Inspection Reports for Family to Family Senior Care
25633 SE 30th St, Sammamish, WA 98075, USA, WA, 98075
Back to Facility ProfileDeficiencies per Year
16
12
8
4
0
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Follow-Up
Census: 4
Capacity: 12
Deficiencies: 1
Jun 18, 2025
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies.
Findings
The follow-up inspection found no deficiencies, indicating the facility meets the Assisted Living Facility licensing requirements. The prior deficiencies related to background checks were corrected.
Deficiencies (1)
| Description |
|---|
| Failure to complete Washington state name and date of birth background checks for 3 of 4 sampled staff every two years, placing 12 residents at risk of abuse, neglect, or exploitation. |
Report Facts
Residents present during inspection: 4
Total licensed capacity: 12
Days late for background check completion: 44
Days late for background check completion: 537
Days late for background check completion: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Thomas Forkgen | ALF Licensor | Department staff who did the on-site verification |
| Michelle Yip | ALF Licensor | Department staff who did the on-site verification |
| Staff C | Employee with late background check; Assistant Administrator | |
| Staff E | Caregiver/Medication Technician | Employee with late background check |
| Staff F | Caregiver/Medication Technician | Employee with late background check |
| Staff G | Executive Director | Interviewed regarding background check renewal delays |
Inspection Report
Follow-Up
Census: 11
Deficiencies: 2
Mar 13, 2024
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies.
Findings
The follow-up inspection found no deficiencies, and the facility meets the Assisted Living Facility licensing requirements.
Deficiencies (2)
| Description |
|---|
| The facility failed to ensure 1 of 7 sampled staff (Staff D) was screened for tuberculosis when hired, placing all 11 residents at risk of potential exposure to tuberculosis. |
| The Assisted Living Facility failed to maintain the Department of Social and Health Services (DSHS) Washington state name and date of birth background inquiry (BGI) document on the premises for Staff D. |
Report Facts
Residents at risk: 11
Sampled staff: 7
Staff working hours: 12
Residents reviewed: 4
Current residents: 11
Former residents: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Yip | ALF Licensor | Department staff who inspected the Assisted Living Facility |
| Laurie Anderson | Field Manager | Field Manager who signed letters and correspondence |
| Staff D | Staff member not screened for tuberculosis as required | |
| Staff A | Executive Director | Confirmed facility rehired Staff D and was aware of tuberculosis testing status |
Inspection Report
Life Safety
Deficiencies: 13
Aug 16, 2023
Visit Reason
The Office of the State Fire Marshal conducted a fire protection inspection at the Family to Family Senior Care facility to assess compliance with fire safety codes and regulations.
Findings
Multiple fire safety violations were identified, including unapproved electrical junction boxes, penetration issues, fire doors not latching, missing fire extinguishers, lack of required inspection paperwork, missing carbon monoxide detectors, non-working emergency lighting, and missing circuit breaker lock devices.
Deficiencies (13)
| Description |
|---|
| Exposed wires found in laundry room servicing laundry chemicals |
| Penetration found in heater room outside East around supply lines for split units |
| Penetration found in ceiling in kitchen dry storage room |
| Fire rated doors found not latching |
| Annual report and quarterly inspections paperwork not provided for sprinkler system |
| Missing fire extinguisher located at second exit |
| Monthly inspection by Facility Maintenance Log not provided |
| Missing fire extinguisher within the required distance from cooking appliances |
| Annual report and sensitivity testing paperwork not provided for inspection, testing and maintenance |
| Carbon monoxide detection needed in laundry room, corridors, and outside in fire alarm, water heater and heater closet |
| #4 dining room emergency lighting not working |
| Annual service, log of weekly inspections, and monthly 30-minute full load test or annual 4 hour load test paperwork not provided for emergency and standby power systems |
| Fire alarm circuit breaker in electrical room is missing the required lock device - locking breaker in the 'ON' position |
Report Facts
Next inspection scheduled date: Sep 18, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason Van Gorkum | Deputy State Fire Marshal | Signed as Deputy State Fire Marshal conducting the inspection |
| Manuela Paul | Owner or Authorized Representative signing the report |
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