Inspection Reports for Mirabella Seattle

WA, 98109

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Deficiencies per Year

16 12 8 4 0
2023
2024
2025
Severe High Moderate Low Unclassified

Census Over Time

24 30 36 42 48 May '23 Mar '24 Nov '24
Inspection Report Life Safety Deficiencies: 6 Mar 3, 2025
Visit Reason
The Office of the State Fire Marshal conducted a fire safety inspection at the Mirabella residential care facility to assess compliance with fire protection and safety codes.
Findings
The inspection found multiple deficiencies related to incomplete or missing documentation for hood cleaning, sprinkler system maintenance, fire extinguishing system servicing, fire door inspections, and carbon monoxide detection testing. The facility was disapproved due to these deficiencies, but all violations from previous inspections had been corrected.
Deficiencies (6)
Description
Hood cleaning reports from 12/2/2024 and 9/2/2024 were incomplete.
Annual sprinkler system maintenance report was not provided.
First and second semi-annual fire extinguishing system servicing reports and deficiencies on main #2 were not provided.
Annual inspection, testing, and maintenance report was not provided.
Carbon monoxide alarms and detectors were not tested, maintained, or documented on a monthly schedule.
Facility failed to provide documentation of locations of fire doors, testing dates, modifications, and repairs for fire door inspection and testing.
Report Facts
Inspection date: Mar 3, 2025 Next inspection scheduled on or after: Apr 2, 2025
Employees Mentioned
NameTitleContext
Jason Van GorkumDeputy State Fire MarshalConducted the fire safety inspection
Marty BradburyMaintenance ManagerFacility representative signing the inspection report
Inspection Report Follow-Up Census: 29 Deficiencies: 1 Nov 6, 2024
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies related to respiratory protection policy compliance.
Findings
The facility met the Assisted Living Facility licensing requirements and no deficiencies were found during the follow-up inspection. The prior deficiency related to failure to have a licensed health care professional review medical evaluations for employees prior to fit testing was corrected.
Complaint Details
The complaint investigation was related to positive COVID-19 cases at the facility. The investigation found the facility had infection control policies and procedures in place and met reporting requirements, but failed to follow their Respiratory Protection Plan policy regarding medical evaluations prior to fit testing employees.
Deficiencies (1)
Description
Failure to have a licensed health care professional review medical evaluations for all employees prior to fit testing respiratory masks.
Report Facts
Total residents: 29 Resident sample size: 2 Compliance Determination Completion Dates: Completion dates for compliance determinations 49774 (2024-11-06) and 46607 (2024-09-11)
Employees Mentioned
NameTitleContext
Lisa HaukComplaint InvestigatorDepartment staff who conducted the on-site verification and investigation
Staff AAssisted Living ManagerInterviewed regarding fit testing and medical evaluations
Staff BActivities DirectorPerformed medical evaluations and fit testing but did not hold a professional medical license
Inspection Report Complaint Investigation Census: 37 Deficiencies: 9 Mar 18, 2024
Visit Reason
The inspection was conducted in response to a complaint alleging that a named resident ran his wheelchair into another resident causing injury, and to investigate compliance with licensing laws and regulations.
Findings
The Assisted Living Facility failed to develop appropriate approaches and interventions in the negotiated service agreement for a resident with behavioral issues, failed to monitor residents' well-being adequately, failed to ensure safe medication administration and refusal protocols, failed to provide proper training and orientation to staff, and failed to maintain safe food sanitation practices. Multiple deficiencies were cited placing residents at risk.
Complaint Details
Complaint involved an incident where a named resident ran his wheelchair into another resident causing injury. The investigation substantiated failure to develop appropriate behavioral interventions and other care deficiencies placing residents at risk.
Deficiencies (9)
Description
Failed to develop approaches and interventions in the negotiated service agreement for a resident's agitative mood and physical aggression.
Failed to evaluate and take appropriate action for a resident's changing needs related to unintended/unplanned weight gain and loss.
Failed to review and update the negotiated service agreement consistent with residents' current assessed needs and preferences.
Failed to implement safe nurse delegation services for residents receiving medication administration from non-licensed staff.
Failed to notify the physician or evaluate for negative outcomes when residents refused medications.
Failed to ensure staff completed facility orientation and specialty training for dementia and mental health.
Failed to secure potentially hazardous supplies and equipment commensurate with assessed needs of residents.
Failed to wash hands or don gloves during meal preparation, placing all residents at risk for foodborne illness.
Failed to integrate and communicate relevant information from external providers into residents' care plans.
Report Facts
Total residents: 37 Resident sample size: 8 Residents at risk for foodborne illness: 37 Residents at risk for not receiving proper care and services: 37 Residents at risk for not having care needs properly addressed: 4 Residents at risk for compromised health status: 4 Residents at risk for compromised mental health condition: 2 Residents at risk for not receiving proper care and compromised health conditions: 2 Residents at risk for foodborne illness: 14 Residents at risk for injury: 19
Employees Mentioned
NameTitleContext
Alma DuranLicensorConducted on-site verification and investigation.
Keiko KitanoLicensorConducted on-site verification and investigation.
Jamie SingerField ManagerSigned multiple documents related to the inspection and enforcement.
Inspection Report Life Safety Deficiencies: 14 Feb 15, 2024
Visit Reason
The Office of the State Fire Marshal conducted a fire safety inspection at the Mirabella residential care facility on 02/15/2024.
Findings
Multiple fire safety violations were observed including blocked electrical panels, extension cords in prohibited areas, exposed wiring, door latch failures, missing fire alarm circuit breaker lock, and deficiencies in sprinkler system testing and emergency lighting. The facility was cited for failure to provide required inspection paperwork and schedules for fire-rated construction and fire doors.
Deficiencies (14)
Description
Blocked electrical panel found in kitchen dish room
Extension cord found in assisted living laundry room
Exposed wires found in memory care kitchen
Open junction box in assisted living trash room by elevator
Facility failed to provide paperwork establishing schedule for inspection of fire-rated construction
Memory care area in electrical room observed
Multiple fire doors and double doors will not latch properly
Missing escutcheon ring in room SC 204
Missed sprinkler riser testing from outside company in memory care mechanical room
Loaded sprinkler heads found in kitchen dish room and throughout kitchen
Bent sprinkler head found over clean kitchen pots
Emergency lighting not working in parking lot by service elevator and on balcony by room 345
Fire alarm circuit breaker in electrical room missing required lock device
Facility failed to provide paperwork establishing schedule for inspection of fire doors
Report Facts
Next inspection scheduled date: Mar 20, 2024
Employees Mentioned
NameTitleContext
Jason Van GorkumDeputy State Fire MarshalConducted the inspection and signed the report
Marty BradburyMaintenance ManagerFacility representative signing the report
Inspection Report Life Safety Deficiencies: 12 Jun 1, 2023
Visit Reason
The Office of the State Fire Marshal conducted an inspection at the facility to assess compliance with fire protection and safety codes.
Findings
The facility was found to be non-compliant with several fire safety requirements including lack of documentation for annual fire wall inspection, deficiencies in smoke detectors, carbon monoxide detector testing, electrical hazards, improper use of power strips, malfunctioning fire doors, and inadequate means of egress illumination.
Deficiencies (12)
Description
Facility is unable to provide documentation that the annual fire wall inspection has been completed.
Facility is unable to provide documentation for the monthly carbon monoxide detector testing.
Mechanical room inside Emerald hall has loose wiring that could present a hazard.
Storage room outside Emerald hall marked staff only has a shelving unit placed in front of an electrical service panel.
Memory care in the nursing station has daisy chained power outlets.
Assisted living office has an extension cord plugged into a multi plug power strip.
Extension cord being used as permanent power in the exercise room.
Power block without overcurrent protection being used in the main office copy room.
Emergency exit doors on the right side of the stage in Emerald hall did not properly open; only one of the double doors was opening.
Double fire door by studio X room did not close properly.
Facility is unable to provide documentation for the monthly single station smoke alarm testing.
Emergency bug eyed light inside studio X at the door did not work.
Report Facts
Next inspection scheduled on or after: Jul 1, 2023 Next inspection scheduled on or after: Mar 30, 2023
Employees Mentioned
NameTitleContext
Marius CullenDirector of Facility ServicesNamed in multiple inspection reports as facility representative
Jesse WardDeputy State Fire MarshalSigned inspection reports as inspector
Inspection Report Complaint Investigation Census: 41 Deficiencies: 1 May 17, 2023
Visit Reason
The inspection was conducted in response to a complaint alleging that a staff member smacked a resident on the arms at the Assisted Living Facility.
Findings
The facility responded promptly by suspending the staff member, investigating the incident, and implementing interventions to protect the resident. No failed provider practice was identified and no citation was written, although a background check deficiency was noted and corrected by the follow-up inspection.
Complaint Details
The Named Resident reported that the Named Staff smacked her on the arms. The allegation was investigated, and the facility took protective actions. The complaint was not substantiated with failed provider practice.
Deficiencies (1)
Description
The Assisted Living Facility did not have a current Criminal History Background Check for one staff member.
Report Facts
Total residents: 41 Resident sample size: 2 Closed records sample size: 0 Staff with expired background check: 1
Employees Mentioned
NameTitleContext
Lisa HaukComplaint InvestigatorConducted the on-site verification and investigation

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