Inspection Reports for Red Oak Residence of North Bend
650 E NORTH BEND WAY, NORTH BEND, WA, 98045
Back to Facility ProfileDeficiencies (last 2 years)
Deficiencies (over 2 years)
28 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
344% worse than Washington average
Washington average: 6.3 deficiencies/yearDeficiencies per year
16
12
8
4
0
Census
Latest occupancy rate
11 residents
Based on a October 2024 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Complaint Investigation
Census: 11
Deficiencies: 1
Date: Oct 25, 2024
Visit Reason
The inspection was conducted due to a complaint investigation regarding a failed Fire Marshall inspection at the assisted living facility.
Complaint Details
Complaint investigation was related to a failed Fire Marshall inspection. The facility was found out of compliance with fire safety regulations. A Statement of Deficiency was issued on 10/25/2024.
Findings
The facility failed a second Fire Marshall inspection, with multiple fire safety violations identified. The facility was out of compliance with State Fire Marshal regulations, placing all 11 residents at risk of harm due to unsafe environmental conditions. A Statement of Deficiency was issued.
Deficiencies (1)
Facility failed to ensure all residents resided in a safe environment approved by the State Fire Marshal, resulting in fire safety violations.
Report Facts
Total residents: 11
Resident sample size: 0
Compliance Determination Number: 49384
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Karri Hernandez | Community Complaint Investigator | Conducted the on-site verification and investigation |
| Staff A | Administrative Assistant | Interviewed regarding facility's awareness and plan to correct fire safety deficiencies |
Inspection Report
Re-Inspection
Deficiencies: 15
Date: Oct 3, 2024
Visit Reason
An unannounced Fire and Life Safety Code re-inspection was conducted at Red Oak Residence of North Bend by the Office of the State Fire Marshal to determine compliance with all applicable codes.
Findings
Several deficiencies were cited during the re-inspection, including failure to provide documentation for forward flow, kitchen suppression correction report, and sprinkler system service reports. Many previously cited deficiencies were corrected.
Deficiencies (15)
Facility was unable to provide documentation for their forward flow.
Facility was unable to provide a correction report for their kitchen suppression; current report shows deficient exhaust fan not coming on upon system activation.
Facility was unable to provide documentation for quarterly sprinkler reports and forward flow test; sprinkler report shows multiple deficiencies.
Facility was unable to provide current service report showing kitchen suppression system has been serviced.
Facility has 2 smoke detectors covered due to construction/painting.
Facility was unable to provide documentation showing monthly testing of CO detectors performed in past 12 months.
Facility does not have a lockout device on the fire alarm circuit breaker; must lock breaker in the 'ON' position located in the kitchen.
Facility only has 3 extra sprinklers located in the sprinkler head box in the Riser room; minimum six required.
The 1st floor Laundry room has a power strip behind the appliance that is dangling by its cord.
The Salon on the 2nd floor has an unapproved heater.
Facility was unable to provide record of their annual fire wall inspection and/or repairs for all fire-resistant-rated construction.
The kitchen has a sprinkler head that is taped due to construction.
The dry storage room in the kitchen has a sprinkler head that has been taped due to construction.
The facility does not have a correction report or documentation that all deficiencies have been corrected for the kitchen suppression system and sprinkler system.
Fire doors did not close/latch properly when tested in electrical room by 301 and laundry room 1st floor.
Report Facts
Next inspection scheduled date: 2024
Next inspection scheduled date: 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Cozetta Christian | Deputy State Fire Marshal | Signed the inspection report |
Inspection Report
Follow-Up
Census: 9
Deficiencies: 9
Date: Aug 15, 2024
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies.
Findings
The follow-up inspection found no deficiencies and confirmed that the facility meets Assisted Living Facility licensing requirements. Previous deficiencies related to service plans, laundry ventilation, water temperature, posting of Ombuds information, resident rights, medication management, tuberculosis screening, staff orientation, and medication availability were corrected.
Deficiencies (9)
Facility failed to update the Individual Service Plan for Resident 2 to reflect diabetic status and care instructions.
Laundry rooms on first and third floors lacked proper ventilation.
Hot water temperatures exceeded 120°F in multiple sinks, risking burns to residents.
Facility failed to post the state and local long-term ombuds information in a conspicuous place.
Facility failed to make the last Department of Social and Health Services inspection report readily accessible to residents.
Facility failed to assess Resident 2's ability to self-administer medications.
Staff member (Staff B) was not screened for tuberculosis within three days of employment.
Two staff members (Staff A and Staff C) did not complete required facility orientation.
Resident 3's prescribed Aspercreme lidocaine patch was not administered as ordered and documentation was inaccurate.
Report Facts
Residents sampled: 4
Residents present: 9
Hot water temperature readings: 5
Medication administration instances: 19
Medication administration instances: 11
Medication administration instances: 16
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Thomas Forkgen | ALF Licensor | Department staff who did on-site verification |
| Steven Garrett | LTC Licensor | Department staff who did on-site verification |
| Laurie Anderson | Field Manager | Signed follow-up inspection letter |
| Staff D | Activity Director and Administrator Designee | Interviewed regarding multiple deficiencies including missing service plan pages, TB screening, and staff orientation |
| Staff G | Administrative Assistant | Interviewed regarding laundry ventilation and Ombuds posting |
| Staff C | Contracted Caregiver | Interviewed regarding medication administration and documentation |
| Staff F | Nighttime Caregiver | Interviewed regarding medication administration and documentation |
| Staff B | Caregiver | Not screened for tuberculosis as required |
| Staff A | Caregiver | Did not complete required facility orientation |
Inspection Report
Follow-Up
Census: 11
Deficiencies: 3
Date: Jan 3, 2024
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies related to staff background checks.
Complaint Details
Complaint investigation for incomplete background checks revealed failed provider practice and citation issued. Investigation conducted from 2023-10-13 through 2023-11-06.
Findings
The follow-up inspection found no deficiencies, confirming that the facility meets Assisted Living Facility licensing requirements. The prior deficiencies related to incomplete staff background checks were corrected.
Deficiencies (3)
Facility failed to complete Washington State name and date of birth background checks every two years and upon hire for all staff, placing residents at risk of abuse, neglect, or exploitation.
Facility failed to submit background check authorizations to the Department within one business day after new staff member starts working.
Facility employed staff with disqualifying negative actions on background checks without proper supervision.
Report Facts
Total residents: 11
Resident sample size: 0
Closed records sample size: 0
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Karri Hernandez | Community Complaint Investigator | Conducted the complaint investigation and on-site verification |
| Laurie Anderson | Field Manager | Signed the follow-up inspection report and statement of deficiencies |
Inspection Report
Complaint Investigation
Census: 38
Capacity: 50
Deficiencies: 1
Date: Sep 19, 2023
Visit Reason
The inspection was conducted as a complaint investigation due to a failed second State Fire Marshal inspection, which identified the facility was out of compliance with fire safety regulations.
Complaint Details
The complaint was related to a failed Fire Marshal inspection. The investigation confirmed the facility failed a second State Fire Marshal inspection, was out of compliance, and a citation was issued.
Findings
The facility failed the second State Fire Marshal inspection and was found out of compliance with fire safety regulations, resulting in a citation. The facility did not ensure a safe environment approved by the State Fire Marshal, placing residents at risk of harm due to unsafe environmental conditions.
Deficiencies (1)
Facility failed to ensure 50 of 50 residents resided in a safe environment approved by the State Fire Marshal, placing residents at risk of harm, injury, and potential fire hazards related to unsafe environmental conditions.
Report Facts
Total residents: 38
Total licensed capacity: 50
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Karri Hernandez | Community Complaint Investigator | Conducted the on-site verification and investigation |
| Laurie Anderson | Field Manager | Signed the compliance determination and statement of deficiencies |
| Staff A | Director of Operation | Interviewed during investigation; discussed compliance and corrective actions |
Inspection Report
Life Safety
Deficiencies: 15
Date: Aug 2, 2023
Visit Reason
The Office of the State Fire Marshal conducted a fire safety inspection at the Red Oak Residence of North Bend facility to assess compliance with fire protection and life safety codes.
Findings
The inspection identified multiple deficiencies related to fire safety systems, including missing required inspection paperwork for sprinkler systems, fire alarms, fire doors, fire-resistance-rated construction, and fire/smoke dampers. Several issues with extension cords and hood cleaning documentation were also noted. Most deficiencies were corrected during the inspection, but some paperwork and scheduled inspections remain outstanding.
Deficiencies (15)
Combustible materials stored in exits or enclosures for stairways and ramps
Extension cords used improperly, including running under doors and stapled to exterior of building
Missing first and second semi-annual hood cleaning paperwork
Missing 5-Year internal pipe testing paperwork for sprinkler system
Missing annual forward flow test paperwork for sprinkler system
Missing 5-years backflow internal pipe paperwork
Missing 5-Year FDC Hydro testing paperwork
Missing quarterly inspections paperwork for sprinkler system
Missing first and second semi-annual servicing paperwork for fire extinguishing system
Missing annual replacement of fusible links/auto sprinkler heads paperwork
Missing NAFED certification for fire extinguishing system
Missing annual fire alarm system report, sensitivity testing, nuisance log, monthly alarm tests, and NICET or ES/NTS certification
Missing facility schedule and annual inspection for fire-resistance-rated construction
Missing schedule and annual inspection for fire doors
Missing 4-year inspection and testing of fire/smoke dampers
Report Facts
Next inspection scheduled date: Sep 4, 2023
Next inspection scheduled date: Jul 26, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jason Van Gorkum | Deputy State Fire Marshal | Signed the inspection report and is the contact for the Fire Protection Bureau |
Inspection Report
Life Safety
Deficiencies: 10
Date: Aug 2, 2023
Visit Reason
The Office of the State Fire Marshal conducted an inspection at the Red Oak Residence of North Bend facility to assess compliance with fire safety codes and regulations.
Findings
The inspection found multiple deficiencies related to fire safety, including improper storage of combustible materials, use of extension cords as permanent wiring, missing required inspection paperwork for fire systems, and issues with fire door inspections and maintenance. Many deficiencies were noted as corrected, but several paperwork and inspection documentation were missing and required follow-up.
Deficiencies (10)
Combustible materials stored in exits or enclosures for stairways and ramps.
Extension cords used improperly, including running under doors and stapled to exterior of building.
Missing first and second semi-annual hood cleaning paperwork.
Facility needs to identify and establish a schedule for inspection of Fire-Rated construction within 30 days and complete annual inspection by end of 2023.
Missing paperwork for 5-Year internal pipe testing, annual forward flow test, backflow internal pipe, FDC hydro testing, and quarterly sprinkler inspections.
Missing paperwork for first and second semi-annual servicing and annual replacement of fusible links/auto sprinkler heads for extinguishing system.
Missing annual report, sensitivity testing, nuisance log, monthly single and multiple station alarms test, and NICET or ES/NTS certification for fire alarm system.
Missing fire/smoke damper 4-year inspection documentation.
Facility needs to identify and establish a schedule for inspection of fire doors within 30 days and complete annual inspection by end of 2023.
Issues with latching hardware, auxiliary hardware, field modifications voiding labels, gasketing and edge seals, and signage on fire doors.
Report Facts
Deficiencies cited: 10
Next inspection scheduled: 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jason Van Gorkum | Deputy State Fire Marshal | Named as the inspector conducting the fire safety inspection. |
| Kimberly Smith | Admin Assistant | Named as authorized facility representative signing the inspection report. |
Inspection Report
Complaint Investigation
Census: 14
Deficiencies: 2
Date: Mar 20, 2023
Visit Reason
The inspection was conducted as a complaint investigation triggered by allegations related to a Norovirus outbreak, concerns about cleaning products, staff infection control practices, sick employee return to work policy, and facility response to the outbreak.
Complaint Details
The complaint investigation was substantiated with failed provider practices identified. Allegations included failure to report a Norovirus outbreak, improper cleaning products, inadequate enteric precautions, sick employee return to work policy concerns, and inadequate facility response to the outbreak.
Findings
The facility experienced a Norovirus outbreak among residents and staff and failed to immediately report the outbreak to the local health department. The facility used effective cleaning products, but lacked procedures to ensure PPE availability during isolation. Staff did not report the outbreak timely, delaying the Department's response. A failed provider practice was identified and citations were written.
Deficiencies (2)
Facility failed to report a gastrointestinal illness outbreak after 7 of 14 residents and staff exhibited Norovirus symptoms, preventing timely public health intervention.
No system or procedure to ensure PPE supplies were stored and readily available when entering resident rooms under isolation during infectious period.
Report Facts
Total residents: 14
Resident sample size: 4
Residents exhibiting symptoms: 7
Staff exhibiting symptoms: 2
Visitors exhibiting symptoms: 3
Days after symptoms before staff returned to work: 3
Sample reviewed during unannounced visit: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary Hayes | Licensor | Investigator who conducted the complaint investigation |
| Deborah Corlis | Complaint Investigator | Department staff who did the on-site verification during follow-up inspection |
| Laurie Anderson | Field Manager | Signed the follow-up inspection letter |
| Staff A | Administrator | Interviewed staff who provided details about outbreak reporting timeline |
| Staff B | Nurse | Reviewed CDC guidelines and communicated with Department about outbreak reporting |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Jan 11, 2023
Visit Reason
The inspection was conducted in response to a complaint regarding multiple power outages at Red Oak Residence of North Bend.
Complaint Details
Complaint ID# 63893 concerned multiple power outages. The complaint was investigated via phone and document review, and no violations were found.
Findings
A phone investigation and document review found that the power outages were community-wide and beyond the facility's control. Monthly and annual emergency lighting and exit sign checks are conducted, and monthly fire drills are performed to ensure safety. No violations or IFC violations were detected.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Lysandra Davis | Deputy State Fire Marshal | Signed as Deputy State Fire Marshal conducting the inspection |
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