Inspection Reports for Madison House Assisted Living Community
12215 NE 128th St, Kirkland, WA 98034, United States, WA, 98034
Back to Facility ProfileDeficiencies per Year
16
12
8
4
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Follow-Up
Census: 69
Capacity: 127
Deficiencies: 0
Oct 10, 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 and confirmed that the facility meets the Assisted Living Facility licensing requirements.
Report Facts
Residents present during inspection: 69
Total licensed capacity: 127
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Steven Garrett | LTC Licensor | Department staff who did the on-site verification |
| Claudia Allis | ALF Licensor | Department staff who did the on-site verification |
Inspection Report
Life Safety
Deficiencies: 13
Dec 30, 2024
Visit Reason
The Office of the State Fire Marshal conducted a fire and life safety inspection at Madison House on December 30, 2024.
Findings
The inspection found multiple fire and life safety code violations including unsecured kitchen cables, broken and bent receptacle covers, blocked electrical panels, stairwell door latch failures, missing sprinkler escutcheon, penetrations around pipes, and laundry chutes needing testing. The facility was disapproved due to these deficiencies.
Deficiencies (13)
| Description |
|---|
| Kitchen secured cable is not attached to Cooking Appliances on Casters |
| 2nd floor has a broken receptacle cover in dining room by kitchen entrance |
| 2nd floor has a bent receptacle cover in dining room |
| 2nd floor med room has a broken receptacle cover |
| Blocked electrical panels found in kitchen |
| Facility failed to provide inspection paperwork for fire-resistance-rated construction |
| 3rd floor stairwell has penetrations found around pipe outside of room 300 |
| 4th floor stairwell door will not latch by room 451 |
| 3rd floor stairwell door will not latch by room 351 |
| 3rd floor stairwell by room 351 has a painted sprinkler head |
| 3rd floor outside of room 351 has a missing escutcheon |
| Laundry chutes will need to be tested |
| Facility failed to provide inspection paperwork for fire doors |
Report Facts
Next inspection scheduled date: Jan 29, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Wilfrido Carrillo | Owner or Authorized Representative | Signed as facility representative on inspection documents |
| Jason Van Gorkum | Deputy State Fire Marshal | Conducted the inspection and signed the report |
Inspection Report
Follow-Up
Census: 61
Capacity: 55
Deficiencies: 0
Jun 18, 2024
Visit Reason
Follow-up inspection to verify correction of previously cited deficiencies related to tuberculosis testing and other licensing requirements.
Findings
The follow-up inspection found no deficiencies and confirmed that previously cited tuberculosis testing deficiencies were corrected. The facility met Assisted Living Facility licensing requirements.
Report Facts
Residents sampled for follow-up: 10
Current residents: 61
Former residents: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Thomas Forkgen | ALF Licensor | Department staff who did the on-site verification during follow-up inspection |
Inspection Report
Enforcement
Deficiencies: 2
Apr 18, 2024
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to Madison House to assess compliance and impose civil fines based on uncorrected deficiencies related to tuberculosis testing of staff.
Findings
The facility failed to ensure that one staff member was tested for tuberculosis as required, placing residents at risk of exposure to infectious disease. These deficiencies were previously cited and remain uncorrected.
Deficiencies (2)
| Description |
|---|
| Failure to ensure one staff member was tested for tuberculosis (TB) - one test. |
| Failure to test one staff member for tuberculosis (TB) - two step skin testing. |
Report Facts
Civil fine amount: 200
Civil fine amount: 200
Total civil fines: 400
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laurie Anderson | Field Manager | Contact person for submission of Statement of Deficiencies and inquiries |
| Matt Hauser | Compliance Specialist | Signed the enforcement letter |
Inspection Report
Life Safety
Deficiencies: 9
Nov 22, 2023
Visit Reason
The Office of the State Fire Marshal conducted an inspection at the Madison House residential care facility to evaluate compliance with fire protection and safety codes.
Findings
The inspection identified multiple deficiencies related to fire-resistance-rated construction, sprinkler system maintenance, fire extinguisher placement, circuit identification, and fire door inspection and testing. The facility was disapproved due to these deficiencies and required to establish schedules for inspections and corrections by the end of 2024.
Deficiencies (9)
| Description |
|---|
| Facility did not provide paperwork for inspection of fire-rated construction and annual inspection schedule. |
| Closet by resident room 215 and 3rd floor theater room lacked proper fire-resistance-rated construction. |
| Facility did not provide paperwork for establishing quarterly sprinkler system inspections. |
| Need to verify size of fusible links used and perform heat survey for kitchen hood. |
| 2nd floor fire extinguisher needs to be relocated inside the room. |
| Fire extinguisher found in copy room on counter, not on hanger or bracket. |
| Fire alarm circuit breaker in electrical room missing required lock device. |
| Facility did not provide paperwork for fire door inspection and testing schedule. |
| Resident doors 230 and 235 had large gaps compromising fire door integrity. |
Report Facts
Inspection date: Nov 22, 2023
Next inspection scheduled: Dec 26, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason Van Gorkum | Deputy State Fire Marshal | Conducted the inspection and signed the report |
| Tara Miller | Executive Director | Facility representative signing the January 8, 2024 inspection report |
| Smith Wiley | Executive Director | Facility representative signing the November 22, 2023 inspection report |
Inspection Report
Life Safety
Deficiencies: 8
Nov 14, 2022
Visit Reason
An unannounced Fire and Life Safety Code inspection was conducted at Madison House to determine compliance with applicable fire and safety codes.
Findings
Multiple fire and life safety code violations were observed, including unapproved portable heaters, open junction boxes, missing receptacle covers, failure to provide records of annual fire wall inspections, fire doors not closing/latching properly, dirty sprinkler head, missing escutcheon rings, lack of documentation for carbon monoxide detector testing, and improper trash chute latching.
Deficiencies (8)
| Description |
|---|
| Unapproved portable heaters found in 4th floor Sun Room and hallway |
| Open junction boxes and open-wiring splices without approved covers in multiple locations including Library 3rd floor storage closet and Elevator room |
| Facility unable to provide record of annual fire wall inspection and repairs for all fire-resistant-rated construction |
| Fire doors on 4th floor stairwell and cable room did not close or latch properly |
| Dirty sprinkler head in 1st floor Resident Laundry room |
| Missing escutcheon rings in multiple locations including hall by room 436, 3rd floor Library, stairwell between floors 2 and 1, 1st floor hallway by Elevator room/Fitness, and Pool room |
| Facility unable to provide documentation showing carbon monoxide detector testing performed in past 12 months |
| Trash chute on 4th floor does not latch properly |
Report Facts
Inspection date: Nov 14, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cozetta Christian | Deputy State Fire Marshal | Conducted the fire and life safety inspection and signed the report |
| Wilfrido Carrillo | PPD | Owner or Authorized Representative who signed the report |
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