Residential Care Services Investigation Summary Report

Provider/Facility: EVERETT PLAZA (687758) Intake ID(s): 3323127

License/Cert. #: AL1921Investigator: Bertomeu, Ann Region/Unit: RCS Region 2/Unit A Investigation

Date(s):03/10/201703/15/2017

through

Complainant Contact Date(s):Allegations:It was alleged a resident;1) was not being granted visitation by family/friends2) it was not certain the facility was ensuring the resident's safety3) there was possible exploitation of the resident (not specified whether financial/social/physical)4) there were resident's rights issues

Investigation Methods:Sample: named resident

1 sampled residentObservations: named resident

1 sampled residentgeneral population of theassisted living facility(ALF)

Interviews: named resident1 sampled resident4 caregiver staff2 Resident CareCoordinators2 Housekeeping staffRegistered Nurse/Directorof NursingAssistant AdministratorAdministrator

Record Reviews: named resident1 sampled resident

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Residential Care Services Investigation Summary Report

Allegation Summary:Based on interviews, observations and record reviews it was determined the Assisted Living Facility (ALF):1) allowed visitation by family/friends of the resident except two family members who were not allowed to visit due to legalorders.2) the resident reported he felt safe and was happy in the facility.3) no exploitation of the resident of any type was found.4) the resident reported he felt he was able to do whatever he wanted. The resident reported he did not feel restricted and/orunsafe.No failed facility practice was identified related to this allegationThe ALF did demonstrate a failed practice related to the return of the sampled resident to the facility from a hospitalization. Noassessment was completed and no care plan was available for staff..

Unalleged Violation(s):Yes.The ALF failed to ensure the sampled resident had an assessment completed on his return from a hospitalization and failedto ensure a care plan was available to facility staff to direct the resident's care.These failures placed the sampled resident at risk for further compromised health status and at risk for having unmet careneeds.

Yes No

Conclusion /Action:

Failed Provider Practice Identified /Citation(s) Written

Failed Provider Practice Not Identified /No Citation Written

WAC 388-78A-2100 (2) (a) On-going assessments; WAC 388-78A-22120 (3) (a) (b) (4) Monitoring resident's well-beingWAC 388-78A-2130 (1) (c) Service agreement planning

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