Redmond Heights Senior Living.

STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES Aging and Long-Term Support Administration PO Box 45600, Olympia, WA 98504-5600 April 3, 2025 ELECTRONIC-FACSIMILE Administrator Redmond Heights Senior Living 7950 Willows Rd NE Redmond, WA 98052 Assisted Living Facility License # 2628 Licensee: Bear Creek Senior Living, Inc IMPOSITION OF CIVIL FINES Dear Administrator: On March 24, 2025, the Department of Social and Health Services (DSHS), Residential Care Services completed a follow-up visit at your facility. This letter constitutes formal notice of civil fines on the license for your assisted living facility, also known as Redmond Heights Senior Living, located at 7950 Willows Rd NE, Redmond, by the State of Washington, Department of Social and Health Services. These actions are taken under the authority granted pursuant to Laws of 1998, Chapter 272 and RCW 18.20.190. The civil fines on the license are based on the following violation of the RCW and/or WAC as described in the attached Statement of Deficiencies (SOD) report dated March 24, 2025. Civil Fines WAC 388-112A-0400 (4)(c) What is specialty training and who is required $200.00 to take it? WAC 388-78A-2500 (1)(2)(a)(b)(c)(d) Specialized training for mental illness. The licensee failed to ensure two staff completed the specialized training for mental health, as required. This failure placed all 68 residents at risk for decreased quality of care provided by caregivers with incomplete training. This is an uncorrected deficiency previously cited on January 16, 2025, WAC 388-78A subsections (1) and (2)(a)(b)(c)(d) and WAC 388-112A-0400 subsection (4)(c). Administrator Redmond Heights Senior Living License # 2628 April 3, 2025 Page 2 WAC 388-112A-0400 (4)(b) What is specialty training and who is required $200.00 to take it? WAC 388-78A-2510 Specialized training for dementia. The licensee failed to ensure one staff received Specialty Training for Dementia within 120 days of hire. This failure placed all 68 residents at risk for receiving care from unqualified staff. This is an uncorrected deficiency previously cited on January 16, 2025, for WAC 388- 78A-2510 and WAC 388-112A-0400 subsection (4)(b). WAC 388-112A-0600 (1) What is continuing education and what topics $300.00 may be covered in continuing education? WAC 388-112A-0611 (1)(a)(i)(ii)(b) Who in an assisted living facility is required to complete continuing education training each year, how many hours of continuing education are required, and when must they be completed? WAC 388-78A-2474 (2)(e) Training and home care aide certification requirements. The licensee failed to ensure two staff completed all trainings, as required. This failure placed all 68 residents at risk for decreased quality of care provided by caregivers with incomplete training. This is an uncorrected deficiency previously cited on January 16, 2025, subsections (2)(e). NOTE: These are the violations, which resulted in the fines; see the attached Statement of Deficiencies for any additional violations. Attestation (Plan of Correction): Return the enclosed SOD within 10 calendar days with the following: • The date you have or will have each deficiency corrected; • A signature and date attesting that you are taking actions to correct and maintain correction for each cited deficiency. Return the signed and dated SOD to: Laurie Anderson, Field Manager Region 2, Unit D 20425 72nd Ave S suite 400 Kent, WA 98032-2388 Phone: (253)234-6020 / Fax: (253) 395-5071 rcsregion2email@dshs.wa.gov Administrator Redmond Heights Senior Living License # 2628 April 3, 2025 Page 3 Appeal Rights: You have two appeal rights: Informal Dispute Resolution (IDR) and an Administrative Hearing. Each has a different request timeline. Informal Dispute Resolution [RCW 18.20.195] You have an opportunity to challenge the deficiencies and/or enforcement actions through the state's IDR process. All IDR requests must be in writing and include: • The deficiencies you are disputing; and • The method of review you prefer (face-to-face, telephone conference or documentation review). The written request must be received by the 10th working day from receipt of this letter. During the IDR process, you will have the opportunity to present written and/or oral evidence to dispute the deficiencies. Please email your request(s) and supporting documentation to: RCSIDR@dshs.wa.gov OR FAX to: 360-725-3225 Formal Administrative Hearing You may contest the civil fines by requesting a formal administrative hearing to challenge the deficiency, which resulted in the civil fines. All hearing requests must be in writing and include: • A copy of this letter; and • A copy of the Statement of Deficiencies. The written request must be received within twenty-eight (28) calendar days of receipt of this letter. Send your written request to: Office of Administrative Hearings PO Box 42489 Olympia, Washington 98504-2489 Administrator Redmond Heights Senior Living License # 2628 April 3, 2025 Page 4 Payment: If you do not request a formal administrative hearing, the civil fines are due to the Office of Financial Recovery twenty-eight (28) calendar days after receipt of this letter. Mail a check for $700.00 payable to the ‘Department of Social and Health Services’, and if you have or have had a Medicaid resident(s), please include your ProviderOne ID Number # on the check, to: DSHS Office of Financial Recovery PO Box 9501 Olympia, WA 98507-9501 (360) 664-5919 / FAX: (360) 664-8401 OFRMMISVendor@dshs.wa.gov If the Office of Financial Recovery has not received your payment within twenty-eight (28) days after receipt of this letter, interest will begin to accrue immediately on the balance, at the rate of one percent per month. If you do not submit a hearing request or make payment within twenty-eight (28) days, the balance due will be recovered. NOTICE: State and federal law provide protections to defendants who are in military service, and to their dependents. Dependents of a service member are the service member’s spouse, the service member’s minor child, or and individual for whom the service member provided more than one-half of the individual’s support for one hundred eight days immediately preceding an application for relief. One protection provided is the protection against the entry of a default judgment in certain circumstances. This notice pertains only to a defendant who is a dependent of a member of the National Guard or a military reserve component under a call to active service, or a National Guard member under a call to service authorized by the governor of the state of Washington, for a period of more than thirty consecutive days. Other defendants in military service also have protections against default judgments not covered by this notice. If you are the dependent of a member of the national guard or a military reserve component under a call to active service, or a national guard member under a call to service authorized by the governor of the state of Washington, for a period of more than thirty consecutive days, you should notify the Department in writing of your status as such within twenty days of the receipt of this notice. If you fail to do so, then a court or an administrative tribunal may presume that you are not a dependent of an active duty member of the national guard or reserves, or a national guard member under a call to service authorized by the governor of the state of Washington, and proceed with the entry of an order of default and/or a default judgment without further proof of your status. Your response to the Department about your status does not constitute an appearance for jurisdictional purposes in any pending litigation nor a waiver of your rights. Administrator Redmond Heights Senior Living License # 2628 April 3, 2025 Page 5 If you have any questions, please contact Laurie Anderson, Field Manager, at (253) 234-6020. Sincerely, Matt Hauser Compliance Specialist Residential Care Services Enclosure cc: Field Manager, Region 2, Unit D RCS Regional Administrator, Region 2 HCS Regional Administrator, Region 2 DDA Regional Administrator, Region 2 WA LTC Ombuds Office of Financial Recovery, Vendor Program Unit HQ Central Files DRW HP

Citation(s) Written Failed Provider Practice Not Identified / No Citation Written N/A . . . . . . . . . . . . . . . . . . . . . . .

Conclusion / Action: Failed Provider Practice Identified / Citation(s) Written Failed Provider Practice Not Identified / No Citation Written N/A . STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES AGING AND LONG-TERM SUPPORT ADMINISTRATION 20425 72nd Avenue S, Suite 400, Kent, WA 98032 Statement of Deficiencies License #: 2628 Compliance Determination # 56706 Plan of Correction Redmond Heights Senior Living Completion Date You are required to be in compliance at all times with all licensing laws and regulations to maintain your Assisted Living Facility license. The department completed data collection for an unannounced on-site complaint investigation on 03/17/2025 and 03/18/2025 of: Redmond Heights Senior Living 7950 Willows Rd NE Redmond, WA 98052 This document references the following complaint number(s): 171499 The following sample was selected for review during the unannounced on-site visit: 0 of 68 current residents and 0 former residents. The department staff that investigated the Assisted Living Facility: Thomas Forkgen, ALF Licensor From: DSHS, Aging and Long-Term Support Administration 20425 72nd Avenue S, Suite 400 Kent, WA 98032 . . 03.28.21l25 14:01: 118 State of washington Statement of Defi~iencies License#: 21:128 Compliance Determination# 56706 Pl.in of correction Redmond Heights Senior Living Completion Date Page2 of3 Licensee: Bear Creek Senior Living, Inc 03/1812025 As a result of the on-site visit(s), the department found that you are not In compliance with the licensing laws and regulations as stated in the cited deficiencies In the enclosed report. 03128/2025 I understand that to maintain an Assisted Living Facility license, the facilify h'lu!it be in compliance with all the licensln~ laws and regi,lations at all times. Administrator (or Representative) Date WAC 388-78A-2570 Notification of change in administrator. The licensee must notify the department in writing within ten calendar days of the etfe<::tive date of a change in the · al!Sisted living facility administrator. The notice must include the full name of the new administrator and the effective date of the change. This requirement was not met as evidenced by: Based on interview and record review, the facility failed to notify the Department of a change in the assisted living facility admir1istrator within 10 days of hire for 2 of 2 sampled staff(Staff Q and Staff GG), as required. This failure placed all 68 residents at risk of being uninformed of who was the correct administrator of the facility, Findings included ... Review of the Departments "Secure Tracking and Reporting Systems" (STARS) showed tt,at on 03/17/2025, Staff A, former Adminietrator, was listed as the Administrator of record. During an interview on 0:3/17/2025 at 11:35 AM, Staff Q, former business office manager, stated that 02/14/2025 was S~aff A last day of work Staff Q stated that on 02/01/2025, they started in the Administrator position. Staff Q slated that there was a two-week training period that overlapped with Staff A. Staff Q stated the! they were informed the corporate office submitted the attestation for change of administrator to the Department of Socil'II and Health Services (DSHS, Residential Care Services (RCS), Business Operations end Analysis Unit (BOAU), Review of an email dated 03/18/2025 at 11:04 AM, from the DSHS, RCS, BOAU showed Statement of Deficiencies License #: 2628 Compliance Determination # 56706 Plan of Correction Redmond Heights Senior Living Completion Date As a result of the on-site visit(s), the department found that you are not in compliance with the licensing laws and regulations as stated in the cited deficiencies in the enclosed report. I understand that to maintain an Assisted Living Facility license, the facility must be in compliance with all the licensing laws and regulations at all times. Administrator (or Representative) Date WAC 388-78A-2570 Notification of change in administrator. The licensee must notify the department in writing within ten calendar days of the effective date of a change in the assisted living facility administrator. The notice must include the full name of the new administrator and the effective date of the change. This requirement was not met as evidenced by: Based on interview and record review, the facility failed to notify the Department of a change in the assisted living facility administrator within 10 days of hire for 2 of 2 sampled staff (Staff Q and Staff GG), as required. This failure placed all 68 residents at risk of being uninformed of who was the correct administrator of the facility. Findings included… Review of the Department's “Secure Tracking and Reporting Systems” (STARS) showed that on 03/17/2025, Staff A, former Administrator, was listed as the Administrator of record. During an interview on 03/17/2025 at 11:35 AM, Staff Q, former business office manager, stated that 02/14/2025 was Staff A last day of work. Staff Q stated that on 02/01/2025, they started in the Administrator position. Staff Q stated that there was a two-week training period that overlapped with Staff A. Staff Q stated that they were informed the corporate office submitted the attestation for change of administrator to the Department of Social and Health Services (DSHS, Residential Care Services (RCS), Business Operations and Analysis Unit (BOAU). Review of an email dated 03/18/2025 at 11:04 AM, from the DSHS, RCS, BOAU showed . . 03.28.2025 14:01 ,08 state of llashi119ton Sllltement of Deficiencies License#: 2628 Compliance Determination# 56706 Plan of correction Redmond Heights Senior Living completion Date Page3 o/3 Licensee: Bear Cre~k Senior Living, Inc 03/18/2025 lhere was no change of administrator attsstatlon form submitted for change in admini$!rator. During an Interview on 03/18/2025 at 11: 17 AM, Staff GG, Nursing Home Administrator. stated that the corporate officed submitted a change of administrator attest,ition to DSHS, RCS, BOAU. Review of an email dated 03/1812025 at 2:0:\ PM, from DSHS, RCS, BOAU showed a change of admini$\rator attestation was "just now submitted", 46. days after Staff Q stated they movEld into the administrator position. Review of the. Department's "Secure Tracking and Rep.orting Systems" (STARS) showed that on 03/1812025, Staff GG was listed as the Administrator of record. PlanfAttestatlon Statement I hereby certify that I have reviewed this report and have taken or will take active · measures to correct this deficiency. By taking ihis action, Redmond HeiQh\s S~n\gr Living is or will be in compliance with this law and/ or regulation on (Dale) Q2 I/%.~ . I In addition, I will Implement a system to monitor and ensure continued compliance with this requirement. .f Ad inistrato,r;jor Repres-entative) Date ,/. ,tf/1,e::::~_,Att,J C!l/llt/-'-6 ~ Statement of Deficiencies License #: 2628 Compliance Determination # 56706 Plan of Correction Redmond Heights Senior Living Completion Date there was no change of administrator attestation form submitted for change in administrator. During an interview on 03/18/2025 at 11:17 AM, Staff GG, Nursing Home Administrator, stated that the corporate officed submitted a change of administrator attestation to DSHS, RCS, BOAU. Review of an email dated 03/18/2025 at 2:03 PM, from DSHS, RCS, BOAU showed a change of administrator attestation was “just now submitted”, 46 days after Staff Q stated they moved into the administrator position. Review of the Department's “Secure Tracking and Reporting Systems” (STARS) showed that on 03/18/2025, Staff GG was listed as the Administrator of record. Plan/Attestation Statement I hereby certify that I have reviewed this report and have taken or will take active measures to correct this deficiency. By taking this action, Redmond Heights Senior Living is or will be in compliance with this law and / or regulation on (Date)________________ . In addition, I will implement a system to monitor and ensure continued compliance with this requirement. Administrator (or Representative) Date .

Conclusion / Action: Failed Provider Practice Identified / Citation(s) Written Failed Provider Practice Not Identified / No Citation Written N/A . . 01.22.2025 13:53:34 state of lla5hington 5112 STA T'E OF \/W\5HINGTON DEPARTN1ErH OF SOCIAL AND HEM. .. TH S::RVl CES AGING AND LONG-TERM SUPPORT AD~W'~!!:lTRA.TR)N 1"4t5 n.1tdAvem,e S, Sufte480, Ke.nt, WA !Ji8t)Jl S!at;;,mer!t ~l De'fbenc,.,,s b~,rnse :#:. lr.118 C:ompltmw,i-D;,;!.,,in1m ;lfom # s,rnm Phm of Cot"lilction ft!i;dmonii He-lghts Senior Livil"l!} C,1mp!~tfon Dat~ f'.-\3g~ 1 of 5 U,:.ensee: Bear Cre~k Se:nior Living, !~c 01.1'16f2D2S 'r'"ou ~rn reqt1i1~i:I to-tie in carnpfomce at all tirn~s wi!tl1 alf licensing laws and regulations tn rmHntain your Assisted Uvinfl Fad!ily !k,;;rtse .. ·nw,· de.r.rnrtn1ent wrnpt€ted dat~1 -co-fo;;dii:m for an u~~r:inow')CfHJ eti--t;ite ,:omp!aint lnvesti~vitkm on 12 1'.13{2014, 01 ft16l2H25 ;:1n-rl 12123/2024 of R:1~dmc1nd Heights Senior L1vif~~~ 79:SO vVillows Rd ~~E Redmond, INA. 9:fl{l52 me foHowmg siu-npte w-as sdtr.-:ted for revi~,w drn·\ng the unanrwunced un-site visit 7 of 57 torrent re. sidents and ~ former re ~Hd~rits. Fwm: OSHS, Ag'ing and l.Otiffr~rm ~~-ppo1t Ad1,foh.5tH':bon Residential Care s~rvk:es, F'(t£\ion 2 . Unit O 20425 72nd AveniJe: S, Srnte 400 Kent, W1\ t38tl~Q /4,s a r~~u!t ot the on-site visn(s), the 1.fopartrnert found !.tmtym.{ are nat-in rximpl!anc~ with the !ic1~nsin9 fa1ws m1<l: ~-~~ulaticns HS-st'ateti in the i::ite·d del'k:.1em:i~,s in th1: emJusE,d n~port. 01-22-2025 Date i L!nderstand the."it h:i mafnti:1in an Assisted Uving F;,1d\it-y ik~n:s.e, the fadhty must be ln to111pl!rince with ~II the lkensmg !aw:s rind 1··r.:\g1iatiz1ns at aH tirnes STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES AGING AND LONG-TERM SUPPORT ADMINISTRATION 20425 72nd Avenue S, Suite 400, Kent, WA 98032 Statement of Deficiencies License #: 2628 Compliance Determination # 52601 Plan of Correction Redmond Heights Senior Living Completion Date You are required to be in compliance at all times with all licensing laws and regulations to maintain your Assisted Living Facility license. The department completed data collection for an unannounced on-site complaint investigation on 12/23/2024, 01/06/2025 and 12/23/2024 of: Redmond Heights Senior Living 7950 Willows Rd NE Redmond, WA 98052 This document references the following complaint number(s): 160355 The following sample was selected for review during the unannounced on-site visit: 7 of 57 current residents and 0 former residents. The department staff that investigated the Assisted Living Facility: Thomas Forkgen, ALF Licensor From: DSHS, Aging and Long-Term Support Administration 20425 72nd Avenue S, Suite 400 Kent, WA 98032 As a result of the on-site visit(s), the department found that you are not in compliance with the licensing laws and regulations as stated in the cited deficiencies in the enclosed report. I understand that to maintain an Assisted Living Facility license, the facility must be in compliance with all the licensing laws and regulations at all times. . . 01.22.2025 13:53:34 State of ~a5hington 6/12 S!.1t~meot ,;if Oefid~ndes Gomplfonc.e Detennin.ifon #51501 Pl.m M Corradit11:1 Risd111~rnd rfotghts Se~ior U,~lt,g c~1rip!sfo~r1 Date Pags 2 ot5 Uca;nsee: Bea1 Crn~l1 Senior Li,1\ng. !ti,. {H/16/2028 (1 ) The :assisted Hving fodhty rnust: (a} Maintain the pre:mise.s frne rJf haran1s; This requir~rm ent was fl!)t nu~t a$ evtdenced by: 8asd€ an obseivati:on, inte1v!ti:w, and recnrd review the fadlity frnl:ed to em,ttre l {l.( 1 sampl~d F'(t,sid~!nt {Remdent 8} did rn:it Bt1uk~ m their apartrnent This failure plat~!d aH 51 tf.!s1d==~·nts safoty and health at risk l'riJm potent!af fire, smo!,e fn11alation, and mmpromised health. f~eview of ttlt) ·1c1cHity's umfated Dlsi:;ost:r:c: d Services -~hov\<'ed that the facility rnatnt~ined a ~make free ecn'lt"!illnit'y'. The Oiscbmire (1f SeNlce:;,; sh0,\"-.'ezt that sn1oking \At«£ pHmirti?.d in a t.lesign:ated iJutskle area. Heview of tne lad!ily's polky titled, •srnol<ing Poiicy'', d"ltt.d Ci4iuil2022, showed that ti1e fa~ihty prnvkled a S.llfo em.<in:inmtr1t 1'ar af! re.skit nts in re.9anfa to upholdinti: th~ rights ()ff r~sidi::11t ta smi::*i:,: if th'€)-' d~·sire. The policy showed that srnokin!~ of any 1,ind ',Nas not allow~d within the fadli~t. The polk.y srwwed th~t ,..rpon ad1n;sf,ion ,1! resid-~ntwnuh1 b~ inte1v1e'1Ned to det,errninft ifthey sm()ksd. A sm-o~ing tv~~t:u~th:)tl Wr)Uld be perform13d by the Wellness D1rf•:tor to rletf;rrrnn-e it the =residaent •was atJh, b snml<e safely in tr11 d~~ign~ted smoking ,ifftHl. Th<'l policy sho~·'\i-ed that In~ r~sutt:;; eif the eva1hJi:'Jtkm wm, to be disi:,wssed witti tbe tf.isidmrtlre,sp~nsible pmty ttnd placed in the resident's recrjrd. The po!h:.y sr1owed tl1t resident str-ric~! phm tNGUld he updated. The pcfa::y stwwed that the fadlity H~ser.,·ed the di;iM: to frnmediatejy ~.onfist:.;:lte -srnokini~ mati~r,ials .3:tt we!l i:IS rescind the resident's smoking p-rivil<:!·G!~S ·'if foi!in~} to tat-;:e !';t,d1 measures wouM jeoi:mrdize regkftmt safety". Th,e policy ;rhowit!d that a nrin-tmnpli1:ltlt re~ii:1£::nt ;,..vauld :r-ect'tive: .~ th\r{y. . m.iy tH}tie~ M ijV\etkm. Fm tm egrr::gious safe~{ risk~,. eviction mav ,Jf:cus-~nDner than days. nn Ohse1Vatlcm on 712024, 12/18:/2024, ·12tl St.2024, i 2/20t2u24, 'l2l23i2024, arH:i =GH06i2024, showed J sr-n:iking area, rnvered V\~th a ,::,mopy ,.,,_,~th c:hairs. outside in thi! pt!rktn,;1 lot acm$S frnm the main entrnn:c~, a; tiffxtfo. the garh1c1g;;; <:x}!lll:ttion station. Ourin::1 the ttfll ln;;;pet:tlon visit, n-mlt.lpie unidentified residents w,~re nbst€ved srnakin~1 in the des:ign.st~d klrea. Statement of Deficiencies License #: 2628 Compliance Determination # 52601 Plan of Correction Redmond Heights Senior Living Completion Date Administrator (or Representative) Date WAC 388-78A-2700 Emergency and disaster preparedness. (1) The assisted living facility must: (a) Maintain the premises free of hazards; This requirement was not met as evidenced by: Based on observation, interview, and record review the facility failed to ensure 1 of 1 sampled Resident (Resident 8) did not smoke in their apartment. This failure placed all 57 residents safety and health at risk from potential fire, smoke inhalation, and compromised health. Finding included… Review of the facility’s undated Disclosure of Services showed that the facility maintained a smoke free community. The Disclosure of Services showed that smoking was permitted in a designated outside area. Review of the facility's policy titled, "Smoking Policy", dated 04/01/2022, showed that the facility provided a safe environment for all residents in regards to upholding the rights off resident to smoke if they desire. The policy showed that smoking of any kind was not allowed within the facility. The policy showed that upon admission a resident would be interviewed to determine if they smoked. A smoking evaluation would be performed by the Wellness Director to determine if the resident was able to smoke safely in the designated smoking area. The policy showed that the results of the evaluation was to be discussed with the resident/responsible party and placed in the resident’s record. The policy showed the resident service plan would be updated. The policy showed that the facility reserved the right to immediately confiscate smoking materials as well as rescind the resident’s smoking privileges “if failing to take such measures would jeopardize resident safety”. The policy showed that a non-compliant resident would receive a thirty-day notice of eviction. For egregious safety risks, eviction may occur sooner than 30 days. Observation on 12/17/2024, 12/18/2024, 12/19/2024, 12/20/2024, 12/23/2024, and 01/06/2024, showed a smoking area, covered with a canopy with chairs, outside in the parking lot, across from the main entrance, a next to the garbage collection station. During the full inspection visit, multiple unidentified residents were observed smoking in the designated area. . Statement of Deficiencies License #: 2628 Compliance Determination # 52601 Plan of Correction Redmond Heights Senior Living Completion Date During interviews on 12/23/2024 at 10:22 AM and at 1:11 PM, Resident 9 stated they lived across from Resident 8’s apartment. Resident 9 complained that Resident 8 often smoked in their apartment, rather than go outside to the designated smoking area. Resident 9 stated that the smoke would enter their apartment which they shared with their spouse, Resident 10. Resident 9 and Resident 10 both stated that the cigarette smoke from Resident 8’s apartment entered their apartment under the entrance door and caused their eyes to water. Resident 10 stated they have difficulty breathing and the cigarette smoke aggravated their condition. Resident 9 stated that they complained to the staff and their concerns were ignored. Resident 9 and Resident 10 stated that they were concerned Resident 8’s cigarette smoking could cause a fire and jeopardize all the residents and staff safety. During interviews on 12/23/2024 at 10:23 AM and at 1:20 PM, Resident 11 stated that they live next door to Resident 8. Resident 11 stated that Resident 8 frequently smoked cigarettes in their apartment and the smoke entered Resident 11’s room. Resident 11 stated that the cigarette smoke was strong and bothered them.

Conclusion / Action: Failed Provider Practice Identified / Citation(s) Written Failed Provider Practice Not Identified / No Citation Written N/A .

deficiency listed on the enclosed report; and • May inspect your program to determine if you have corrected all deficiencies; and • Expects all deficiencies to be corrected within the timeframe accepted by the department. You Must: • Begin the process of correcting the deficiency or deficiencies immediately; • Contact the Field Manager for clarifications related to the Statement of Deficiencies (SOD); • Within 10 calendar days after you receive this letter, complete and return the enclosed 'Plan/Attestation Statement'; o Sign and date the enclosed report; o For each deficiency, indicate the date you have or will correct each deficiency; o Mail the Plan/Attestation Statement and report with original signatures to: Laurie Anderson, Field Manager Region 2, Unit D 20425 72nd Avenue S, Suite 400 . Redmond Heights Senior Living # 2628 06/15/2023 Kent, WA 98032 • Complete correction(s) within 45 days, or sooner if directed by the Department, after review of your proposed correction dates. • Have your plan approved by the Department. Consultation(s): In addition, the Department provided consultation on the following deficiency or deficiencies not listed on the enclosed report. WAC 388-78A-2090 Full assessment topics. The assisted living facility must obtain sufficient information to be able to assess the capabilities, needs, and preferences for each resident, and must complete a full assessment addressing the following, within fourteen days of the resident's move-in date, unless extended by the department for good cause: (7) Individual's special needs, by evaluating available information, or if available information does not indicate the presence of special needs, selecting and using an appropriate tool, to determine the presence of symptoms consistent with, and implications for care and services of: (c) Dementia. While screening a resident for dementia, the assisted living facility must: (i) Base any determination that the resident has short-term memory loss upon objective evidence; and (ii) Document the evidence in the resident's record. (d) Other conditions affecting cognition, such as traumatic brain injury. (10) Individual's personal identity and lifestyle, to the extent the individual is willing to share the information, and the manner in which they are expressed, including preferences regarding food, community contacts, hobbies, spiritual preferences, or other sources of pleasure and comfort. The facility did not fully evaluate Memory Care residents and document the personal information needed to complete an accurate assessment that described each residents' care assistance needs and personal preferences. There was no documentation in the residents' assessments to establish a base line of functioning to be used as a guide for care assistance (such as mini-mental status exams that helped to determine residents' current level of cognitive functioning). Documentation of base line conditions assist facility staff to recognize changes in residents' conditions and cognitive functioning. Staff A, Administrator in Training, and Staff B, Wellness Director, stated they would update all assessments, which would include information obtained for development of base line functioning. WAC 388-78A-2450 Staff. (1) Each assisted living facility must provide sufficient, trained staff persons to: (a) Furnish the services and care needed by each resident consistent with his or her negotiated service agreement; . Redmond Heights Senior Living # 2628 06/15/2023 (b) Maintain the assisted living facility free of safety hazards; and (c) Implement fire and disaster plans. The facility failed to provide sufficient staff on each shift to meet the needs of the Memory Care residents. Five memory care residents required two caregivers for assistance with mobility, transfers, and personal care (such as toileting and bathing). Memory Care staff reported that when additional staff needed for assistance with resident care, caregivers in the assisted living portion of the building were called over the walkie talkie communication system. Staff A, Administrator, stated that due to staffing shortage, the facility only provided one caregiver per shift in the memory care unit. Staff A stated the facility was actively working to hire more staff. WAC 388-78A-2700 Emergency and disaster preparedness. (1) The assisted living facility must: (e) Make sure first-aid supplies are: (i) Readily available and not locked; (ii) Clearly marked; The location of first aid kits throughout the facility were not identified. The kits were not readily available. During the inspection, the facility staff placed several first aid kits throughout the facility with identifier signs posted with each kit. WAC 388-78A-2730 Licensee's responsibilities. (2) The licensee must: (b) Maintain and post in a size and format that is easily read, in a conspicuous place on the assisted living facility premises: (i) A current assisted living facility license, including any related conditions on the license; The facility license posted expired 12/31/2022. During the inspection, facility Administrator removed the expired license. Administrator posted the current facility license. WAC 388-78A-2950 Water supply. The assisted living facility must: (6) Provide all sinks in resident rooms, toilet rooms and bathrooms, and bathing fixtures used by residents with hot water between 105 F and 120 F at all times; and Water temperature in three bathroom sinks, used by residents and visitors, measured below the regulation requirements of 105 degrees Fahrenheit. During the inspection, Facility Maintenance staff replaced sink fixtures where needed and adjusted thermostat on water tank. Water temperature increased to meet the regulatory requirements. . Redmond Heights Senior Living # 2628 06/15/2023 You Are Not: • Required to submit a plan of correction for the consultation deficiency or deficiencies stated in this letter and not listed on the enclosed report. You May: • Contact me for clarification of the deficiency or deficiencies found. In Addition, You May: • Request an Informal Dispute Resolution (IDR) review within 10 working days after you receive this letter. Your IDR request must include: o What specific deficiency or deficiencies you disagree with; o Why you disagree with each deficiency; and o Whether you want an IDR to occur in-person, by telephone or as a paper review. o Send your request to: IDR Program Manager Department of Social and Health Services Olympia, WA 98504-5600 If You Have Any Questions: • Please contact me at (253)234-6020. Sincerely, Laurie Anderson, Field Manager Region 2, Unit D Enclosure .