Overlake Terrace.

WAC 388-78A-3010(8)(e): The facility failed to provide lockable storage for 3 of 8 assisted living residents (Residents 3, 4, and 10). Each sleeping room must have a lockable drawer, cupboard, or other secure space measuring at least one-half cubic foot with a minimum dimension of four inches. WAC 388-78A-3100(1): The facility failed to ensure 1 of 1 housekeeping utility cart (third-floor cart) with hazardous chemicals was locked while unattended and in resident areas. A housekeeping cart on the third floor was observed unlocked with cleaning chemicals in view, placing all 64 residents at risk of injury from hazardous chemicals. WAC 388-78A-3100(2): The facility failed to ensure 1 of 2 memory care resident's (Resident 6) apartment was free of unlocked hazardous chemicals. An unlocked cabinet in Resident 6's apartment contained liquid laundry detergent and hand sanitizer, placing residents at risk of ingestion or skin and eye contact. WAC 388-78A-2474(2)(c): The facility failed to ensure that 2 of 4 staff (Staff A and Staff C) completed required dementia and mental health specialty training as required for staff serving residents with those primary special needs. WAC 388-78A-2474(2)(d): The facility failed to ensure that 1 of 4 staff (Staff E) completed required cardiopulmonary resuscitation (CPR) training with hands-on skill development and first aid training. WAC 388-78A-2474(2)(e): The facility failed to ensure that 1 of 4 staff (Staff D) completed 12 hours of Department approved continuing education training between their August 2023 birthday and August 2024 birthday as required. WAC 388-78A-2600(1)(b): The facility failed to develop and implement policies and procedures to ensure all staff completed required training, including specialty training for dementia and mental health, CPR/first aid, and continuing education, necessary to provide care and services for residents with special needs. WAC 388-78A-2100(2)(a): The facility failed to ensure all staff completed required training to perform their job duties and responsibilities, placing all residents at risk of unmet care needs. WAC 388-78A-3090(1)(c): The facility's hazardous material policy regarding locking housekeeping carts did not ensure staff consistently secured hazardous chemicals in resident areas, placing residents at risk of exposure.

WAC 388-78A-2210: The facility failed to implement safe medication service for a resident by not clarifying physician orders and verifying pharmacy entries when the electronic medication administration record (eMAR) showed incorrect orders. A resident received Eliquis 2.5 mg three days before the physician-ordered start date, resulting in hospitalization for worsening rectal bleeding.

WAC 388-78A-2320: Facility failed to ensure 2 of 2 sampled staff (Staff U and Staff X) completed Nurse Delegation (ND) training and on-going oversight for 4 of 4 sampled residents (Resident 9, Resident 15, Resident 16, and Resident 18) who required medication and/or insulin administration. Staff U's NAR credential was in pending status when delegated, and there was no documentation of required weekly supervision for insulin administration. WAC 388-78A-2320: Initial citation for failure to ensure nurse delegation training and on-going oversight for staff (Staff S, Staff T, Staff U, Staff V, and Staff W) providing nursing services to residents. WAC 388-78A-2320: Second citation for failure to ensure nurse delegation training and on-going oversight for Staff U and Staff X who administered medications and insulin to residents.