investigation summary report - washington not obtained from food bank, no expired food found at the...

Residential Care Services Investigation Summary Report

Provider/Facility: ABLE CARE ADULT FAMILY HOME(688832)

Intake ID(s): 3183653

License/Cert. #: AF751713Investigator: Miranda, Julie Region/Unit: RCS Region 2/Unit G Investigation

Date(s):04/27/201604/27/2016

through

Complainant Contact Date(s): 04/26/2016Allegations:Named resident told reporter that access driver that was hit by caregiver, feels safe to go back home but reporteris thinking about moving named resident to a new home, reporter has contacted named resident's family.

Investigation Methods:Sample: Named resident and 2

other residents at thehome.

Observations: One current resident atthe home, caregivers andProvider providing care toone resident and theirinteraction with theresident.

Interviews: One current resident atthe home, namedresident's collateralcontact, Provider andcaregivers.

Record Reviews: Named resident's and 2other current residents'records,caregivers'background checks.

Allegation Summary:Based on observations, interviews and record reviews, allegations of abuse were unsubstantiated on named resident and other 2residents at the home. Failed practice not identified.

Unalleged Violation(s):None.

Yes No

Conclusion /Action:

Failed Provider Practice Identified /Citation(s) Written

Failed Provider Practice Not Identified /No Citation Written

No failed practice.

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Date(s):04/27/201604/27/2016

through

Complainant Contact Date(s): 04/26/2016Allegations:1. Operations manager of a bus was told by the driver that named resident told her that was beaten in the head by acaregiver at the AFH. Driver did not notice any injuries nor the named resident requested any medical attention.

Investigation Methods:Sample: One current resident at

the home.Observations: One current resident at

the home, Provider,husband caregiver andcaregiver in trainingproviding care and theirinteraction with oneresident.

Interviews: One current resident atthe home, Provider,husband caregiver,caregiver in training,named resident'scollateral contact.

Record Reviews: Named resident's and 2other residents' records,Provider, caregivers'background checks,training documents,nurse delegationcertificates.

Allegation Summary:Based on observations, interviews and record reviews, allegations of abuse on named resident and other residents wereunsubstantiated. Collateral contact interview stated named resident informed her accidentally bumped head against thewall while was being assisted by caregivers and they couldn't get to on time. No injuries were sustained.

Unalleged Violation(s):None.

Yes No

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Date(s):04/27/201604/27/2016

through

Complainant Contact Date(s):Allegations:1. AFH never treat residents with respect and love, Provider and caregiver husband were weird, rude, mean, unkindly toresidents, abused residents physically and verbally.2. Depends, gloves, orajex 70% are being taken away and hiding them next door in the other house. Provider's husband hasbeen hiding the thrifty one and he's hiding all the good ones which are for their residents.3. Residents are served food from the food bank and are expired, there was no food for the residents only foods.4. A caregiver has no certificates at all, administering meds, not delegated, not an NAR, abusing named resident physically andemotionally.

Investigation Methods:Sample: Named resident and 2

other current residents atthe home.

Observations: One current resident atthe home, Provider andcaregivers providing careand their interaction withthe resident, kitchen andrefrigerator, residents'closets and supplies.

Interviews: One current resident atthe home, namedresident's collateralcontact, Provider,husband caregiver andone caregiver in training.

Record Reviews: Named resident's and 2other current residents'records, Provider andcaregivers' and noncaregiver's backgroundchecks, TB record,training records, nursedelegation trainingrecords.

Page 1 of 2


Allegation Summary:Based on observations, interviews and record reviews, allegations for abuse on named resident and other residents notsubstantiated, residents' supplies were provided adequately to residents, residents were served food as planned on daily menusand not obtained from food bank, no expired food found at the home's refrigerator.Citation written for Caregiver A's expired background check, Non Caregiving Staff observing care did not complete a Washingtonstate name and date of birth background check and TB test not completed.

Unalleged Violation(s):Citation written for Caregiver A's expired background check and not renewed every 2 years, Non Caregiving Staff did notcomplete a Washington state name and date of birth background check and TB test not completed.

Yes No

Conclusion /Action:



Citation written for Caregiver A's expired background check 388-76-10165-1 (a); Non Caregiving Staff did not complete aWashington state name and date of birth background check 388-76- 93) and a one step TB test not completed 388-76- 10280(2).

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Conclusion /Action:



No citations written.

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investigation summary report - washington not obtained from food bank, no expired food found at the...

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