Inspection Reports for Merrill Gardens at Renton Centre
104 Burnett Ave S, Renton, WA 98057, WA, 98057
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Inspection Report
Life Safety
Deficiencies: 18
Apr 23, 2025
Visit Reason
An unannounced Fire and Life Safety Code inspection was conducted at Merrill Gardens at Renton by a representative of the Washington State Patrol, State Fire Marshal's Office to determine compliance with all applicable codes.
Findings
Multiple fire and life safety code violations were observed throughout the facility, including combustibles on stove tops, open junction boxes, unapproved extension cords, obstructed fire extinguishers and manual pull stations, emergency lighting issues, and failure to provide required documentation for previous deficiencies and fire drills.
Deficiencies (18)
| Description |
|---|
| Combustibles placed on the stove top in the Community Room - 1st floor |
| Lit candle on a table surrounded by combustibles in the Community room |
| Open junction box exposing internal wiring at the main entrance by the fire panel on the wall |
| Appliances plugged into power strips in Resident rooms 524, 652, and Select Rehab room |
| Unapproved multi plug adapters in use in Resident rooms 550 and 260 |
| Power strip connected to another power strip in Resident room 524 |
| Unapproved extension cords in use in Resident room 534, Salon on 2nd floor, and Resident room 210 |
| Salon door failed to close and latch when tested - 2nd floor |
| Loaded sprinkler head in the kitchen line area |
| Facility unable to provide correction report for deficiency found on annual inspection report dated 11/27/2024 |
| Fire extinguishers obstructed on rooftop 7th floor by the grill and kitchen by the storage area |
| Manual pull stations obstructed at Stair East B Exit and Loading dock exit area |
| Smoke control confidence test shows deficiencies |
| Emergency lighting missing on the 1st floor electrical room where transfer switch is located |
| Emergency egress door facing William Ave. S failed to open when tested |
| Protruding objects reducing means of egress width at kitchen exit by dry storage room and underground garage by maintenance workshop |
| Facility unable to provide documentation for their generator fuel testing |
| Facility unable to provide documentation for a fire drill on NOC shift for the fourth quarter of 2024 |
Report Facts
Next inspection scheduled date: May 23, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jessica Teobaldino-Mutton | Deputy State Fire Marshal | Conducted the inspection and signed the report |
Inspection Report
Follow-Up
Census: 95
Deficiencies: 6
Sep 19, 2024
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility on 09/19/2024 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 training, service planning, and medication management were corrected.
Deficiencies (6)
| Description |
|---|
| Failed to ensure 3 of 6 staff completed required training including dementia specialty and continuing education. |
| Failed to document a plan to monitor and address interventions required to meet clinical needs for 4 of 9 residents. |
| Resident 3's service plan lacked documentation of blood thinner medication and related side effect guidance. |
| Resident 5 self-administered medications without assessment or documentation. |
| Resident 6's medication assistance and hygiene care were not documented in the service plan. |
| Resident 8's service plan lacked specific behavioral intervention instructions and medication administration guidance. |
Report Facts
Residents reviewed: 9
Staff training noncompliance: 3
Residents with unmet service plan needs: 4
Medication doses: 5
Medication doses: 600
Medication doses: 125
Water temperature: 120
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff C | Caregiver | Failed to complete dementia and mental health specialty training. |
| Staff E | Caregiver | Failed to complete required continuing education. |
| Staff F | Caregiver | Failed to complete required continuing education. |
| Staff A | Senior General Manager | Interviewed and stated unawareness of staff training deficiencies. |
| Staff I | Nurse Assisted Living | Unaware of Resident 5 self-administering medications without assessment. |
| Staff K | Garden House Director | Unaware of missing documentation for Resident 6 and Resident 8 medication and behavioral plans. |
| Laurie Anderson | Field Manager | Signed follow-up inspection report and correspondence. |
Inspection Report
Follow-Up
Census: 84
Deficiencies: 3
May 17, 2023
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. Previous deficiencies related to respiratory protection, housekeeping chemical safety, and food sanitation were corrected.
Deficiencies (3)
| Description |
|---|
| Failure to implement required respiratory protection program for staff, placing residents at risk of contracting and spreading a potentially life-threatening disease. |
| Failure to ensure housekeeping carts with hazardous cleaning chemicals were secured, placing residents at risk of harm. |
| Failure to ensure dishwasher staff followed proper handwashing protocols, placing residents at risk of illness from cross contamination. |
Report Facts
Resident census: 84
Staff sample size: 17
Housekeeping carts observed: 4
Dishwasher staff observed: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Thomas Forkgen | ALF Licensor | Department staff who did the on-site verification and investigation |
| Michelle Yip | ALF Licensor | Department staff who did the on-site verification and investigation |
| Laurie Anderson | Field Manager | Signed letters related to inspection and follow-up |
| Staff N | Business Office Director | Interviewed regarding background check deficiency and housekeeping chemical safety |
| Staff P | Housekeeper | Interviewed and observed regarding hazardous chemical cart safety |
| Staff M | Housekeeper | Interviewed and observed regarding hazardous chemical cart safety and new staff status |
| Staff R | Maintenance Director | Interviewed regarding housekeeping supervision and plan of correction |
| Staff O | Executive Chef | Interviewed regarding dishwasher staffing and handwashing protocols |
| Staff J | Dishwasher | Observed not following proper handwashing protocols |
Inspection Report
Life Safety
Deficiencies: 21
Apr 27, 2023
Visit Reason
An unannounced Fire and Life Safety Code inspection was conducted at Merrill Gardens at Renton Centre by the Washington State Patrol, State Fire Marshal's Office to determine compliance with applicable fire and safety codes.
Findings
The inspection found multiple violations including storage too close to sprinkler heads, use of multi-plug adapters and extension cords, missing documentation for hood cleaning and fire-resistant construction inspections, open electrical panels, missing fire door hardware, fire doors not closing properly, deficient fire sprinkler system status, unsecured oxygen tank, blocked exit, lack of carbon monoxide alarms, and failure to provide documentation for emergency generator servicing and fire department connection hydro testing.
Deficiencies (21)
| Description |
|---|
| Storage closet in the kitchen has storage within 18 inches of the sprinkler head. |
| Therapy room has multi plug adapters / extension cords plugged into both TVs. |
| Kitchen had an extension cord in use, removed at time of inspection. |
| Electrical panel in the Electrical Standby room has an open breaker cover. |
| Facility unable to provide documentation for annual and semi-annual hood cleaning. |
| Facility unable to provide record of annual fire wall inspection and/or repairs for fire-resistant-rated construction. |
| Open conduits/penetrations in multiple electrical rooms and maintenance office. |
| Fire doors missing closure hardware in electrical rooms. |
| Facility unable to provide inventory record of annual inspection and/or repairs for all fire-resistant-rated doors. |
| 2nd floor bathroom door did not close/latch properly. |
| Facility unable to provide documentation for current fire/smoke damper testing. |
| Facility unable to provide annual fire sprinkler inspection documentation; sprinkler system tagged yellow and in deficient status. |
| Facility's fire sprinkler system report shows deficiency due to needing to be re-piped; scheduled for May 2, 2023. |
| Facility needs heat survey for commercial hood fusible link rating; currently five 450 degree links. |
| Fire alarm breaker not securely locked out in fire alarm panel room. |
| Facility unable to provide record of annual fire alarm system inspection; fire alarm tagged yellow and in trouble status. |
| Facility unable to provide documentation that Fire Department Connection has been hydro tested. |
| No carbon monoxide alarms where gas fed appliances are used in laundry and clean linen/laundry areas. |
| Activity room exit blocked with activity supplies. |
| Facility unable to provide documentation of annual servicing of emergency generator within last 12 months. |
| Resident room 523 has unsecured oxygen tank behind chair. |
Report Facts
Number of fusible links: 5
Scheduled date: 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cozetta Christian | Deputy State Fire Marshal | Signed as inspector conducting the fire safety inspection. |
Inspection Report
Follow-Up
Deficiencies: 3
Mar 9, 2023
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to Merrill Gardens at Renton Centre to assess correction of previously cited deficiencies and to impose civil fines based on uncorrected violations.
Findings
The facility was found to have uncorrected deficiencies related to failure to implement a respiratory protection program for staff, unsafe storage of hazardous cleaning chemicals, and improper handwashing protocols by staff, all placing residents at risk.
Deficiencies (3)
| Description |
|---|
| Failure to implement the required respiratory protection program for 12 staff. |
| Failure to ensure three housekeeping carts with potentially hazardous cleaning chemicals were inaccessible or under staff supervision. |
| Failure to ensure one staff followed proper handwashing protocols when handling dirty and clean dishes. |
Report Facts
Civil fines total amount: 900
Number of staff affected by respiratory protection deficiency: 12
Number of housekeeping carts with hazardous chemicals: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jim Sherman | Compliance Specialist | Signed the enforcement letter |
| Laurie Anderson | Field Manager | Contact person for the enforcement and plan of correction |
Inspection Report
Complaint Investigation
Census: 14
Deficiencies: 1
Feb 1, 2023
Visit Reason
The inspection was conducted as a complaint investigation regarding a resident fall at Merrill Gardens at Renton Centre.
Findings
The facility failed to implement the negotiated electronic video monitoring service care plan for a resident, resulting in several falls going undetected due to staff not activating or enabling the monitoring system as agreed. A failed provider practice was identified and citations were written.
Complaint Details
Complaint investigation related to a resident fall. The allegation was substantiated with failed provider practice identified and citations written.
Deficiencies (1)
| Description |
|---|
| Failure to implement the negotiated service agreement for electronic video monitoring, resulting in undetected falls and failure to follow procedures to enable the monitoring system. |
Report Facts
Total residents: 14
Resident sample size: 3
Closed records sample size: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mary Hayes | Licensor | Investigator who conducted the complaint investigation and on-site visit |
| Karri Hernandez | Community Complaint Investigator | Department staff who did the on-site verification |
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