigation |
Loading inspection reports...
