Trustwell Living at Ridgeview Place.

This document was prepared by Residential Care Services for the Locator website. This document was prepared by Residential Care Services for the Locator website. STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES HOME AND COMMUNITY LIVING ADMINISTRATION 8517 E Trent Ave, Ste 102, Spokane Valley, WA 99212 Statement of Deficiencies License #: 2730 Compliance Determination # 72666 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 1 of 6 Licensee: Spokane Valley AL, LLC 02/09/2026 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 the unannounced on-site full inspection on 02/04/2026, 02/05/2026, 02/06/2026 and 02/09/2026 of: Trustwell Living at Ridgeview Place 12903 E Mission Ave Spokane Valley, WA 99216 The following sample was selected for review during the unannounced on-site visit: 7 of 48 current residents and 0 former residents. The department staff that inspected the Assisted Living Facility: Jennifer Lee, Assisted Living Facility Licensor Brian Zbylski, ALF Licensor From: DSHS, Home and Community Living Administration Residential Care Services, Region 1 , Unit B 8517 E Trent Ave, Ste 102 Spokane Valley, WA 99212 This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 72666 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 2 of 6 Licensee: Spokane Valley AL, LLC 02/09/2026 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. Residential Care Services Date 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 RCW 70.129.140 Quality of life -- Rights. (1) The facility must promote care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality. WAC 388-78A-2660 Resident rights. The assisted living facility must: (1) Comply with chapter 70.129 RCW, Long-term care resident rights; This requirement was not met as evidenced by: Based on observation, interview and record review, the facility failed to provide meal service that enhanced residents’ dignity and respect for 3 of 4 residents (Resident 8, 9, and 10) reviewed for meal service. This failure resulted in extended wait times for meal service and placed the residents at risk of a decreased quality of life. Findings included… In an interview on 02/04/2026 at 1:00 PM, Staff A, Executive Director, stated that facility mealtimes were scheduled daily at 8:00 AM, 12:00 PM, and 5:00 PM. In an interview on 02/05/2026 at 11:40 AM, Resident 8 stated that they usually had to wait between 15-20 minutes for the meals to be served. Observation on 02/05/2026 at 12:02 PM showed multiple residents seated in the dining room. Further observation showed the first plates of food for residents were brought to the residents’ tables at 12:23 PM. Observation on 02/06/2026 at 8:34 AM showed residents in the dining room being This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 72666 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 3 of 6 Licensee: Spokane Valley AL, LLC 02/09/2026 served oatmeal. Further observation showed the breakfast entrée was served at 8:38 AM. Observation on 02/06/2026 at 12:30 PM showed staff began to serve lunch to residents in the dining room. Observation on 02/06/2026 at 12:37 PM showed staff began to serve memory care residents their lunch with the last meal being served at 12:45 PM. In an interview on 02/06/2026 at 4:14 PM, Staff A confirmed that mealtimes were 8:00 AM, 12:00 PM and 5:00 PM. Observation on 02/09/2026 at 8:14 AM showed staff began to serve bowls of oatmeal to residents in the dining room. Observation at 8:19 AM showed staff began to serve breakfast entrees to residents. In an interview on 02/09/2026 at 9:43 AM, Resident 10 stated that residents usually had to wait about 15 minutes before meals were served in the dining room. In an interview on 02/09/2026 at 2:10 PM, Resident 9 stated that meals had been about 30 minutes late the past weekend and that breakfast, lunch, and dinner meals were often late. 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, Trustwell Living at Ridgeview Place 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 WAC 388-78A-2474 Training and home care aide certification requirements. (1) The assisted living facility must ensure staff persons hired before January 7, 2012 meet training requirements in effect on the date hired, including requirements in chapter 388-112A WAC. (2) The assisted living facility must ensure all assisted living facility administrators, or their designees, and caregivers hired on or after January 7, 2012 meet the long-term care worker training requirements of chapter 388-112A WAC, including but not limited to: (a) Orientation and safety; This document was prepared by Residential Care Services for the Locator website. This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 72666 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 4 of 6 Licensee: Spokane Valley AL, LLC 02/09/2026 (d) Cardiopulmonary resuscitation and first aid; and (e) Continuing education. This requirement was not met as evidenced by: Based on interview and record review, the facility failed to ensure orientation and safety training was completed by 1 of 5 staff (Staff C), cardiopulmonary resuscitation and first aid was completed by 1 of 5 staff (Staff D), and continuing education was completed by 2 of 5 staff (Staff D and F). This failure placed the residents at risk of receiving care from untrained staff and staff that had not completed the required education hours for ongoing professional development. Findings included... Per WACs 388-112A-0200 and 388-112A-0220 Long-term care workers must complete orientation and safety training prior to providing care to a resident. Per WAC 388-112A-0720 Assisted living facility long-term care workers must maintain a valid Cardiopulmonary Resuscitation (CPR) and first-aid card. Per WAC 388-112A-0611 Long-term care workers must complete 12 hours of continuing education by their birthday each year. <Orientation and Safety> Review of Staff C’s, Resident Care Assistant, personnel file showed a hire date of 12/27/2024. Further review showed training for orientation and safety had been completed on 02/05/2026, 405 days after their date of hire. Review of the facility’s staff schedule dated 01/18/2026-02/03/2026 showed that Staff C had worked and provided resident care on 11 different days. In an interview on 02/09/2026 at 1:04 PM, Staff A, Executive Director, confirmed that Staff C was still employed as a resident care assistant. Staff A further stated that Staff C had not completed their safety and orientation prior to 02/05/2026. <Cardiopulmonary Resuscitation/First Aid> Review of Staff D’s, Resident Care Assistant, personnel file showed a hire date of 06/07/2024. Further review showed Staff D’s training for CPR and first aid expired on 11/14/2025. Review of the facility’s staff schedule dated 01/18/2026 -02/03/2026 showed that Staff D had worked and provided resident care on 11 different days. In an interview on 02/09/2026 at 1:04 PM, Staff A stated that they were not aware that Staff D’s CPR/first aid had expired. This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 72666 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 5 of 6 Licensee: Spokane Valley AL, LLC 02/09/2026 <Continuing Education> Review of Staff D’s personnel file showed a hire date of 12/27/2024 as a certified nursing assistant. Further review showed that Staff D did not have any Continuing Education (CE) credits for the requested period of 05/15/2024-05/15/2025. Review of the facility’s staff schedule dated 01/18/2026 -02/03/2026 showed that Staff D had worked and provided resident care on 11 different days. Review of Staff F’s, Resident Care Assistant, personnel file showed a hire date of 02/05/2023 as a home care aide. Further review showed that Staff F had completed 6.75 CE hours for the requested period of 02/20/2024-02/20/2025. Review of the facility’s staff schedule dated 01/18/2026 -02/03/2026 showed that Staff F had worked and provided resident care on 14 different days. In an interview on 02/09/2026 at 1:04 PM, Staff A stated they did not have documentation of CE hours for Staff D, and did not have more than 6.75 hours of continuing education documented for Staff F. 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, Trustwell Living at Ridgeview Place 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 WAC 388-78A-2690 Electronic monitoring equipment Resident requested use. (1) Audio or video monitoring equipment may not be installed in the assisted living facility to monitor any resident apartment or sleeping area unless the resident or the residents' representative has requested and consents to the monitoring. (7) The assisted living facility must: (a) Reevaluate the need for the electronic monitoring with the resident at least quarterly; and (b) Have each reevaluation in writing, signed and dated by the resident. This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 72666 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 6 of 6 Licensee: Spokane Valley AL, LLC 02/09/2026 This requirement was not met as evidenced by: Based on observation and interview, the facility failed to obtain written consent from 2 of 2 residents (Residents 1 and 3) who had video monitoring in their private rooms. This failure resulted in the residents not being afforded the opportunity to provide consent or decline video monitoring. Findings included… Observation on 02/04/2026 at 1:30 PM showed posted signs that stated video recording was in progress inside the private rooms of Resident 1 and Resident 3. Observation on 02/05/2026 at 3:15 PM, showed a video camera placed next to Resident 1’s television and directed toward the room. In an interview at that time, the resident stated that their child had access to the video and could see everything in the room. Observation on 02/06/2026 at 11:48 AM, showed a video camera placed on Resident 3’s table and directed toward the room. In an interview at that time, the resident stated that they were not sure if they had a video camera but did know that there was a sign outside the door saying there was a camera in the room. In an interview on 02/06/2026 at 4:15 PM, Staff A, Executive Director, stated that staff reported an electronic monitor in Resident 3’s room and placed a sign next to the door. In an interview on 02/09/2026 at 10:55 AM, Staff A stated that they had video recording signs posted outside of Resident 1 and 3’s rooms but were unaware of the requirement to have residents sign consent forms. 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, Trustwell Living at Ridgeview Place 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 This document was prepared by Residential Care Services for the Locator website.

This document was prepared by Residential Care Services for the Locator website. STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEAL TH SERVICES HOME AND COMMUNITY LIVING ADMINISTRATION 8517 E Trent Ave, Ste 102, Spokane Valley, WA 99212 Spokane Valley AL, LLC Trustwell Living at Ridgeview Place 12903 E Mission Ave Spokane Valley, WA 99216 RE: Trustwell Living at Ridgeview Place License# 2730 Dear Administrator: This letter addresses Compliance Determination(s) 72461 (Completion Date 02/06/2026) and 70581 (Completion Date 01/16/2026). The Department completed a follow-up inspection of your Assisted Living Facility on 02/06/2026 and found no deficiencies. Your facility meets the Assisted Living Facility licensing requirements. The Department found that deficiencies for the following licensing laws and regulations were corrected: WAC 388-78A-2466-1, WAC 388-78A-2466-1-a, WAC 388-78A-2466-1-b The Department staff who did the on-site verification: Sandra Fast, Community Complaint Investigator If you have any questions, please contact me at (509)993-7821. Sincerely, Stephanie Jenks, Community Field Manager Region 1, Unit B Residential Care Services Residential Care Services Investigation Summary Report Provider/Facility: Trustwell Living at Provider Type: Assisted Living Facility Ridgeview Place License/Cert.#: 2730 Intake ID: 203349 Compliance Determination #: 70581 Region/Unit #: RCS Region 1 / Unit B Investigator: Sandra Fast Investigation Date(s): 12/24/2025 through 01/16/2026 Complainant Contact Date(s): 12/19/2025 Allegation(s): 1. A resident with a change in condition was not appropriately assessed or given care. 2. The facility staff did not call emergency services when a resident had requested. 3. The facility failed to renew a staff’s name and date of birth background check after two years. Investigation Methods: Sample: Total residents: 49 Resident sample size: 4 Closed records sample size: 0 Observations: Identified resident Residents Resident rooms Staff to resident interactions Interviews: Identified resident Nursing staff Residents Family members Administrative staff Record Reviews: Medical records Incident investigation Facility policies Personnel files Staff training records Staff patterns Investigation Summary: 1. All sampled residents interviewed stated no concerns regarding the facility or its staff. The residents stated that they received the cares that they required. All sampled resident’s representatives interviewed stated they had no concerns regarding the facility. The representative stated that all the staff were willing to do any task that was requested. The facility’s house policy for resident emergencies This document was prepared by Residential Care Services for the Locator website. reviewed showed that staff were instructed to summon emergency services immediately if there was a change that was a serious threat to a resident’s health. All sampled staff stated what process to follow for resident emergencies and that they would contact emergency services immediately if a resident’s health was seriously jeopardized. All sampled residents observed were well groomed, in fresh clothing and wore appropriated footwear. The residents were calm and showed no signs of distress. The facility’s staff observed were rounding on residents and assisting them with their needs. Residents’ records reviewed showed that appropriate assessments and monitoring were done. No failed facility practice was identified. 2. The identified residents interviewed stated that they did not require staff assistance and had no concerns regarding the facility or its staff. The identified residents observed were well groomed, in fresh clothing and wore appropriate footwear. The residents were calm and showed no distress. All sampled care staff interviewed stated that they would contact emergency services if a resident or their representative requested. No failed facility practice was identified. 3. A sampled staff’s name and date of birth background check was expired. A citation was issued based on Washington Administrative Code 388-78a-2466(1)(a)(b). Conclusion / Action: Failed Provider Practice Identified / Citation(s) Written Failed Provider Practice Not Identified / No Citation Written N/A This document was prepared by Residential Care Services for the Locator website. Ii □ □ STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES AGING AND LONG-TERM SUPPORT ADMINISTRATION 8517 E Trent Ave, Ste 102, Spokane Valley, WA 99212 Statement of Deficiencies License #: 2730 Compliance Determination # 70581 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 1 of 3 Licensee: Spokane Valley AL, LLC 01/16/2026 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 12/24/2025 of: Trustwell Living at Ridgeview Place 12903 E Mission Ave Spokane Valley, WA 99216 This document references the following complaint number(s): 203349 The following sample was selected for review during the unannounced on-site visit: 4 of 49 current residents and 0 former residents. The department staff that investigated the Assisted Living Facility: Sandra Fast, Community Complaint Investigator From: DSHS, Aging and Long-Term Support Administration Residential Care Services, Region 1 , Unit B 8517 E Trent Ave, Ste 102 Spokane Valley, WA 99212 This document was prepared by Residential Care Services for the Locator website. This document was prepared by Residential Care Services for the Locator website. J an . 23 . 20 2 6 2: 29 P M '11,Ql,17 ur Wl»l II lll:fWII No. 4685 P. 3 • LJ • L'IIL\J Statement of Deficiencies License#: 2730 Cornpliance Determination# 70581 Plan of Correction Trustwell Living al Ridgeview Place completion Date Page 2 of 3 Licensee: Spokane Valley AL, LLC 01/16/2026 As a result of th~ on-site visit(s), the department found that you are not In compliance with the licensing laws and regulatlons as stated in the cited deficiencies in the enclosed report. 01/23/l026 Residential Care Services Date I understand that to maintain an Assisted LMng Facility license. the facility must be in compliance with all the licensing laws and reg1,1latians at all times. Date WAC 388-78A-2466 Background checks Washington state name and date of birth background ~keck Valid for two years National fingerprint background check Valld indefinitely. tx) {1) A Washingtotl state name .and date of birth background check is valid for two years from the initial date it is cor)ducted, The assisted living facility must ensure: (a) A new DSHS background authorization form is submitted to the department's background check central unit every two years for all administrators, caregivers, staff persons, volunteers and students; and (b) There is a valid Washington state name and d~te of birth background check for all administrators, caregivers, staff persons, volunteers and students. This requirement was not met as evidenced by: Based on interview and record review, the facility failed to ensure a curren1 Washington state name and date of birth background check was on file for 1 of 2 staff (Staff B). This failed practice placed residents et risk of receiving care and services from potentially disqualified staff. Findings include ... •R eview of Slaff B's, Caregiver, personnel documents showed no current Washington state name and date of birth was an file. Review of the facility's document titled, ''Employee Log with Hire Dates," dated 12/24/2026, showed that Steff B's hire date was 02/05/2023. Statement of Deficiencies License #: 2730 Compliance Determination # 70581 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 2 of 3 Licensee: Spokane Valley AL, LLC 01/16/2026 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. Residential Care Services Date 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-2466 Background checks Washington state name and date of birth background check Valid for two years National fingerprint background check Valid indefinitely. (1) A Washington state name and date of birth background check is valid for two years from the initial date it is conducted. The assisted living facility must ensure: (a) A new DSHS background authorization form is submitted to the department's background check central unit every two years for all administrators, caregivers, staff persons, volunteers and students; and (b) There is a valid Washington state name and date of birth background check for all administrators, caregivers, staff persons, volunteers and students. This requirement was not met as evidenced by: Based on interview and record review, the facility failed to ensure a current Washington state name and date of birth background check was on file for 1 of 2 staff (Staff B). This failed practice placed residents at risk of receiving care and services from potentially disqualified staff. Findings include… Review of Staff B’s, Caregiver, personnel documents showed no current Washington state name and date of birth was on file. Review of the facility’s document titled, “Employee Log with Hire Dates,” dated 12/24/2026, showed that Staff B’s hire date was 02/05/2023. This document was prepared by Residential Care Services for the Locator website. This document was prepared by Residential Care Services for the Locator website. ,w,m.uJan. 23. 2026 2:29PM ;)1,121,t: ur l\ld:Jlllll~l,Ull No. 4685 P. 4 Statemimt of Deficiencies License#: 2730 Compliance Determination# 70581 Pl:an of Correction Trustwell LiVlng at Rldgevlew Place Completion Date Page3 of3 Licensee: Spokane Valley AL, LLC 01/16/2026 Review of the facility's staff schedules for 11/02/2025 through 12/30/2.025 showed that Staff 8 worked up to seven days in each 10-day period. Observation on 12/24/2025 at 1: 44 PM showed that Staff 8 was rounding on residents and interacting with them without supeivision. In an interview on '12/24/2025 at 4:23 PM, Staff A, Executive Director, stated that there was no current Washington state name and date of birth background check on file for Staff B. Plan/Attestation Statemant I hare by certify that I have reviewed this report and have taken or will take active measures to correct this deficiency. By taking this a.ction, Trustwell !.Jving at Ridgev[ew Place is Of wil} be In compliance with this law and I or regulation on 1131 Qlo . . (Date) In addition, I will implement a system to monitor and ensure continued compliance with this requirement. Date Statement of Deficiencies License #: 2730 Compliance Determination # 70581 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 3 of 3 Licensee: Spokane Valley AL, LLC 01/16/2026 Review of the facility’s staff schedules for 11/02/2025 through 12/30/2025 showed that Staff B worked up to seven days in each 10-day period. Observation on 12/24/2025 at 1:44 PM showed that Staff B was rounding on residents and interacting with them without supervision. In an interview on 12/24/2025 at 4:23 PM, Staff A, Executive Director, stated that there was no current Washington state name and date of birth background check on file for Staff B. 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, Trustwell Living at Ridgeview Place 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 This document was prepared by Residential Care Services for the Locator website.

—: WA DSHS report: Investigations (01/2026)

Residential Care Services Investigation Summary Report Provider/Facility: Trustwell Living at Provider Type: Assisted Living Facility Ridgeview Place License/Cert.#: 2730 Intake ID: 159170 Compliance Determination #: 52798 Region/Unit #: RCS Region 1 / Unit B Investigator: Sandra Fast Investigation Date(s): 01/09/2025 through 01/28/2025 Complainant Contact Date(s): 01/08/2025, 01/30/2025 Allegation(s): 1. Insufficient staff. 2. Increased resident falls. 3. A caregiver was working unsupervised with vulnerable adults and had no background information in their records. Investigation Methods: Sample: Total residents: 44 Resident sample size: 3 Closed records sample size: 0 Observations: Residents Resident rooms Staff to resident interactions Interviews: Administrative staff Nursing staff Residents Family members Record Reviews: Medical records State reporting log Incident investigation Facility policies Personnel files Staff training records Investigation Summary: 1) The sampled residents observed were well groomed and in fresh clothing. The sampled residents showed no signs of distress of any kind. The sampled residents’ representatives interviewed and stated no safety concerns. Facility staff were observed to be readily available and interacted gently with the residents. The interviewed staff stated no concerns regarding residents and stated they were able to accomplish all tasks for their shift. A referral was made to Labor and Industries for staffing related issues. No failed facility practice was identified. 2) All sampled residents were interviewed and had no concerns related to fall. The This document was prepared by Residential Care Services for the Locator website. sampled residents were observed and showed no signs of distress of any kind. All sampled residents’ apartments were clean and organized with no lingering odors or trip hazards identified. All sampled residents were observed to have call pendants. The staff were observed to be readily available and interacted gently with the residents. The facility followed their policy regarding resident falls. The facility investigated the incident and implemented interventions to prevent future falls. The facility had a system for recording and tracking incidents. No failed facility practice was identified. 3. No Department background authorization or background information found for a care staff. A citation was issued based on Washington Administrative Code 388-78A-2464(1)(2). Conclusion / Action: Failed Provider Practice Identified / Citation(s) Written Failed Provider Practice Not Identified / No Citation Written N/A This document was prepared by Residential Care Services for the Locator website. STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES AGING AND LONG-TERM SUPPORT ADMINISTRATION 8517 E Trent Ave, Ste 102, Spokane Valley, WA 99212 Statement of Deficiencies License #: 2730 Compliance Determination # 52798 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 1 of 3 Licensee: Spokane Valley AL, LLC 01/28/2025 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 01/09/2025 of: Trustwell Living at Ridgeview Place 12903 E Mission Ave Spokane Valley, WA 99216 This document references the following complaint number(s): 159170 The following sample was selected for review during the unannounced on-site visit: 3 of 44 current residents and 0 former residents. The department staff that investigated the Assisted Living Facility: Sandra Fast, Community Complaint Investigator From: DSHS, Aging and Long-Term Support Administration Residential Care Services, Region 1 , Unit B 8517 E Trent Ave, Ste 102 Spokane Valley, WA 99212 This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 52798 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 2 of 3 Licensee: Spokane Valley AL, LLC 01/28/2025 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. Residential Care Services Date 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-2464 Background checks Process Background authorization form. Before the assisted living facility employs, directly or by contract, an administrator, staff person or caregiver, or accepts any volunteer, or student, the home must: (1) Require the person to complete a DSHS background authorization form; and (2) Submit to the department's background check central unit, including any additional documentation and information requested by the department. This requirement was not met as evidenced by: Based on interview, observation, and record review the facility failed to ensure a staff member completed a Department background authorization prior to employment for 1 of 3 staff members (Staff B). This failure put residents at risk of exposure to a staff member with no background information on file. Findings included… In an interview on 01/09/2025 at 9:51 AM, Staff B, Caregiver, stated that they had worked at the facility for 3 weeks. Staff B explained that they performed all 1 person cares (unsupervised) for residents who did not require a second staff’s help first and then did all 2 person cares with a second staff afterwards. In an observation on 01/09/2025 between 9:00 - 10:00 AM, Staff B was observed interacting with and assisting residents without supervision. Staff B was observed entering residents’ apartment without supervision. In a record review on 01/09/2025, Staff B’s personnel file showed no Department This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 52798 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 3 of 3 Licensee: Spokane Valley AL, LLC 01/28/2025 authorization for background check and did not contain any background information. In an interview on 01/09/2025 at 11:16 AM Staff C, Business Office Manager, stated that they did not know where the Department background authorization was for Staff B. 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, Trustwell Living at Ridgeview Place 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 This document was prepared by Residential Care Services for the Locator website.

This document was prepared by Residential Care Services for the Locator website. Residential Care Services Investigation Summary Report Provider/Facility: Trustwell Living at Provider Type: Assisted Living Facility Ridgeview Place License/Cert.#: 2730 Intake ID: 199377 Compliance Determination #: 67937 Region/Unit #: RCS Region 1 / Unit B Investigator: Brian Zbylski Investigation Date(s): 10/28/2025 through 10/29/2025 Complainant Contact Date(s): Allegation(s): Named resident fell and sustained an injury. Investigation Methods: Sample: Total residents: 44 Resident sample size: 7 Closed records sample size: 0 Observations: Resident appearance. Resident footwear and use of ambulatory aides. Pendant and call system. Environmental safety conditions. Staff assisting residents. Interviews: Current residents. Caregivers. Licensed nurse. Executive Director. Resident Care Wellness Coordinator. Record Reviews: Resident records including face sheets, assessments, service plans. Incident reports. Disclosure of Services. Resident Characteristic Roster. Staff List. Investigation Summary: The named resident sustained an injury from a fall. The facility took action to assess the resident and sent out for further medical evaluation. The facility investigated the incident. The resident's assessment and service plan reflected the current needs of the resident. Staff were aware of fall prevention interventions that were being used in the facility. There was a system in place to communicate residents' changes of conditions for frontline caregiving staff. Deficient practice not identified related to falls. The facility had a current COVID outbreak and was issued a citation due to not practicing infection control. Washington Administrative Code (WAC) 388- This document was prepared by Residential Care Services for the Locator website. 78A-2610 (1); (2-c,d) Infection control. Conclusion / Action: Failed Provider Practice Identified / Citation(s) Written Failed Provider Practice Not Identified / No Citation Written N/A This document was prepared by Residential Care Services for the Locator website. STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES AGING AND LONG-TERM SUPPORT ADMINISTRATION 8517 E Trent Ave, Ste 102, Spokane Valley, WA 99212 Statement of Deficiencies License #: 2730 Compliance Determination # 67937 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 1 of 4 Licensee: Spokane Valley AL, LLC 10/29/2025 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 10/28/2025 of: Trustwell Living at Ridgeview Place 12903 E Mission Ave Spokane Valley, WA 99216 This document references the following complaint number(s): 199377 The following sample was selected for review during the unannounced on-site visit: 7 of 44 current residents and 0 former residents. The department staff that investigated the Assisted Living Facility: Brian Zbylski, ALF Licensor From: DSHS, Aging and Long-Term Support Administration Residential Care Services, Region 1 , Unit B 8517 E Trent Ave, Ste 102 Spokane Valley, WA 99212 This document was prepared by Residential Care Services for the Locator website. This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 67937 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 2 of 4 Licensee: Spokane Valley AL, LLC 10/29/2025 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. Residential Care Services Date 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-2610 Infection control. (1) The assisted living facility must institute appropriate infection control practices in the assisted living facility to prevent and limit the spread of infections. (2) The assisted living facility must: (c) Maintain and provide staff persons with the necessary training, supplies, equipment, and personal protective equipment for preventing and controlling the spread of infections by: (d) Provide all resident care and services according to current acceptable standards for infection control; This requirement was not met as evidenced by: Based on observation, interview and record review, the facility failed to ensure that infection control interventions were implemented and recommended personal protective equipment was used by 3 of 3 staff (Staff C, D, and E) during a COVID outbreak. This failure resulted in staff members not wearing recommended respirators and placed the residents at risk of contracting a contagious virus. Findings included… Review of Washington State Department of Health recommendations for healthcare settings, dated June 2025, showed that healthcare workers should use a National Institute of Occupational Health and Safety approved respirator (N95) when providing care for patients with suspected or confirmed SARS-Co-V-2 [COVID, (contagious respiratory virus)]. This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 67937 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 3 of 4 Licensee: Spokane Valley AL, LLC 10/29/2025 Review of facility’s policy titled, “Infection Control: COVID-19 Policy and Procedure,” dated 02/15/2024, showed that staff were to use N95 respirators when caring for quarantined, positive, suspected or presumed positive residents. In an interview on 10/28/2025 at 12:30 PM, Staff A, Executive Director, stated that a total of five residents had tested positive for COVID on 10/27/2025 and 10/28/2025 in the Memory Care unit. In an interview on 10/28/2025 at 1:45 PM, Staff E, Resident Care Assistant, stated that there were currently five residents in the Memory Care unit that had tested positive for COVID, and that staff wore N95 respirators when they entered their private rooms. Observation at that time showed Staff E wearing a surgical mask. Observation on 10/28/2025 at 1:53 PM, showed Staff C, Medication Technician, wearing a surgical mask while they assisted Resident 2 in the Memory Care common area. At that time, Staff E was observed assisting Resident 1 in a wheelchair in the common area. An unidentified resident was also observed in the common area at that time. In an interview on 10/28/2025 at 1:55 PM, Staff C stated that Residents 1 and 2 tested positive for COVID and were unable to be quarantined in their private rooms due to their cognitive status. Staff C stated that they had not been fit-tested for an N95 respirator and had not been given any instructions to wear an N95 while in the common areas of the unit. Observation on 10/28/2025 at 1:55 PM, showed Staff D, Medication Technician, wearing a surgical mask in the common area of the Memory Care unit. In an interview on 10/28/2025 at 3:00 PM, Staff B, Health Services Director/Nurse, stated that staff were to wear “at least” a surgical mask during an outbreak, and to wear N95 respirators when they entered the private room of a resident positive with COVID. In an interview on 10/28/2025 at 3:40 PM, Staff A stated that they were responsible for performing staff fit-testing for N95 respirators upon hire and that Staff C, Staff D, and Staff E had not been fit- tested since their date of hire. This document was prepared by Residential Care Services for the Locator website. This document was prepared by Residential Care Services for the Locator website. Statement of Deficiencies License #: 2730 Compliance Determination # 67937 Plan of Correction Trustwell Living at Ridgeview Place Completion Date Page 4 of 4 Licensee: Spokane Valley AL, LLC 10/29/2025 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, Trustwell Living at Ridgeview Place 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 This document was prepared by Residential Care Services for the Locator website.