Rose Pointe Assisted Living.

WAC 388-78A-2210(1)(b): The facility failed to ensure safe medication services by allowing a resident to ingest medications that had been dropped on the floor. Per facility policy, contaminated medications should be destroyed and a new uncontaminated dose obtained, but staff instead allowed the resident to take the dropped medications.

WAC 388-78A-2210(1)(b)(2)(b): A narcotic patch was not removed when a new patch was applied to a resident. The nurse manager was unaware of the proper procedure for removing, disposing of, and applying new patches and did not investigate or document the medication error. WAC 388-78A-2660: The facility failed to ensure care was provided with dignity for 7 of 18 sampled residents and failed to ensure food was not served on disposable dinnerware in 2 of 2 living areas. Findings included residents unattended in activity rooms, inadequate dining assistance, and a resident unable to use their own bathroom due to roommate sanitation issues. WAC 388-78A-3090: The facility failed to ensure the environment was well-maintained, safe, and sanitary in interior and exterior areas. Deficiencies included debris-filled air vents, strong urine odors, non-functional plumbing, damaged furnishings with sharp edges, water damage, excessive clutter in resident-accessible exterior areas, and numerous maintenance issues that placed residents at risk of injury.

WAC 388-78A-3090: The facility failed to ensure residents' quarters were maintained in a safe and sanitary condition consistent with negotiated service agreements. Cockroach infestation was observed in 11 of 14 resident rooms sampled, exposing residents to unhygienic conditions and contamination.

STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES Home and Community Living Administration PO Box 45600, Olympia, WA 98504-5600 December 24, 2025 ELECTRONIC-FACSIMILE Administrator Rose Pointe Assisted Living 13013 E Mission Ave Spokane Valley, WA 99216 Assisted Living Facility License # 2452 Licensee: RP Operations, LLC IMPOSITION OF CIVIL FINES Dear Administrator: On December 10, 2025, the Department of Social and Health Services (DSHS), Residential Care Services completed a Full Inspections and Complaint Investigation at your facility. This letter constitutes formal notice of civil fines on the license for your assisted living facility, also known as Rose Pointe Assisted Living, located at 13013 E Mission Ave, Spokane Valley, 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 December 10, 2025. Civil Fines RCW 70.129.140 (1) Quality of life -- Rights. WAC 388-78A-2660 (1) Resident rights. $500.00 The licensee failed to ensure that care was provided with dignity for seven residents and and failed to ensure that food was not served on disposable dinnerware in two living areas. This failure resulted in one resident feeling insulted to have to use disposable dinnerware and another resident not being able to use their own bathroom. This is a recurring deficiency previously cited on December 27, 2024, for WAC 388-78A- 2660, on June 18, 2024, and on October 26, 2023. Administrator Rose Pointe Assisted Living License # 2452 December 24, 2025 Page 2 NOTE: These are the violations, which resulted in the fines; see the attached Statement of Deficiencies for any additional violations. WAC 388-78A-3090 (1)(a)(b)(c) Maintenance and housekeeping. $300.00 The licensee failed to ensure the environment was well maintained, safe and sanitary in two facility areas. This failure placed residents at risk of injury and a decreased quality of life. This is a recurring deficiency previously cited on June 17, 2025, for subsections (1) (a) (c), December 27, 2024, for subsections (1) (a) (b), and June 18, 2024. 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: Stephanie Jenks, Field Manager Region 1, Unit B 8517 E Trent Ave, Suite 102 Spokane Valley, WA 99212-2329 Phone: (509) 993-7821/ Fax: 509-921-2426 rcsregion1email@dshs.wa.gov 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. Administrator Rose Pointe Assisted Living License # 2452 December 24, 2025 Page 3 During the IDR process, you will have the opportunity to present written and/or oral evidence to dispute the deficiencies. You can make an IDR request and find directions on the IDR web page at: http://www.dshs.wa.gov/altsa/idr. 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 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 $800.00 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. Administrator Rose Pointe Assisted Living License # 2452 December 24, 2025 Page 4 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. If you have any questions, please contact Stephanie Jenks, Field Manager, at (509) 993-7821. Sincerely, Matt Hauser Compliance Specialist Residential Care Services Enclosure cc: Field Manager, Region 1, Unit B RCS Regional Administrator, Region 1 HCS Regional Administrator, Region 1 DDA Regional Administrator, Region 1 WA LTC Ombuds Office of Financial Recovery, Vendor Program Unit HQ Central Files DRW SN

WAC 388-78A-2920: The facility failed to provide sufficient sanitary storage space for nursing supplies and equipment with work surfaces for preparation of supplies in 3 of 5 facility locations (Room, bathroom on south end of memory care dining room, and staff bathroom in nurses' office on Hall 1). Medical supplies including sterile items, wipes, gloves, briefs, and personal protective equipment were improperly stored in bathrooms next to toilets, placing residents at increased risk for illness and health complications. WAC 388-78A-3090: The facility failed to ensure a safe, sanitary, and well-maintained environment. General maintenance was not completed, water stains were not addressed, carpets were not clean in multiple areas (Hall 1, Hall 2, and resident rooms), light fixtures were not maintained in Hall 2, and cleaning tasks were incomplete in the dining room, television room, and resident rooms. This resulted in resident dissatisfaction and placed residents at risk for injury and harm from unsanitary living conditions. WAC 388-78A-2120: The facility failed to take appropriate action when it was identified that a resident had wound healing complications, failing to monitor and appropriately respond to the resident's well-being.

WAC 388-78A-2300: Facility failed to ensure weekly menus were dated appropriately with year, maintained for six months, provided variety of foods, and included documented alternative meal choices. Residents were served repetitive meals (cereal, pizza, sandwiches) for extended periods without proper menu documentation or alternative options. WAC 388-78A-2140: Facility failed to identify in the negotiated service agreement whether a resident with memory deficits could safely leave the assisted living facility unsupervised. The resident was sent to an appointment alone without adequate clothing and supervision. WAC 388-78A-2630: Facility failed to report the abandonment of a resident with memory deficits who was sent to an appointment alone without appropriate supervision or clothing, as required by the reporting abuse and neglect regulation.

WAC 388-78A-3030(2)(d): Plumbing fixtures not kept in good repair. A resident's cold water faucet did not work and the facility was aware but had not completed repairs. WAC 388-78A-3090(1)(a)(b): Facility failed to maintain a safe, sanitary and well-maintained environment. Black and gray stains were found on carpets throughout hallways and resident rooms that could not be removed, and black mold was observed on ceilings in main hallways and one resident room with a wet musty smell. RCW 70.129.110(3)(a)(b)(c)(d): Facility gave discharge notices to residents without attempting reasonable accommodations to avoid discharge and without providing required notice containing the reason for discharge, transfer location, and ombudsman contact information. WAC 388-78A-2660(1)(4): Facility failed to comply with resident rights requirements related to discharge and transfer procedures under RCW 70.129.110.

WAC 388-78A-2140(3): Resident care plans and negotiated service agreements did not include frequency and time of shower assistance, despite facility having a shower schedule and log. One resident reported not receiving a shower over the weekend. WAC 388-78A-2210(2)(a): One staff member reported concern that a named resident was not receiving medication as prescribed. However, record review and nursing staff verification confirmed the resident had been receiving medications as prescribed with proper monitoring in place.

WAC 388-78A-2140: The facility's negotiated service agreement contents did not comply with regulatory requirements. A consultation was issued regarding the proper documentation and contents of service agreements.

WAC 388-78A-2730: The facility failed to ensure staff were fit tested with NIOSH-approved N95 respirators before assignment to duties that may require use of respirators. Five of five sampled staff (Executive Director, Med Tech, two Caregivers, and another Med Tech) lacked required N95 respirator fit test records in their personnel files, and the facility was using unapproved KN95 respirators instead of NIOSH-approved N95 respirators for fit testing. WAC 388-78A-2240: The facility failed to ensure availability of resident medications. Record review of medication administration records showed that an identified resident went without ordered medications, with staff failing to order medications prior to running out.

WAC 388-78A-2060: Named resident with history of falls was admitted without a preadmission assessment to identify fall risk factors. WAC 388-78A-2130: Care plan was not established to alert staff of fall risk or to implement fall prevention interventions for named resident. WAC 388-78A-2371: Incident reports for named resident's falls lacked root cause analysis or implementation of measures to prevent reoccurrence. WAC 388-78A-2130: Care plan for resident requiring assistance with transfers was never developed, leaving staff without guidance for proper transfer procedures. WAC 388-78A-2660: Named resident received only one shower during an 18-day stay at the facility, failing to meet resident hygiene rights requirements. WAC 388-78A-2060: Named resident with history of falls was admitted without a preadmission assessment to identify fall risk factors. WAC 388-78A-2130: Care plan was not established to alert staff of fall risk or to implement fall prevention interventions for named resident. WAC 388-78A-2371: Incident reports for named resident's falls lacked root cause analysis or implementation of measures to prevent reoccurrence. WAC 388-78A-2130: No treatment orders were in place to prevent lower extremity swelling or improve skin integrity for resident with medical condition compromising skin integrity.