Inspection Reports for North Point Village
1110 E Westview Ct, Spokane, WA 99218, United States, WA, 99218
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Inspection Report
Follow-Up
Census: 76
Deficiencies: 1
Jul 15, 2025
Visit Reason
The Department completed a follow-up inspection of North Point Village Assisted Living Facility on 07/15/2025 to verify correction of previously cited deficiencies related to resident care and rights.
Findings
The follow-up inspection found no deficiencies, indicating that previously cited issues related to resident dignity, rights, and monitoring of residents' well-being were corrected. The prior complaint investigation identified failures in wound care and monitoring that resulted in resident harm and required emergency treatment.
Complaint Details
Complaint investigation conducted from 04/24/2025 through 05/23/2025 regarding an unassessed and untreated wound on a resident. The investigation found failed provider practice related to wound care and resident rights, resulting in bodily harm and emergency room visit. The complaint was substantiated with citations written.
Deficiencies (1)
| Description |
|---|
| Failed to provide care that promoted health, dignity, respect, and resident rights; failed to follow protocol for resident refusals of care; resulted in unassessed and untreated wounds leading to infection and emergency room visit. |
Report Facts
Total residents: 76
Resident sample size: 4
Duration of complaint investigation: 30
Size of wound discoloration: 8
Size of wound discoloration: 10
Size of open wound area: 1.5
Size of blistered area: 2
Size of blistered area width: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sandra Fast | Community Complaint Investigator | Conducted the complaint investigation and follow-up inspection |
| Stephanie Jenks | Community Field Manager | Signed follow-up inspection letter |
| Staff B | Health and Wellness Specialist | Notified of wound but failed to document wound assessments |
| Staff F | Medication Technician | Reported resident refusals and wound concerns |
| Staff D | Medication Technician | Informed by ER physician about infected wound |
| Collateral Contact 2 | Resident Representative | Reported resident had wounds on admission and delayed home health involvement |
| Collateral Contact 3 | Primary Care Provider | Provided medical assessment and referral for wound care |
Inspection Report
Follow-Up
Census: 76
Deficiencies: 1
Jul 8, 2025
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies related to infection control.
Findings
The follow-up inspection on 07/08/2025 found no deficiencies; the facility corrected the previously cited infection control issues by providing necessary supplies and protective clothing to staff.
Complaint Details
Complaint investigation conducted from 04/29/2025 through 05/20/2025 regarding lack of personal protective equipment, insufficient trained staff, and a resident found in soaked/soiled briefs. Failed provider practice was identified and citations were written.
Deficiencies (1)
| Description |
|---|
| Failure to provide appropriate personal protective equipment to staff, placing residents at risk for infection spread. |
Report Facts
Total residents: 76
Staff lacking PPE: 3
Staff sample size: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sandra Fast | Community Complaint Investigator | Conducted the complaint investigation and on-site verification |
| Stephanie Jenks | Community Field Manager | Signed the follow-up inspection letter |
Notice
Deficiencies: 0
Jun 30, 2025
Visit Reason
This notice was issued to impose conditions on the facility's license based on a Statement of Deficiencies dated June 16, 2025, requiring the hiring of a Registered Nurse Consultant and other corrective actions to address medication system compliance.
Findings
The Department found continued non-compliance with medication regulations requiring the facility to hire an external Registered Nurse Consultant to assess and improve the medication delivery system, train staff, and provide weekly progress reports until compliance is demonstrated.
Report Facts
Statement of Deficiencies dates: 6
Deadline for hiring RNC: 22
Deadline for meeting: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the Notice of Conditions of Operation. |
Inspection Report
Follow-Up
Deficiencies: 4
Jun 16, 2025
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to North Point Village, Assisted Living & Memory Care to assess compliance with previously cited deficiencies and to impose civil fines and conditions on the facility's license.
Findings
The facility was found to have multiple uncorrected and recurring deficiencies related to fall program policies, monitoring of residents' medication needs, intermittent nursing service practices, and medication administration. These deficiencies placed residents at risk of harm and health complications, resulting in civil fines and conditions imposed on the license.
Deficiencies (4)
| Description |
|---|
| Failure to follow fall program policy and procedures for six residents, resulting in falls not being tracked and residents at risk of harm. |
| Failure to monitor the need for as needed medications for bowel movements for one resident, placing the resident at risk of health complications. |
| Failure to provide safe intermittent nursing service practices for three residents, resulting in delegated nursing tasks without registered nurse oversight and risk of serious health complications. |
| Failure to ensure residents received medication as prescribed for two residents and failure to follow health care provider orders related to blood pressure medications for another resident, resulting in delayed medication administration and risk of health complications. |
Report Facts
Civil fine amount: 1500
Residents affected: 6
Residents affected: 1
Residents affected: 3
Residents affected: 3
Deadline: 10
Deadline: 28
Deadline: 22
Deadline: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Field Manager | Contact for submission of Statement of Deficiencies and questions |
| Matt Hauser | Compliance Specialist | Signed the enforcement letter |
Inspection Report
Follow-Up
Census: 80
Deficiencies: 1
May 27, 2025
Visit Reason
The Department completed a follow-up inspection of North Point Village, Assisted Living & Memory Care on 05/27/2025 to verify correction of previously cited deficiencies related to background checks and employment disqualifications.
Findings
The follow-up inspection found no deficiencies, confirming that previously cited issues regarding employment of staff with disqualifying criminal convictions were corrected. The prior complaint investigation found a staff member with a disqualifying background status who had unsupervised access to vulnerable adults, resulting in a citation.
Complaint Details
Complaint investigation conducted from 04/02/2025 through 04/08/2025 regarding staff with disqualifying background status having unsupervised access to vulnerable adults. Citation issued. Complaint number 173149.
Deficiencies (1)
| Description |
|---|
| Staff allowed to have unsupervised access to vulnerable adults with background status of 'Disqualify.' |
Report Facts
Total residents: 80
Staff with disqualifying background: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sandra Fast | Community Complaint Investigator | Investigator who conducted the complaint investigation and follow-up |
| Staff B | Concierge | Staff member with disqualifying criminal conviction who had unsupervised access to vulnerable adults |
| Staff A | Executive Director | Interviewed regarding discovery of Staff B's disqualifying status |
Inspection Report
Complaint Investigation
Deficiencies: 2
May 23, 2025
Visit Reason
The Department of Social and Health Services completed a complaint investigation at North Point Village, Assisted Living & Memory Care on May 23, 2025, due to concerns about resident care and wound treatment.
Findings
The investigation found that the licensee failed to provide care that promoted health and well-being for one resident, resulting in pain, discomfort, lack of wound assessment and treatment, wound infection, and the need for surgical interventions. These failures were recurring deficiencies previously cited in 2023.
Complaint Details
The visit was complaint-related, with deficiencies substantiated as recurring issues previously cited on December 5, 2023, and January 4, 2023.
Deficiencies (2)
| Description |
|---|
| Failure to provide care promoting health and well-being for one resident, resulting in pain, discomfort, lack of wound assessment and treatment, wound infection, and risk of health complications. |
| Failure to ensure staff evaluated and took appropriate action for wounds sustained by one resident, resulting in pain, ongoing wounds, need for surgical repair, and risk of ongoing skin breakdown. |
Report Facts
Civil fines total: 2000
Previous deficiency citation dates: December 5, 2023 and January 4, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the letter regarding the imposition of civil fines. |
| Stephanie Jenks | Field Manager | Contact person for the plan of correction and appeals process. |
Inspection Report
Follow-Up
Census: 80
Deficiencies: 1
Apr 24, 2025
Visit Reason
The visit was a follow-up inspection to verify correction of previously cited deficiencies related to background checks at North Point Village, Assisted Living & Memory Care.
Findings
The Department found no deficiencies during the follow-up inspection on 04/24/2025, confirming that the previously cited background check deficiencies were corrected.
Complaint Details
The complaint allegation was that medications were passed with no credentials. The investigation found that one medication technician had an expired background check, which was cited.
Deficiencies (1)
| Description |
|---|
| One medication technician’s Washington state name and date of birth background check was expired and was cited according to Washington Administrative Code (WAC) 388-78A-2466(1)(a)(b). |
Report Facts
Total residents: 80
Resident sample size: 3
Staff with expired background check: 1
Staff total: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sandra Fast | Community Complaint Investigator | Investigator who conducted the complaint investigation and follow-up inspection |
| Staff B | Medication Technician | Staff member with expired Washington state name and date of birth background check |
| Staff A | Executive Director | Interviewed regarding the expired background check for Staff B |
Inspection Report
Complaint Investigation
Deficiencies: 4
Apr 15, 2025
Visit Reason
The Department of Social and Health Services completed a complaint investigation and full inspection at North Point Village, Assisted Living & Memory Care on April 15, 2025, resulting in civil fines for regulatory violations.
Findings
The facility was found to have multiple recurring deficiencies including failure to ensure a safe medication system for five residents, failure to investigate and document incidents related to falls for three residents, failure to monitor changing physical health conditions for one resident, and failure to ensure required training and certification for several staff members.
Complaint Details
The visit was complaint-related, triggered by allegations that led to a full inspection and resulted in civil fines for multiple violations.
Deficiencies (4)
| Description |
|---|
| Failure to ensure a safe medication system and medications given as prescribed to five residents. |
| Failure to investigate, document investigative findings, and determine circumstances of incidents for residents who had falls for three residents. |
| Failure to monitor for changing physical health conditions for one resident. |
| Failure to ensure orientation, safety training, basic training, professional certification, specialty training for mental health, and CPR/first aid training for multiple staff. |
Report Facts
Civil fine amount: 1000
Civil fine amount: 1000
Civil fine amount: 300
Civil fine amount: 400
Total civil fines: 2700
Residents affected by medication violation: 5
Residents with medications not given as prescribed: 3
Residents with physician's orders not followed: 2
Residents with falls not investigated: 3
Staff lacking orientation and safety training: 1
Staff lacking basic training and professional certification: 2
Staff lacking specialty mental health training: 1
Staff lacking CPR and first aid training: 3
Residents with unmonitored changing physical health conditions: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Field Manager | Contact person for submission of Statement of Deficiencies and inquiries |
| Rathana Duong | Compliance Specialist | Signed the imposition of civil fines letter |
Inspection Report
Life Safety
Deficiencies: 5
Apr 4, 2025
Visit Reason
The Office of the State Fire Marshal conducted a fire safety inspection at North Point Village, Assisted Living & Memory Care facility to assess compliance with fire protection and life safety codes.
Findings
The inspection found several fire safety and maintenance issues, including missing escutcheons, loaded fire sprinklers, electrical cover and switch cover missing, and required testing and maintenance of fire protection systems. Most deficiencies were corrected or noted for follow-up.
Deficiencies (5)
| Description |
|---|
| Missing escutcheons in storage room and dining room |
| Loaded fire sprinklers in the lobby |
| Electrical cover missing on first floor receiving area |
| Electrical light switch cover missing in Cottage C |
| Forward flow testing on backflow preventer required annually, scheduled prior to 4/30/25 |
Report Facts
Provider Number: 2479
Next inspection scheduled: Mar 31, 2026
Next inspection scheduled: Mar 30, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Bridget Kosinski | Executive Director | Signed as Owner or Authorized Representative |
| Barbara McMullen | Deputy State Fire Marshal | Signed inspection report |
Inspection Report
Complaint Investigation
Census: 76
Deficiencies: 4
Dec 5, 2024
Visit Reason
The inspection was conducted as an unannounced complaint investigation based on multiple allegations including no staff credentials, medication destruction system issues, short staffing, mechanical diet concerns, staff treatment of residents, lack of staff orientation and training, and missing background checks.
Findings
The investigation found failed provider practices related to lack of staff training, missing tuberculosis testing, incomplete background checks, missing food handler cards, and incomplete specialty training for dementia and mental illness. Some allegations such as medication destruction and staff treatment of residents were not substantiated. Multiple citations were written for these deficiencies.
Complaint Details
The complaint investigation was based on allegations of no staff credentials, medication destruction system/storing, short staffing, mechanical diet, staff treatment of residents, no staff orientation/credentials, no staff training, and no staff for monitoring resident swallow issues. The investigation found some substantiated deficiencies related to staff training, background checks, and tuberculosis testing, while other allegations were not substantiated.
Deficiencies (4)
| Description |
|---|
| Failed to ensure staff had appropriate Tuberculin screening testing within three days of employment for 7 of 15 staff. |
| Failed to ensure training requirements were met for staff regarding orientation, safety, basic training, and specialty training for dementia and mental illness. |
| Failed to ensure staff had updated Washington Name and Date Background checks for 2 of 15 staff. |
| Failed to ensure staff had current food handler cards for 10 of 15 staff required to have them. |
Report Facts
Resident sample size: 9
Total residents: 76
Staff missing TB testing: 7
Staff missing food handler card: 10
Staff missing background check: 2
Staff missing specialty training: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Anne Sinclair | NCI Community Complaint Investigator | Investigator conducting complaint investigation |
| Abigail Vanderkolk | Community Complaint Investigator | Investigator conducting complaint investigation |
| Joy Pipgras | LTC Surveyor | Surveyor involved in complaint investigation |
| Staff D | Health and Wellness Specialist | Confirmed missing TB testing and food handler card requirements during interviews |
| Staff E | Resident Care Coordinator | Named in findings for missing basic training, specialty training, and food handler card |
| Staff F | Resident Care Coordinator | Named in findings for missing TB testing and specialty training |
| Staff G | Memory Care Director | Named in findings for missing TB testing and food handler card |
| Staff H | Registered Nurse / Health and Wellness Specialist | Named in findings for missing TB testing, specialty training, and food handler card |
| Staff J | Care Partner | Named in findings for missing TB testing and food handler card |
| Staff L | Care Partner | Named in findings for missing TB testing, specialty training, and food handler card |
| Staff N | Care Partner | Named in findings for missing TB testing, specialty training, and food handler card |
| Staff O | Resident Care Coordinator | Named in findings for missing TB testing and specialty training |
Inspection Report
Follow-Up
Deficiencies: 0
Dec 2, 2024
Visit Reason
The Department completed a follow-up inspection of North Point Village, Assisted Living & Memory Care to verify correction of previously cited deficiencies related to medication services.
Findings
The follow-up inspection on 12/02/2024 found no deficiencies and confirmed that previously cited medication service deficiencies were corrected.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carla Rose | NCI Community Licensor | Named as Department staff who did the On Site verification during follow-up inspection. |
| Patricia Eddy | Community Licensor | Named as Department staff who did the On Site verification during follow-up inspection. |
Inspection Report
Follow-Up
Census: 98
Deficiencies: 5
Nov 26, 2024
Visit Reason
Follow-up inspection to verify correction of previously cited deficiencies related to negotiated service agreements and communication systems.
Findings
The follow-up inspection on 11/26/2024 found no deficiencies, confirming that previously cited deficiencies regarding implementation of negotiated service agreements and communication systems were corrected.
Complaint Details
Complaints investigated included physician's orders not being followed, staffing issues, insufficient cleaning and care supplies, unreliable communication system for memory care cottages, and injuries of unknown origin. Multiple failed provider practices were identified and citations written.
Deficiencies (5)
| Description |
|---|
| Failure to ensure care and services listed in the negotiated service agreement were implemented, resulting in decreased showers and skin breakdown for a resident. |
| Failure to ensure a consistently operational telephone available for communication between residents, family, and staff for 12 residents, inhibiting communication and placing residents at risk for psychosocial harm. |
| Failure to ensure physician ordered treatments listed in the resident’s negotiated service agreement were implemented, resulting in swelling, difficulty with activities of daily living, and decreased quality of life. |
| Failure to ensure adequate staffing in memory care cottages with shifts having only one care staff available. |
| Failure to conduct a fall investigation for injuries of unknown origin as required. |
Report Facts
Resident census during inspection: 98
Total residents: 103
Resident sample size: 2
Closed records sample size: 1
Residents affected by phone communication deficiency: 12
Residents affected by phone communication deficiency: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carla Rose | NCI Community Licensor | Department staff who did the on-site verification during follow-up inspection |
| Jessica Salquist | Field Manager | Signed follow-up inspection letter |
| Amy Wright | NCI Complaint Investigator | Investigator for complaint investigations conducted 04/11/2024 through 06/14/2024 |
| Tethra Wales | Assisted Living Facility Licensor | Department staff who inspected the facility |
| Veronica Jackson | Assisted Living Facility Licensor | Department staff who inspected the facility |
| Joy Pipgras | LTC Surveyor | Department staff who inspected the facility |
Inspection Report
Follow-Up
Deficiencies: 0
Nov 26, 2024
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies.
Findings
The Department found no deficiencies during the follow-up inspection and confirmed that previously cited deficiencies related to negotiated service agreements, medication availability, and inspection responsibilities were corrected.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Zbylski | ALF Licensor | Department staff who did the On Site verification |
| Jennifer Lee | Assisted Living Facility Licensor | Department staff who did the On Site verification |
| Jessica Salquist | Field Manager | Signed the follow-up inspection letter |
Notice
Deficiencies: 0
Nov 25, 2024
Visit Reason
This letter serves as formal notice that the stop placement order prohibiting admissions placed on the facility's license is lifted effective November 25, 2024.
Findings
The stop placement order prohibiting admissions, initially placed verbally on September 5, 2024, and continued through October 10, 2024, has been lifted as of November 25, 2024.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the letter lifting the stop placement order |
| Stephanie Jenks | Field Manager | Contact person for questions regarding the stop placement order |
Notice
Deficiencies: 0
Oct 10, 2024
Visit Reason
The document serves to notify that the Department of Social and Health Services has imposed a Continued Stop Placement Order on the license of North Point Village Assisted Living & Memory Care, prohibiting admissions to the facility.
Findings
The stop placement order was initially effective upon verbal notice on September 5, 2024, and is continued as of October 10, 2024, remaining in effect until formally lifted by the Department of Social and Health Services.
Report Facts
License number: 2479
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the notice of continued stop placement order |
Inspection Report
Enforcement
Deficiencies: 3
Oct 4, 2024
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to North Point Village, Assisted Living & Memory Care to impose civil fines based on violations found during prior inspections.
Findings
The facility was cited for multiple uncorrected deficiencies including failure to investigate and document incidents involving residents, failure to verify staff work references prior to hiring, and failure to report alleged abuse and neglect. These violations placed residents at risk of psychosocial harm, diminished dignity, infection, and future falls.
Deficiencies (3)
| Description |
|---|
| Failure to thoroughly investigate, document investigative findings, and take action to prevent recurrence for residents threatened with withholding of food and water, left unchanged and soiled, and with an unwitnessed fall. |
| Failure to verify staff persons’ work references prior to hiring for three staff. |
| Failure to report incidents of alleged abuse and neglect to the Complaint Resolution Unit for two residents. |
Report Facts
Civil fine amount: 1000
Civil fine amount: 200
Civil fine amount: 400
Total civil fines: 1600
Number of staff with unverified work references: 3
Number of residents involved in abuse/neglect reporting failure: 2
Number of residents involved in investigation failure: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the enforcement letter |
| Stephanie Jenks | Field Manager | Contact person for the enforcement actions and plan of correction |
Inspection Report
Enforcement
Deficiencies: 1
Oct 4, 2024
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to the assisted living facility to address previously cited deficiencies and enforce compliance, resulting in the imposition of a civil fine.
Findings
The licensee failed to ensure medications were administered as prescribed for two residents, resulting in missed medications, discomfort for one resident, and risk of health decline for both. This deficiency was uncorrected from a prior citation and is recurring.
Deficiencies (1)
| Description |
|---|
| Failure to ensure medications were administered as prescribed for two residents, resulting in missed medications and health risks. |
Report Facts
Civil fine amount: 800
Previous citation dates: Uncorrected deficiency previously cited on June 4, 2024, and recurring deficiency cited on September 6, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Field Manager | Contact for plan of correction submission and inquiries |
| Matthew Hauser | Compliance Specialist | Signed the enforcement letter |
Inspection Report
Enforcement
Deficiencies: 2
Oct 4, 2024
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to North Point Village Assisted Living & Memory Care to assess compliance and impose civil fines based on violations of RCW and WAC regulations.
Findings
The facility was found to have uncorrected and recurring deficiencies including failure to implement negotiated service agreements for a resident and failure to maintain a consistently operational telephone communication system for 12 residents, resulting in civil fines totaling $1,400.
Deficiencies (2)
| Description |
|---|
| Failure to ensure care and services listed on the negotiated service agreements were implemented for one resident, resulting in decreased showers and increased risk for compromised skin integrity and infections. |
| Failure to ensure a consistently operational telephone was available for communication between residents, family, and staff for 12 residents, placing them at risk for psychosocial harm, delay in treatment, and decreased quality of life. |
Report Facts
Civil fine amount: 900
Civil fine amount: 500
Total civil fines: 1400
Residents affected: 12
Previous citation dates: February 9, 2024 and June 14, 2024 for recurring deficiencies
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Field Manager | Contact person for submission of Plan of Correction and inquiries |
| Matt Hauser | Compliance Specialist | Signed the enforcement letter |
Inspection Report
Enforcement
Deficiencies: 3
Oct 4, 2024
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to North Point Village Assisted Living & Memory Care to assess compliance and impose civil fines based on violations of state regulations.
Findings
The facility was found to have multiple uncorrected deficiencies including failure to include behavioral interventions in service agreements, failure to obtain prescribed medications timely for residents, and failure to provide grievance forms requested by the department. These deficiencies resulted in civil fines totaling $1,600.
Deficiencies (3)
| Description |
|---|
| Failure to ensure behavioral interventions were included in the negotiated service agreement for one resident. |
| Failure to ensure prescribed medications were obtained in a timely manner for two residents. |
| Failure to provide grievance forms requested by the department from one administrator. |
Report Facts
Civil fine amount: 300
Civil fine amount: 1000
Civil fine amount: 300
Total civil fines: 1600
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Field Manager | Contact person for plan of correction and inquiries |
| Matt Hauser | Compliance Specialist | Signed the enforcement letter |
Inspection Report
Complaint Investigation
Deficiencies: 2
Sep 26, 2024
Visit Reason
The Department of Social and Health Services completed a complaint investigation at North Point Village, Assisted Living & Memory Care on September 26, 2024, due to allegations of staff failures impacting resident safety and care.
Findings
The investigation found multiple violations including failure to maintain a safe environment for residents, inadequate staff training, failure to provide care as per service agreements, and failure to serve specialty diets correctly. These deficiencies resulted in injuries such as a second degree burn, a fall with injury, unmet shower needs, and a choking episode with aspiration.
Complaint Details
Complaint investigation conducted on September 26, 2024. The deficiencies were substantiated and resulted in a civil fine and a continued stop placement order prohibiting admissions.
Deficiencies (2)
| Description |
|---|
| Failure to ensure staff maintained a safe environment for one resident, failed to provide required training to one staff, and failed to provide care identified in negotiated service agreements for three residents. |
| Failure to ensure specialty diets were served per a diet manual and as ordered for seven residents and failure to have a diet manual available for food preparation. |
Report Facts
Civil fine amount: 500
Residents affected by diet failures: 7
Residents affected by care failures: 3
Date stop placement order effective: Verbal notice given on September 5, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Field Manager | Contact person for approval requests and plan of correction submission |
| Matt Hauser | Compliance Specialist | Signed the enforcement letter |
Inspection Report
Complaint Investigation
Census: 109
Deficiencies: 4
Sep 26, 2024
Visit Reason
The inspection was conducted due to complaints involving a resident choking on improperly prepared food and another resident receiving second degree burns from hot liquid.
Findings
The investigation found that the facility failed to ensure food was prepared according to diet orders, resulting in a choking incident, and failed to properly train staff on serving hot liquids, leading to a resident receiving second degree burns. Deficient practices were identified and citations were written.
Complaint Details
Complaints involved a resident choking on food that was not pureed as ordered and a resident receiving second degree burns from hot liquid served at unsafe temperature. Both complaints were substantiated with deficient practices identified and citations written.
Deficiencies (4)
| Description |
|---|
| Facility staff did not ensure food was prepared as ordered and the care staff assisting the resident did not ensure the food was the proper texture and safe for the resident to eat. |
| Staff did not wait for hot beverage to cool before serving, resulting in a resident receiving second degree burns; no signage or warnings about hot water dispenser; staff had not received specialty training for dementia. |
| Facility failed to ensure resident specialty diets were served per diet manual and as ordered for 7 of 7 sampled residents, placing residents at risk for unmet dietary needs and health complications. |
| Facility failed to ensure staff maintained a safe environment and provided required training, contributing to a second degree burn, a fall with injury, unmet shower needs, and residents at risk for unmet care needs and injury. |
Report Facts
Total residents: 109
Resident sample size: 7
Hot chocolate initial temperature: 170
Hot water dispenser temperature: 170
Hot water dispenser temperature after 5 minutes: 164
Unfilled day shifts: 21
Unfilled evening shifts: 20
Memory care residents in Cottage A: 11
Memory care residents in Cottage B: 9
Memory care residents in Cottage C: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Joy Pipgras | LTC Surveyor | Investigator conducting complaint investigations and follow-up inspections |
| Jessica Salquist | Field Manager | Signed follow-up inspection letter confirming no deficiencies |
Inspection Report
Complaint Investigation
Census: 99
Deficiencies: 1
Sep 13, 2024
Visit Reason
The inspection was conducted as an unannounced complaint investigation regarding allegations that staff who tested positive for Covid-19 and were symptomatic were forced to work.
Findings
The investigation found multiple failures in infection control practices, including staff not practicing proper hand hygiene and staff working while symptomatic or positive for Covid-19, placing residents at risk of infection spread. The facility was found not in compliance with infection control regulations.
Complaint Details
The complaint alleged that staff who tested positive for Covid-19 and were symptomatic were forced to work. The investigation substantiated this allegation with multiple staff interviews and schedule reviews confirming staff worked while ill or positive for Covid-19.
Deficiencies (1)
| Description |
|---|
| Failure to ensure staff practiced hand hygiene for 6 of 6 observed staff and failure to prevent staff from providing resident care while symptomatic for 7 of 7 staff. |
Report Facts
Total residents: 99
Resident sample size: 4
Staff observed not washing hands: 6
Staff providing care while symptomatic: 7
Dates of investigation: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sylvia Shauvin | Complaint Investigator | Investigator who conducted the complaint investigation |
| Staff C | Medication Aide | Worked while symptomatic and Covid-19 positive; central to complaint |
| Staff E | Caregiver | Observed providing care without proper hand hygiene and working while ill |
| Staff F | Caregiver | Observed providing care without proper hand hygiene and working while ill |
| Staff G | Caregiver | Observed disposing trash without hand washing and working while ill |
| Staff K | Caregiver | Worked while Covid-19 positive and symptomatic |
| Staff M | Caregiver | Observed providing care without hand washing |
| Staff L | Medication Aide | Expressed concern about ill staff working and infection spread |
| Staff H | Memory Care Director | Reported concerns about staff working while ill |
| Staff B | Health and Wellness Director | Provided statements on infection control expectations and staff working while ill |
| Staff N | Activities Coordinator | Observed staff working while symptomatic |
| Staff A | Administrator | Authorized staff to work while ill due to critical staffing |
Inspection Report
Complaint Investigation
Census: 101
Deficiencies: 1
Aug 27, 2024
Visit Reason
The inspection was conducted as an unannounced on-site complaint investigation regarding multiple allegations including failure to provide medications, trip/fall hazards, and issues with residents' access to working phones at North Point Village, Assisted Living & Memory Care.
Findings
The investigation found that the facility failed to provide a resident their medication as ordered, resulting in medication withdrawal symptoms, a fall, and injury. Other allegations such as access to phones, safety hazards, and food quality were either not substantiated or pending further follow-up inspections. The facility was found not in compliance with medication service regulations.
Complaint Details
The complaint investigation was triggered by allegations including failure to provide medications, trip/fall hazards, and other resident care concerns. The complaint was substantiated with failed provider practice identified and citations written related to medication services.
Deficiencies (1)
| Description |
|---|
| Facility failed to implement a safe system for medication refills and resident representative contact to ensure residents received their medication as ordered, resulting in abrupt discontinuation of medication and risk of serious harm. |
Report Facts
Total residents: 101
Resident sample size: 8
Closed records sample size: 4
Medication omission duration: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sylvia Shauvin | Complaint Investigator | Investigator who conducted the complaint investigation |
| Staff F | Medication Aide | Provided information about medication refill procedures and awareness of medication shortages |
| Staff E | Medication Aide | Recalled facility ran out of Resident 2's medication and described training on refill procedures |
| Staff C | Resident Care Coordinator | Provided information about knowledge of medication omissions and refill procedures |
| Staff G | Medication Aide | Described communication procedures for medication shortages and training received |
| Staff B | Health and Wellness Director | Described attempts to contact prescriber and pharmacy regarding medication refill and family notification |
| Staff H | Medication Aide | Called pharmacy to follow up on unavailable medication |
Inspection Report
Complaint Investigation
Deficiencies: 1
Jul 3, 2024
Visit Reason
The Department of Social and Health Services completed a complaint investigation at North Point Village, Assisted Living & Memory Care on July 3, 2024, due to concerns about medication availability and administration.
Findings
The investigation found that the licensee failed to ensure prescribed medications were obtained from a resident's comfort kit in a timely manner, resulting in the resident not receiving end-of-life medications as prescribed. This failure contributed to unmanaged nausea, pain, anxiety, agitation, and increased risk for health complications related to an untreated infection. This was a recurring deficiency previously cited in 2022.
Complaint Details
The visit was complaint-related and substantiated, resulting in a civil fine of $1,000 for nonavailability of medications under WAC 388-78A-2240.
Deficiencies (1)
| Description |
|---|
| Failure to ensure prescribed medications were obtained from a resident's comfort kit in a timely manner, resulting in the resident not receiving end-of-life medications as prescribed. |
Report Facts
Civil fine amount: 1000
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the letter regarding the civil fine and complaint investigation |
| Stephanie Jenks | Field Manager | Contact person for plan of correction and appeals |
Inspection Report
Complaint Investigation
Deficiencies: 3
Jun 21, 2024
Visit Reason
The Department of Social and Health Services conducted a complaint investigation at North Point Village, Assisted Living & Memory Care on June 21, 2024, due to allegations of resident abuse and neglect.
Findings
The investigation found multiple violations including failure to investigate alleged incidents of resident abuse and neglect, failure to verify staff work references prior to hiring, and failure to ensure staff reported alleged or suspected abuse and neglect. These failures placed residents at risk of psychosocial and physical harm.
Complaint Details
The complaint investigation was substantiated with findings of failure to investigate abuse and neglect, failure to verify staff references, and failure to report abuse and neglect, resulting in civil fines.
Deficiencies (3)
| Description |
|---|
| Failed to investigate alleged incidents of resident abuse and neglect by a staff member, resulting in ongoing allegations and risk to residents. |
| Failed to verify staff persons’ work references prior to hiring for eleven staff. |
| Failed to ensure staff reported alleged or suspected abuse and neglect to the Complaint Resolution Unit for eight residents. |
Report Facts
Civil fine amount: 500
Civil fine amount: 400
Civil fine amount: 400
Total civil fines: 1300
Number of staff with unverified references: 11
Number of residents involved in abuse reporting failure: 8
Number of residents involved in abuse investigation failure: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the letter imposing civil fines related to the complaint investigation. |
| Stephanie Jenks | Field Manager | Contact person for the facility regarding the complaint investigation and plan of correction. |
Inspection Report
Complaint Investigation
Census: 93
Deficiencies: 6
Jun 21, 2024
Visit Reason
The department conducted an unannounced complaint investigation at North Point Village Assisted Living & Memory Care due to allegations including witnessed falls, poor facility communication, inadequate staffing, and missing items.
Findings
The investigation found multiple failures including inadequate investigation of abuse and neglect allegations, failure to verify staff references prior to hiring, failure to report abuse and neglect to the Complaint Resolution Unit, failure to promote resident rights, and failure to adhere to grievance policies. These failures placed residents at risk of physical injury, psychosocial harm, and decreased quality of life.
Complaint Details
The complaint investigation was triggered by allegations of witnessed falls, poor facility communication, inadequate staffing, missing items, and resident abuse by staff.
Deficiencies (6)
| Description |
|---|
| Failed to thoroughly investigate, document investigative findings, and take action to prevent recurrence for residents threatened with withholding of food and water, left soiled, and with unwitnessed falls. |
| Failed to verify staff persons' work references prior to hiring for 11 of 11 sampled staff. |
| Failed to report incidents of alleged abuse and neglect to the Complaint Resolution Unit for 8 residents. |
| Failed to promote residents' rights during staff provision of care for 8 of 9 residents, resulting in physical and verbal abuse, neglect, and improper restraint. |
| Failed to adhere to grievance policy for 1 staff following receipt of three documented resident care concerns, placing residents at risk for harm and elopement due to inadequate supervision. |
| Failed to ensure staff persons were trained on policies and procedures to address grievances. |
Report Facts
Total residents: 93
Resident sample size: 14
Closed records sample size: 3
Staff with unverified references: 11
Residents with abuse/neglect reporting failures: 8
Residents with rights promotion failures: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Executive Director | Named in multiple findings related to failure to investigate, report abuse, and address grievances |
| Staff P | Care Partner | Named as alleged perpetrator of abuse and neglect towards multiple residents |
| Staff D | Business Office Manager | Named in grievance handling and reporting failures |
| Staff C | Memory Care Coordinator | Named in failure to investigate and address staff concerns |
| Staff E | Medication Technician | Named as reporting staff and witness to abuse and neglect concerns |
| Staff F | Care Partner | Named as reporting staff and witness to abuse and neglect concerns |
| Staff G | Medication Technician | Named as reporting staff and witness to abuse and neglect concerns |
| Staff I | Care Partner | Named as reporting staff and witness to abuse and neglect concerns |
| Staff K | Care Partner | Named as reporting staff and witness to abuse and neglect concerns |
| Staff L | Care Partner | Named as reporting staff and witness to abuse and neglect concerns |
| Staff M | Medication Technician | Named as reporting staff and witness to abuse and neglect concerns |
| Staff O | Care Partner | Named as reporting staff and witness to abuse and neglect concerns |
| Staff Q | Care Partner | Named as reporting staff and witness to abuse and neglect concerns |
| Staff S | Care Partner | Named as reporting staff and witness to abuse and neglect concerns |
Inspection Report
Complaint Investigation
Deficiencies: 1
Jun 14, 2024
Visit Reason
The Department of Social and Health Services completed a complaint investigation at North Point Village, Assisted Living & Memory Care on June 14, 2024, due to concerns about failure to implement physician ordered treatments.
Findings
The licensee failed to ensure physician ordered treatments listed in a resident's negotiated service agreement were implemented, resulting in swelling, difficulty with activities of daily living, decreased quality of life, and risk for compromised skin integrity and infection. This was a recurring deficiency previously cited on February 9, 2024.
Complaint Details
The complaint investigation found the deficiency substantiated, resulting in a civil fine of $500.00 for failure to implement physician ordered treatments, which caused harm and risk to a resident.
Deficiencies (1)
| Description |
|---|
| Failure to ensure physician ordered treatments listed in the resident’s negotiated service agreement were implemented. |
Report Facts
Civil fine amount: 500
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the letter imposing the civil fine. |
| Stephanie Jenks | Field Manager | Contact person for plan of correction and inquiries. |
Inspection Report
Complaint Investigation
Deficiencies: 1
Jun 4, 2024
Visit Reason
The Department of Social and Health Services completed a complaint investigation at North Point Village, Assisted Living & Memory Care on June 4, 2024, due to concerns about medication administration.
Findings
The investigation found that the licensee failed to ensure prescribed medication was administered as ordered for one resident, resulting in missed medications, increased discomfort, and a trip to the emergency room involving multiple invasive procedures. This failure placed residents requiring medication assistance at risk for health complications and decreased quality of life.
Complaint Details
Complaint investigation conducted on June 4, 2024. The deficiency was substantiated and resulted in a civil fine.
Deficiencies (1)
| Description |
|---|
| Failure to ensure prescribed medication was administered as ordered for one resident, resulting in missed medications and increased discomfort requiring emergency room visit. |
Report Facts
Civil fine amount: 400
Previous citation date: Recurring citation previously cited on September 6, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the imposition of civil fine letter |
| Stephanie Jenks | Field Manager | Contact person for plan of correction and inquiries |
Inspection Report
Enforcement
Deficiencies: 1
Apr 4, 2024
Visit Reason
The Department of Social and Health Services completed a follow-up visit to North Point Village, Assisted Living & Memory Care to assess compliance and impose a civil fine based on violations found during prior inspections.
Findings
The facility was fined $600 for failing to ensure that staff received tuberculosis testing within three days of employment for three staff members. This deficiency was uncorrected from a prior citation and is considered recurring.
Deficiencies (1)
| Description |
|---|
| Failure to ensure that staff received tuberculosis testing within three days of employment for three staff members. |
Report Facts
Civil fine amount: 600
Number of staff without timely tuberculosis testing: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Field Manager | Contact for plan of correction and follow-up communication |
| Rathana Duong | Compliance Specialist | Signed the enforcement letter |
Inspection Report
Complaint Investigation
Census: 94
Deficiencies: 1
Feb 7, 2024
Visit Reason
The inspection was conducted as an unannounced on-site complaint investigation regarding a resident fall with injury at North Point Village, Assisted Living & Memory Care.
Findings
The investigation found that a resident was left unattended, suffered a fall, and sustained three broken ribs. The facility failed to provide agreed-upon services in the negotiated service agreement, specifically assistance with bathing and dressing/undressing, which contributed to the fall and injury.
Complaint Details
The complaint involved a resident fall with injury. The investigation substantiated that the facility failed to provide required care and services, leading to the resident's fall and injury.
Deficiencies (1)
| Description |
|---|
| Failure to ensure a caregiver followed fall precautions outlined in the negotiated service agreement for one sampled resident, resulting in a fall with injury. |
Report Facts
Total residents: 94
Resident sample size: 6
Broken ribs sustained: 3
Complaint investigation dates: Investigation conducted from 2024-02-07 through 2024-02-09
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carla Rose | NCI Community Licensor | Investigator and on-site verification staff |
| Patty Ford | LTC Surveyor | Investigator and on-site verification staff |
| Staff A | Staff member involved in the incident, responsible for leaving resident unattended |
Inspection Report
Follow-Up
Deficiencies: 4
Jan 30, 2024
Visit Reason
The Department of Social and Health Services conducted a follow-up visit to North Point Village, Assisted Living & Memory Care to verify correction of previously cited deficiencies.
Findings
The facility was found to have multiple uncorrected deficiencies related to food sanitation, room use changes, resident assessments, and tuberculosis testing for staff, resulting in civil fines totaling $1,400.
Deficiencies (4)
| Description |
|---|
| Failure to ensure that staff employed in dining services had a current food worker card for three staff. |
| Failure to notify construction review services in advance, obtain approval, and update the room list to reflect a change in the use of one room (staff break room). |
| Failure to complete a full assessment within 14 days of admission for one resident and safety assessments for three residents with medical devices. |
| Failure to ensure that staff received tuberculosis testing within three days of employment for three staff. |
Report Facts
Civil fine amount: 300
Civil fine amount: 400
Civil fine amount: 400
Civil fine amount: 300
Total civil fines: 1400
Number of staff without food worker cards: 3
Number of residents without full assessment: 1
Number of residents without safety assessments: 3
Number of staff without tuberculosis testing: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Field Manager | Contact person for the facility regarding the inspection and enforcement actions |
| Matt Hauser | Compliance Specialist | Signed the enforcement letter |
Inspection Report
Complaint Investigation
Census: 92
Deficiencies: 1
Dec 13, 2023
Visit Reason
The inspection was conducted as a complaint investigation triggered by allegations including a resident fall, non-working resident airmattress, resident wandering, and facility communication issues.
Findings
The facility failed to notify the resident's hospice nurse of a fall and had communication concerns with the resident's representative regarding timely access to records. Other allegations related to the airmattress and wandering were found not to support failed facility practice.
Complaint Details
Complaint investigation included allegations of resident fall, non-working airmattress, resident wandering, and facility communication. The investigation found failure to notify hospice nurse of fall and communication issues with resident representative regarding records. Other allegations were not substantiated.
Deficiencies (1)
| Description |
|---|
| Failure to notify resident's hospice nurse of fall and communication concerns with resident representative. |
Report Facts
Total residents: 92
Resident sample size: 6
Closed records sample size: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Anne Sinclair | NCI Community Complaint Investigator | Investigator who conducted the complaint investigation |
Inspection Report
Complaint Investigation
Deficiencies: 2
Dec 5, 2023
Visit Reason
The Department of Social and Health Services completed a Full and Complaint Investigation at the assisted living facility to assess compliance with regulatory requirements.
Findings
The facility was found to have recurring deficiencies related to failure to evaluate resident skin injuries and failure to provide a communication system for residents and staff to call for assistance from outdoor areas, resulting in civil fines.
Complaint Details
The visit was complaint-related as stated in the report. The deficiencies cited were recurring and resulted in civil fines.
Deficiencies (2)
| Description |
|---|
| Failure to ensure that staff evaluated resident skin injuries and took appropriate action for two residents, contributing to ongoing skin injuries and decreased quality of life. |
| Failure to provide a way for residents and staff to call for assistance from four outdoor areas of the facility, placing residents at risk of not receiving emergency assistance. |
Report Facts
Civil fine amount: 700
Civil fine amount: 400
Total civil fines: 1100
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Hauser | Compliance Specialist | Signed the letter regarding civil fines and compliance |
| Stephanie Jenks | Field Manager | Contact person for plan of correction and appeals |
Inspection Report
Annual Inspection
Census: 92
Deficiencies: 13
Dec 5, 2023
Visit Reason
The department completed a full inspection and complaint investigation of North Point Village, Assisted Living & Memory Care due to multiple complaint numbers and routine oversight.
Findings
The facility was found non-compliant in multiple areas including staff tuberculosis testing, staff training and orientation, resident care response times, environmental sanitation, food service compliance, safety assessments, negotiated service agreements, record retention, water temperature regulation, and communication systems. Several deficiencies were recurring from prior inspections.
Complaint Details
The inspection included complaint investigations related to diversion, housekeeping services, misappropriation of resident supplies, and monitoring residents' conditions.
Deficiencies (13)
| Description |
|---|
| Staff tuberculosis testing was not completed within required timeframes for initial and second tests for multiple staff members. |
| Staff orientation and specialty training documentation was incomplete or missing for multiple staff members. |
| Resident call light response times were frequently 30 minutes or longer, placing residents at risk of unmet care needs. |
| Facility environmental sanitation was poor, with dirty floors, unclean laundry rooms, and cluttered mechanical rooms. |
| Food service practices did not comply with state food code, including cross contamination and expired food handler cards. |
| Resident assessments and safety evaluations, including for medical devices, were incomplete or delayed. |
| Negotiated service agreements were not signed by residents or representatives for several sampled residents. |
| Resident records were not properly maintained or available for review. |
| Water temperatures in resident and common areas exceeded safe limits or were inconsistent. |
| Communication systems to summon staff were not available in outdoor resident areas. |
| Facility failed to notify construction review services and obtain approval for change in room use. |
| Facility failed to complete character, competence, and suitability reviews for staff with non-disqualifying criminal convictions. |
| Facility failed to complete respirator fit testing for staff prior to resident care duties. |
Report Facts
Resident sample size: 11
Former resident sample size: 2
Staff sample size: 13
Call light response times: 30
Tuberculosis testing delay days: 335
Water temperature: 134.2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Executive Director | Named in tuberculosis testing and staff orientation deficiencies |
| Staff B | Memory Care Coordinator | Named in staff training, tuberculosis testing, and respirator fit testing deficiencies |
| Staff C | Housekeeper | Named in staff orientation, tuberculosis testing, and respirator fit testing deficiencies |
| Staff D | Memory Care Med Aide | Named in tuberculosis testing, staff orientation, and respirator fit testing deficiencies |
| Staff E | Assisted Living Med Aide | Named in staff orientation and respirator fit testing deficiencies |
| Staff F | Assisted Living Med Aide | Named in tuberculosis testing, staff orientation, and respirator fit testing deficiencies |
| Staff G | Regional Health and Wellness Specialist | Interviewed regarding resident care and staff training |
| Staff H | Maintenance Director | Interviewed regarding environmental and facility maintenance deficiencies |
| Staff J | Cook | Named in food service cross contamination and hygiene deficiencies |
| Staff P | Business Office Manager | Interviewed regarding staff training, tuberculosis testing, and record keeping |
Inspection Report
Complaint Investigation
Census: 86
Deficiencies: 1
Nov 6, 2023
Visit Reason
The Department completed a complaint investigation of the Assisted Living Facility due to an allegation of an unsanitary living apartment.
Findings
A resident's room was observed to be unclean, unkept, unsanitary, and in poor repair, with strong urine odor, pet urine and feces on the floor, and overflowing trash. Failed practice was identified and cited for WAC 388-78A-3090.
Complaint Details
Investigation was complaint-driven based on allegation of unsanitary living apartment. The complaint was substantiated with failed provider practice identified and citation written.
Deficiencies (1)
| Description |
|---|
| Resident's apartment was cluttered and unsanitary with broken doors, stained carpet, urine and feces on the floor, and overflowing trash. |
Report Facts
Total residents: 86
Resident sample size: 4
Closed records sample size: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Community Field Manager / Investigator | Conducted the complaint investigation and provided consultation |
Inspection Report
Complaint Investigation
Census: 85
Deficiencies: 1
Aug 29, 2023
Visit Reason
The inspection was conducted as an unannounced on-site complaint investigation triggered by an allegation of a medication error involving a resident receiving medication prescribed for another resident.
Findings
The facility failed to ensure medications were given as prescribed for one sampled resident, resulting in hospitalization due to receiving the wrong medication. The investigation found that staff did not properly identify the resident before medication administration, leading to a medication error and risk to residents.
Complaint Details
The complaint involved a medication error where Resident 1 received Resident 2's medications, leading to hospitalization. The complaint was substantiated with findings of failed provider practice and citation(s) written.
Deficiencies (1)
| Description |
|---|
| Failed to ensure medications were given as prescribed for one resident, resulting in hospitalization due to medication error. |
Report Facts
Total residents: 85
Resident sample size: 7
Hospitalization: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Anne Sinclair | NCI Community Complaint Investigator | Investigator who conducted the complaint investigation |
| Sandra Fast | Community Complaint Investigator | Investigator who conducted the complaint investigation |
| Stephanie Jenks | Community Field Manager | Department staff who did the on-site verification |
Inspection Report
Complaint Investigation
Census: 12
Deficiencies: 0
Apr 21, 2023
Visit Reason
The inspection was conducted in response to a complaint (#79186) regarding a possible gas leak at North Point Village Assisted Living and Memory Care facility.
Findings
The inspection found that a gas leak was reported and investigated, with evacuation of 12 residents and 1 staff member to the second floor. The leak was repaired the same day by Avista, no injuries were reported, and no violations were found.
Complaint Details
Complaint #79186 involved a possible gas leak. The complaint was investigated through interviews and site inspection. The facility followed evacuation procedures and completed a census of staff and residents. The gas leak was fixed and no injuries or violations were reported.
Report Facts
Residents evacuated: 12
Staff evacuated: 1
Gas level: 100
Inspection date: Apr 21, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Chelsea Searle | Assistant Executive Director | Interviewed regarding complaint #79186 |
| Barbara McMullen | Deputy State Fire Marshal | Signed inspection report |
Inspection Report
Complaint Investigation
Census: 80
Deficiencies: 4
Jan 4, 2023
Visit Reason
The inspection was conducted as a complaint investigation based on multiple allegations including improper diabetic medication management, failure to notify resident representatives, lack of insulin availability, failure to provide diabetic diet, inappropriate staff behavior, and concerns about resident safety and emergency response.
Findings
The investigation found failed provider practices related to monitoring residents' well-being, specifically failure to evaluate and consult with the prescriber for a resident hospitalized due to diabetic complications. Additional findings included failure to verify staff work references and ensure current CPR and first aid certification for some staff. Other allegations such as lack of insulin stock and diabetic diet provision were not substantiated. The facility took corrective actions and reported incidents as required.
Complaint Details
The complaint investigation included allegations of improper diabetic medication management, failure to notify resident's representative, lack of insulin availability, failure to provide diabetic diet, sending a resident to hospital with serious symptoms, staff found resident without pulse and respirations, and rude behavior by a staff person. The investigation substantiated failed provider practices and citations were written.
Deficiencies (4)
| Description |
|---|
| Failure to evaluate resident and consult with prescriber when resident was hospitalized for diabetic complications. |
| Failure to verify one of four sample staff's work references prior to hiring. |
| Failure to ensure three of four sample staff had current cardiopulmonary resuscitation and first aid cards. |
| Failure to follow proper staff conduct; a caregiver was rude to a resident and facility failed to verify work references. |
Report Facts
Total residents: 80
Resident sample size: 9
Closed records sample size: 1
Investigation Date Range: 2022-12-09 to 2023-01-04
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sylvia Shauvin | Complaint Investigator | Conducted the on-site verification and investigation |
Inspection Report
Complaint Investigation
Census: 87
Deficiencies: 3
Nov 16, 2022
Visit Reason
The inspection was conducted as a complaint investigation based on multiple allegations including medication not available, resident fall with injury, neglect by a staff member, and medication error at North Point Village, Assisted Living & Memory Care.
Findings
The investigation found multiple failed provider practices including failure to ensure prescribed medications were ordered and available, failure to investigate and document incidents such as resident falls and neglect, destruction and falsification of resident records by a staff nurse, and failure to provide requested documentation. Citations were written for these deficiencies.
Complaint Details
The complaint investigation included allegations of medication not available, resident fall with injury, neglect by a staff member, and medication error. The investigation substantiated failed provider practices and citations were issued.
Deficiencies (3)
| Description |
|---|
| Failure to ensure two prescribed medications were ordered and administered for 26 days, putting the resident at risk. |
| Failure to investigate and document a resident fall with injury, including lack of incident report and fall interventions. |
| Failure to investigate allegations of neglect by a staff nurse, including destruction and falsification of resident records. |
Report Facts
Total residents: 87
Resident sample size: 6
Closed records sample size: 1
Days medication not available: 26
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Jenks | Investigator | Conducted the complaint investigation |
| Sylvia Shauvin | Complaint Investigator | Conducted on-site verification during follow-up inspection |
| Jessica Salquist | Field Manager | Signed follow-up inspection letter |
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