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Page 1: dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · Residential Care Services, Region 2, Unit E 20425 72nd Avenue S, Suite 400 Kent, WA 98032-2388 (253)234-6033 As a result of the

This document w

as prepared by Residential Care Services for the Locator website.

Page 2: dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · Residential Care Services, Region 2, Unit E 20425 72nd Avenue S, Suite 400 Kent, WA 98032-2388 (253)234-6033 As a result of the

This document w

as prepared by Residential Care Services for the Locator website.

Page 3: dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · Residential Care Services, Region 2, Unit E 20425 72nd Avenue S, Suite 400 Kent, WA 98032-2388 (253)234-6033 As a result of the

This document w

as prepared by Residential Care Services for the Locator website.

Page 4: dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · Residential Care Services, Region 2, Unit E 20425 72nd Avenue S, Suite 400 Kent, WA 98032-2388 (253)234-6033 As a result of the
Page 5: dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · Residential Care Services, Region 2, Unit E 20425 72nd Avenue S, Suite 400 Kent, WA 98032-2388 (253)234-6033 As a result of the

This document w

as prepared by Residential Care Services for the Locator website.


dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · qualifications. Allegation Summary: 1) Prior to fall, Named Resident recognized need to toilet and walked with and without assistive

dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · Residential Care Services Investigation Summary Report assessment and care plans Allegation Summary: Named resident (AV) was admitted

dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · Provider/Facility: Amber Waves ALF LLC (878473) Intake ID(s): 3687978 License/Cert. #: AL2324 Investigator: Webster, Brenda Region/Unit:RCS

dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · 2019-08-22 · Record review revealed Volunteer A had a Washington State Name and Date of Birth background check and no documentation

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dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · Licensee: WRG PHASE 1 Completion Date October 16, 2017 Per WAC (Washington Administrative Code) 388-112-0207(1), all long-term

dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · The Provider stated he had bronchitis but acknowledged and trying to was an issue since admission and the doctor had been notified

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dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X...Page 2 of 4 License #: 630300 COLE ADULT FAMILY HOME Licensee: ELSIE COLE Completion Date August 19, 2019 WAC 388-76-10355 Negotiated

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dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · 2019-10-15 · DEPARTMENT OF SOCIAL AND HEALTH SERVICES AGING AND LONG-TERM SUPPORT ADMINISTRATION 20425 72nd Avenue S, suite 400,

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dZ] } µu v Á ÇZ ] v ]o ^ À] (} Z >} } Á ] X · Provider/Facility: Hearthside Manor (699683) Intake ID(s): 3355204 License/Cert. #: AL2142 Investigator: Goulet, Michael Region/Unit:RCS

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