Deficiencies per Year
12
9
6
3
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Inspection Report
Follow-Up
Census: 62
Deficiencies: 3
Jun 20, 2025
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies.
Findings
The follow-up inspection found no deficiencies and confirmed that the facility meets Assisted Living Facility licensing requirements. The prior deficiencies were corrected as documented.
Deficiencies (3)
| Description |
|---|
| Failure to ensure 1 of 6 staff completed all required training for job duties and responsibilities, placing all 62 residents at risk of unmet care needs. |
| Failure to secure, account for, and properly document narcotic medications in 4 medication carts, risking potential medication errors and exploitation. |
| Failure to ensure 4 residents' rights to privacy and dignity were maintained, including exposure of health information on medication carts and medication administration in dining area. |
Report Facts
Residents present during inspection: 62
Sample size for review: 9
Medication carts with narcotic issues: 4
Missing team member signatures: 85
Days staff worked without certification: 214
Residents with privacy rights violations: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff D | Failed to complete required training and certification; worked 214 days without Home Care Aide certification | |
| Staff A | Executive Director | Unaware of Staff D's incomplete certification; stated Resident Care Director position vacant since January 2025 |
| Staff J | Wellness Nurse | Reported two authorized team members required to sign daily controlled medication count logs |
| Staff G | Administered medications in dining area violating residents' privacy and rights; unaware this practice violated policies | |
| Staff H | Observed taking blood pressure measurements of residents | |
| Staff I | Medication Care Manager | Reported medication administration to residents on third floor |
Inspection Report
Life Safety
Deficiencies: 7
Aug 14, 2024
Visit Reason
The Office of the State Fire Marshal conducted a fire safety inspection at the Sunrise of Bellevue residential care facility on 08/14/2024.
Findings
Several fire safety deficiencies were identified, including improper use of power strips, penetration issues in fire-resistance-rated construction, missing door wedges on fire-rated doors, and missing required inspection paperwork for sprinkler systems and fire/smoke dampers.
Deficiencies (7)
| Description |
|---|
| Daisy Chain power strips found on 4th floor nurses station |
| Penetration found on 3rd floor network closet |
| Door wedges found at all fire rated doors going to kitchen |
| Quarterly 8/15/2024 sprinkler system deficiencies paperwork not provided |
| 3-Year Dry System Full flow trip test paperwork not provided |
| Annual forward flow test paperwork not provided |
| Annual inspection paperwork for fire/smoke dampers not provided |
Report Facts
Next inspection scheduled date: Aug 16, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Molly Clark | Executive Director | Signed as Owner or Authorized Representative |
| Jason Van Gorkum | Deputy State Fire Marshal | Conducted the inspection and signed the report |
Inspection Report
Complaint Investigation
Census: 60
Deficiencies: 5
Nov 29, 2023
Visit Reason
The investigation was conducted due to a complaint alleging a resident-to-resident altercation where one resident knocked down another, resulting in the injured resident requiring emergency department treatment.
Findings
The facility failed to investigate the incident properly, protect memory care residents from further harm, and assess and monitor the wellbeing of the injured resident. Multiple deficiencies were cited including failure to inform visitors about exit procedures, incomplete veterinary records for pets, inadequate housekeeping ventilation, incomplete background checks, and failure to investigate and document incidents of abuse and neglect.
Complaint Details
The complaint alleged a resident-to-resident altercation where Named Resident 2 knocked down Named Resident 1, who required emergency treatment. The investigation found the facility failed to investigate the incident, protect residents, and monitor the wellbeing of the injured resident. The complaint was substantiated with citations issued.
Deficiencies (5)
| Description |
|---|
| Failure to inform visitors how to exit the secured memory care unit, placing visitors at risk. |
| Failure to ensure pets received regular veterinary examinations and certification to be free of diseases transmissible to humans. |
| Failure to maintain proper housekeeping ventilation systems, risking poor air quality. |
| Failure to complete required Washington state background checks for staff, placing residents at risk of abuse or neglect. |
| Failure to investigate and document an incident of resident-to-resident altercation and abuse, placing residents at risk of harm. |
Report Facts
Resident census: 60
Resident sample size: 9
Closed records sample size: 1
Pets with incomplete veterinary records: 4
Staff with expired background checks: 1
Memory care residents: 21
Days to correct deficiencies: 45
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Thomas Forkgen | ALF Licensor | Investigator and on-site inspection staff |
| Kathy Young | Licensor | On-site inspection staff |
| Michelle Yip | ALF Licensor | On-site inspection staff |
| Staff Q | Maintenance Coordinator | Interviewed regarding exit system failure |
| Staff O | Activities and Volunteer Coordinator | Interviewed regarding pet policy and ventilation issues |
| Staff R | Business Office Coordinator | Interviewed regarding background checks |
| Staff Y | Resident Care Director, Registered Nurse | Provided summary report and interview regarding incident documentation |
| Staff V | Registered Nurse, Wellness Nurse | Interviewed regarding knowledge of resident altercation |
| Staff W | Registered Nurse, Wellness Nurse | Interviewed regarding knowledge of resident altercation |
| Staff T | Wellness Nurse | Interviewed regarding knowledge of resident altercation and witness statement |
| Staff S | Wellness Nurse | Witnessed resident altercation and provided statements |
Inspection Report
Life Safety
Deficiencies: 10
Aug 21, 2023
Visit Reason
The Office of the State Fire Marshal conducted a fire safety inspection at the Sunrise of Bellevue residential care facility on 8/21/2023.
Findings
Multiple fire safety deficiencies were observed, including storage below sprinkler heads, extension cord misuse, open junction boxes, blocked fire doors, and issues with fire extinguisher maintenance and emergency lighting. Several deficiencies involved missing or incomplete paperwork for inspections and maintenance schedules.
Deficiencies (10)
| Description |
|---|
| Kitchen dry storage area has boxes below sprinkler head |
| Front lobby entrance and business office had extension cords observed |
| Open junction boxes and open-wiring splices observed in 5th floor dining room and 1st floor rehab room |
| Electrical room by residents room 408 observed |
| 4th floor nurses cart blocking fire door |
| Repair needed on 2nd floor flow switch |
| 2nd floor commercial laundry room has out-of-date fire extinguisher; 4th floor laundry room fire extinguisher closer than 4 feet to ground |
| Loose O2 cylinder found in resident room 413 |
| West stairwell emergency lighting not working |
| Missing paperwork for fire-rated construction inspection and fire door inspection schedule |
Report Facts
Inspection date: Aug 21, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jason Van Gorkum | Deputy State Fire Marshal | Signed inspection report |
| Alex Yusim | Owner or Owner's Representative who signed the report |
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