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Residential Care Services Investigation Summary Report
Provider/Facility: 1st Blissful Abode AFH (932692) Intake ID(s): 3247498
License/Cert. #: AF753012Investigator: Glover, Monika Region/Unit: RCS Region 2/Unit A Investigation
Date(s):07/21/201608/16/2016
through
Complainant Contact Date(s):Allegations:Allegation the Adult Family Home (AFH) provider is moving personal possessions from a named residents shared room afterrefusing to allow the named resident to return to the AFH after hospital discharge. The provider was observed to be " a littlemean" to the named resident's .
Investigation Methods:Sample: Named resident and 2
sample residentsObservations: Exterior and interior
environment, tour of AFH,staff/providerinteractions;staff/provider to residentinteractions; resident toresident interaction;visitor interaction withresidents; meal service;activities of residentpopulation.
Interviews: Named resident, sampleresident, provider, facilitystaff and those notaffiliated with facility.
Record Reviews: Named residents'records, sample residentrecords, medicationadministration reports,negotiated care plans,chart notes, medicalrecords, stateassessments, and allcomplaints related to theallegations.
Page 1 of 2
Residential Care Services Investigation Summary Report
Allegation Summary:The AFH provider failed to ensure that all residents were free of verbal and emotional abuse. The AFH also improperlydischarged 2 named residents. Failed practice was identified and cited.Also refer to intakes 3246019, 3250659 and 3250746
Unalleged Violation(s):Cited under WAC388-76-10670 Prevention of Abuse388-76-10680 Staff Behavior related to abuse388-76-10135 Caregiver qualifications388-76-10615 Resident Rights- transfer and discharge388-76-10400 Care and Services388-7610415 Food Services388-76-10420 Meals and Snacks
Yes No
Conclusion /Action:
Failed Provider Practice Identified /Citation(s) Written
Failed Provider Practice Not Identified /No Citation Written
Failed practice identified and cited
Page 2 of 2
Residential Care Services Investigation Summary Report
Provider/Facility: 1st Blissful Abode AFH (932692) Intake ID(s): 3246019
License/Cert. #: AF753012Investigator: Glover, Monika Region/Unit: RCS Region 2/Unit A Investigation
Date(s):07/21/201608/16/2016
through
Complainant Contact Date(s):Allegations:Allegation that the local hospital attempted to discharge the named resident back to the Adult Family Home (AFH) and theprovider refused to take resident back to AFH and would not provide the reason for refusal.
Investigation Methods:Sample: Named resident and
sample resident.Observations: Exterior and interior
environment tour of AFH,staff/provider andprovider/staffinteractions;staff/provider to residentinteractions; mealservice; activities ofresident population.
Interviews: Named resident, sampleresident, facility staff,provider, and those notaffiliated with the facility
Record Reviews: Named resident andsample resident records,discharge notices, chartnotes, medical records,negotiated care plans,state assessments, andall complaints related tothe allegation.
Allegation Summary:The AFH provider refused to accept the named resident back at the AFH, citing improper reasons for discharge. The AFH alsofailed to notify the named representative of the resident. Failed practice identified.Also refer to 3247498, 3250659 and 3250746.
Page 1 of 2
Residential Care Services Investigation Summary Report
Unalleged Violation(s):Cited under WAC388-76-10670 Prevention of Abuse388-76-10680 Staff Behavior related to abuse388-76-10135 Caregiver qualifications388-76-10615 Resident Rights- transfer and discharge388-76-10400 Care and Services388-76-10415 Food Services388-76-10420 Meals and Snacks
Yes No
Conclusion /Action:
Failed Provider Practice Identified /Citation(s) Written
Failed Provider Practice Not Identified /No Citation Written
Failed practice identified and cited.
Page 2 of 2
Residential Care Services Investigation Summary Report
Provider/Facility: 1st Blissful Abode AFH (932692) Intake ID(s): 3250659
License/Cert. #: AF753012Investigator: Glover, Monika Region/Unit: RCS Region 2/Unit A Investigation
Date(s):07/21/201608/16/2016
through
Complainant Contact Date(s):Allegations:Allegation the provider of the Adult Family Home (AFH) and her husband were yelling at named residents.
Investigation Methods:Sample: Named residents and
sample residentsObservations: Exterior and interior
environment tour of AFH,staff/provider andprovider/staffinteractions;staff/provider to residentinteractions; mealservice; activities ofresident population
Interviews: Named resident, sampleresident, provider, facilitystaff and those notaffiliated with facility.
Record Reviews: Named resident andsample resident records,discharge notices, chartnotes, medical records,negotiated care plans,state assessments, andall complaints related tothe allegation.
Allegation Summary:The provider of the AFH failed to prevent on-going verbal and emotional abuse. Findings resulted in failed practice and AFH wascited.Also refer intake no. 3246019, 3247498 and 3250746.
Page 1 of 2
Residential Care Services Investigation Summary Report
Unalleged Violation(s):Cited under WAC388-76-10670 Prevention of Abuse388-76-10680 Staff Behavior related to abuse388-76-10135 Caregiver qualifications388-76-10615 Resident Rights- transfer and discharge388-76-10400 Care and Services388-76-10415 Food Services388-76-10420 Meals and Snacks
Yes No
Conclusion /Action:
Failed Provider Practice Identified /Citation(s) Written
Failed Provider Practice Not Identified /No Citation Written
Failed practice identified and cited.
Page 2 of 2
Residential Care Services Investigation Summary Report
Provider/Facility: 1st Blissful Abode AFH (932692) Intake ID(s): 3250746
License/Cert. #: AF753012Investigator: Glover, Monika Region/Unit: RCS Region 2/Unit A Investigation
Date(s):07/21/201608/16/2016
through
Complainant Contact Date(s):Allegations:Allegation that a named resident at the Adult Family Home (AFH) self harmed and reported abuse at the AFH.
Investigation Methods:Sample: Named resident and
sample residents.Observations: Exterior and interior
environment tour of AFH,staff/provider andprovider/staffinteractions;staff/provider to residentinteractions; mealservice; activities ofresident population
Interviews: Named resident, sampleresident, provider, facilitystaff and those notaffiliated with facility.
Record Reviews: Named resident andsample resident records,discharge notices, chartnotes, medical records,negotiated care plans,state assessments, andall complaints related tothe allegation.
Allegation Summary:The named resident self-harmed and reported on-going verbal and mental abuse to 4 out of 4 residents in the AFH. Failedpractice was identified and cited.Also refer to intake 3246019, 3247498, 3250659.
Page 1 of 2
Residential Care Services Investigation Summary Report
Unalleged Violation(s):Cited under WAC388-76-10670 Prevention of Abuse388-76-10680 Staff Behavior related to abuse388-76-10135 Caregiver qualifications388-76-10615 Resident Rights- transfer and discharge388-76-10400 Care and Services388-76-10415 Food Services388-76-10420 Meals and Snacks
Yes No
Conclusion /Action:
Failed Provider Practice Identified /Citation(s) Written
Failed Provider Practice Not Identified /No Citation Written
Failed practice identified and cited.
Page 2 of 2
