The Cottages of Covington.

WAC 388-78A-2100: Facility failed to complete an updated assessment for a resident when there were changes in the resident's overall condition. The resident required total assistance with all care needs and developed pressure wounds on both buttocks due to inadequate skin assessments and monitoring, resulting in hospitalization.

—: Facility failed to notify Home and Community Services (HCS) when a resident was out of the Assisted Living Facility for medical leave/hospitalization exceeding 24 hours. Newly hired staff were not familiar with the required reporting timeline to HCS.

WAC 388-78A-2474: Facility failed to ensure 4 of 5 direct care staff (Staff C, D, E, and I) met all required training requirements, including long-term care worker basic training that must be completed within 120 days of hire. This placed all residents at risk of receiving inadequate care from untrained staff. WAC 388-78A-2700: Medication Technicians did not perform hand hygiene before and after providing medication administration assistance to residents. Observations showed staff handled medication cart keys with bare hands, touched residents and walkers with gloved hands between different residents, and did not sanitize or wash hands before priming an insulin pen, despite being aware of hand hygiene requirements. WAC 388-78A-2700: Empty paper towel dispensers were observed next to handwashing sinks in common dining areas, preventing residents from drying their hands after washing. Staff were unaware who maintained the dispensers or held the keys to restock them.