Deficiencies per Year
24
18
12
6
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Follow-Up
Census: 40
Deficiencies: 0
Jan 27, 2025
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility on 01/27/2025 to verify correction of previously cited deficiencies.
Findings
The follow-up inspection found no deficiencies and confirmed that the facility meets the Assisted Living Facility licensing requirements. Previously cited deficiencies were corrected as noted in the report.
Report Facts
Residents sampled: 6
Residents at risk: 40
Days staff M employed without required training: 131
Food services staff without valid Food Worker Card: 3
Residents sampled for service plan deficiencies: 7
Residents at risk due to water temperature: 1
Residents at risk due to unsafe medical devices: 2
Residents at risk due to oxygen management: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Michelle Yip | ALF Licensor | Department staff who did on-site verification |
| Claudia Allis | ALF Licensor | Department staff who inspected the Assisted Living Facility |
| Laurie Anderson | Community Field Manager / Field Manager | Signed multiple letters and reports related to inspections and compliance |
| Staff M | Caregiver | Named in deficiency for incomplete dementia and mental health specialty training |
| Staff A | Executive Director | Interviewed regarding staff training and service plan deficiencies |
| Staff B | Named in deficiency for incomplete specialty training | |
| Staff C | Named in deficiency for incomplete specialty training | |
| Staff G | Food services staff without valid Food Worker Card | |
| Staff H | Food services staff without valid Food Worker Card | |
| Staff I | Food services staff without valid Food Worker Card | |
| Staff K | Maintenance Director | Interviewed about water temperature monitoring |
| Staff J | Health Services Director | Interviewed about oxygen use and bed rail issues |
Inspection Report
Re-Inspection
Deficiencies: 21
Sep 12, 2024
Visit Reason
An unannounced Fire and Life Safety Code re-inspection was conducted at Village Green Retirement Campus by a representative of the Washington State Patrol, State Fire Marshal's Office to determine compliance with all applicable codes.
Findings
Multiple deficiencies were cited during the re-inspection, including issues with door operations, fire alarm trouble status, and missing documentation for sprinkler and fire extinguisher maintenance. Many deficiencies were corrected at the time of inspection, while some violations remained and were documented for follow-up.
Deficiencies (21)
| Description |
|---|
| Relocatable power taps and current taps not in accordance with NFPA 70 and code |
| Hoods, grease-removal devices, fans, ducts and other appurtenances not inspected at required intervals |
| Swinging fire doors did not close/latch properly on testing |
| Fire alarm is in trouble status |
| Fire extinguishers not maintained or outdated (e.g., fire extinguisher by room G105) |
| Missing documentation for annual and semi-annual fire and life safety inspections and repairs |
| Missing door closures on resident rooms H214, H210, H203 |
| Missing documentation for sprinkler system testing and maintenance |
| Missing documentation for kitchen suppression system servicing |
| Missing documentation for annual fire alarm testing and nuisance log |
| Missing documentation for smoke detector sensitivity testing |
| Missing documentation for carbon monoxide detector testing |
| Exit door in 2nd dining area requires extra force to open |
| Exit doors near reception area blocked by table and chair |
| Facility generator lacks emergency shut off switch or annunciation panel |
| Missing documentation for annual generator servicing |
| Unsecured oxygen cylinder in resident room H103 |
| Missing documentation for monthly fire extinguisher inspections in employee break room and emergency panel room |
| Missing escutcheon ring in housekeeping closet by kitchen |
| Fire alarm breaker lock out device needs to be re-added |
| Missing documentation for twelve planned and unannounced fire drills in previous 12 months |
Report Facts
Next inspection scheduled: Oct 12, 2024
Extension requested: 15
Dates of inspections: Jul 2, 2024
Dates of inspections: Sep 12, 2024
Scheduled sprinkler forward flow test: Nov 16, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Georgy Bennett | Maint Director | Named as Owner or Authorized Representative signing the report |
| Cozetta Christian | Deputy State Fire Marshal | Signed as Deputy State Fire Marshal conducting the inspection |
Inspection Report
Follow-Up
Census: 9
Capacity: 32
Deficiencies: 2
Jun 7, 2023
Visit Reason
The Department completed a follow-up inspection of the Assisted Living Facility to verify correction of previously cited deficiencies related to licensing laws and regulations.
Findings
The facility was found to meet the Assisted Living Facility licensing requirements on the follow-up inspection conducted on 06/07/2023. Previous deficiencies related to nurse delegation and medication assistance were corrected.
Deficiencies (2)
| Description |
|---|
| Failure to ensure medication assistance was provided by delegated and monitored staff with proper nurse delegation and written consent for 10 residents, placing residents at risk for medication errors. |
| Lack of documentation for nurse delegation task information including resident-specific instructions, competency verification, and weekly nurse visits for insulin injection assistance. |
Report Facts
Residents reviewed: 9
Current residents: 32
Residents failed medication assistance: 10
Residents without written nurse delegation consent: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Steven Garrett | LTC Licensor | Department staff who did the on-site verification and inspection |
| Claudia Machado | Community Complaint Investigator | Department staff who did the on-site verification and inspection |
| Staff J | Registered Nurse - Delegator who assumed nurse delegation duties and admitted lack of proper documentation and supervision | |
| Staff B | Director of Nursing | Stated Staff J did not return to assess, supervise, or evaluate delegated staff |
Loading inspection reports...
