Investigation Summary Report - Washington · Replacement tiles were ordered, had recently arrived at the facility, and were scheduled for replacement. No failed practice identified

Residential Care Services Investigation Summary Report

Provider/Facility: Cherrywood Place (1118321) Intake ID(s): 3680784

License/Cert. #: AL2434Investigator: Soper, Michael Region/Unit: RCS Region 1/Unit B Investigation

Date(s):11/26/201901/03/2020

through

Complainant Contact Date(s): 01/07/2020, 12/11/2019Allegations:1) The facility's parent company filed for chapter 11 bankruptcy.

Investigation Methods:Sample: 14 current residents. Observations: General environment.

Resident abilities,comfort, & safety.Staff interactions withresidents.Utilities (electricity &water).Food availability.Kitchen and laundryappliances.Housekeeping supplies.Care supplies.Building maintenance.Staffing patterns andscheduling.

Interviews: 3 current residents.1 regional director.1 assistant regionaldirector.1 administrator.1 life enrichmentcoordinator.1 resident carecoordinator.1 kitchen manager.

Record Reviews: Assessments & careplans.Facility work orders.

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as prepared by Residential Care Services for the Locator website.


1 housekeeping manager.2 caregivers/ medicationtechnicians.1 housekeeper.

Allegation Summary:1) The parent company of the facility filed for chapter 11 bankruptcy. The facility was reviewed for functioning utilities, foodavailability, functioning appliances and tools, housekeeping and resident care supplies, building maintenance, and staffingpatterns and scheduling. No deficiencies directly related to the Chapter 11 filing were discovered. See unalleged violations formore information.

Unalleged Violation(s):1) Two resident toilet seats were not secure and were in unsafe condition. Citation issued. See conclusion for details.2) Two ceiling tiles had water and structural damage in a resident area. The water source had been repaired. Replacement tileswere ordered, had recently arrived at the facility, and were scheduled for replacement. No failed practice identified.3) A washing machine in the 2nd floor, resident laundry room leaked water and bleach onto the floor. The cause was determinedto be a supply hose that fell behind the washer. Maintenance immediately repaired the deficiency. No failed practice identified.4) The water temperature in the 3rd floor, resident laundry room was 101 degrees Fahrenheit at the utility sink outlet. The watertemperature should be maintained between 105-120 degrees for resident accessible areas. Facility management was notified ofthe deficiency and no citation was issued on this occasion according to Department procedures and a recent full inspection thataddressed this issue.5) The bleach dispenser was empty in one of the washing machines in the 3rd floor, resident laundry room. Bleach was refilledby staff. No failed practice identified.6) Chemical supplies were left unattended on a housekeeping cart and accessible to residents. Staff were able to identify safeprocedures for chemical storage and that chemicals should not be left unattended. Management immediately corrected thedeficiency and held a staff in-service for all housekeepers. No residents were harmed and there was no negative outcome.Residents had no complaints about housekeeping services. Consultation issued. See conclusion for details.

Yes No

Conclusion /Action:

Failed Provider Practice Identified /Citation(s) Written

Failed Provider Practice Not Identified /No Citation Written

Deficient practice was cited for an unalleged violation under statement of deficiencies dated 01/03/20 related to WAC 388-78A-3090, Maintenance and Housekeeping, related to unsecure toilet seats. Deficient practice was cited as a consultation understatement of deficiencies dated 01/03/20 related to WAC 388-78A-3100, Safe Storage of Supplies and Equipment, related tounattended housekeeping supplies.

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License/Cert. #: AL2434Investigator: Sturtevant, Kelly Region/Unit: RCS Region 1/Unit B Investigation

Date(s):12/27/201901/03/2020

through

Complainant Contact Date(s): 01/17/2020, 12/27/2019Allegations:1. Residents haven't had any showers due to no hot water for the past two weeks; the facility was going to bus residentssomewhere for showers.

Investigation Methods:Sample: 16 current residents Observations: Overall appearance of

residents, hot watertemperatures

Interviews: Residents, staff, othersnot associated with thefacility

Record Reviews: Facility repairstatements, facilitytemperature logs

Allegation Summary:The investigation revealed the facility had been without water for the past 5-6 days due to a leak in the pipe and then a mixingvalve malfunction. The facility had called a plumber to fix the issue. The facility arranged after 5 days to allow residents to go toa sister facility for showers which some refused. Residents stated the hot water had been an issue for the past year. Residentsstated staff did not fix maintenance issues timely and did not give the impression it was important to fix them timely.

Unalleged Violation(s): Yes No

Conclusion /Action:



Citation was written for WAC 388-78A-3090 Housekeeping and Maintenance due to the delay in response to fix maintenanceissues. See Statement of Deficiencies dated 01/03/2020.

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License/Cert. #: AL2434Investigator: Sturtevant, Kelly Region/Unit: RCS Region 1/Unit B Investigation

Date(s):12/27/201901/03/2020

through

Complainant Contact Date(s): 01/17/2020, 12/27/2019Allegations:1. No hot water for showers and has been fluctuating for the last few weeks; beginning of the year without consistent hot waterfor three months.2. No regular maintenance workers and others are sent from sister facility occasionally.

Investigation Methods:Sample: 16 current residents Observations: Overall appearance of

residents, hot watertemperatures

Interviews: Residents, Staff, othersnot associated with thefacility

Record Reviews: Facility repairstatements, facilitytemperature logs

Allegation Summary:1. The investigation revealed the facility had been without water for the past 5-6 days due to a leak in the pipe and then amixing valve malfunction. The facility had called a plumber to fix the issue. The facility arranged after 5 days to allow residentsto go to a sister facility for showers which some refused. Residents stated the hot water had been an issue for the past year.Residents stated staff did not fix things timely and did not give the impression it was important to fix things timely.2. The facility was actively advertising for maintenance staff but had not hired anyone to date. The maintenance staff from thesister facility came and did tasks when needed and the administrator and care staff attempted to fix things when maintenancewas not available. Maintenance issues were not addressed timely.

Unalleged Violation(s): Yes No

Conclusion /Action:



Citation was written for WAC 388-78A-3090 Housekeeping and Maintenance due to the delay in response to fix maintenanceissues. See Statement of Deficiencies dated 01/03/2020.

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Investigation Summary Report - Washington · Replacement tiles were ordered, had recently arrived at the facility, and were scheduled for replacement. No failed practice identified