Residential Care Services Investigation Summary Report

Provider/Facility: ANGEL ADULT FAMILY HOME CARELLC (709699)

Intake ID(s): 3241586, 3245528

License/Cert. #: AF752282Investigator: Boyer, Robin Region/Unit: RCS Region 2/Unit E Investigation

Date(s):07/11/201609/01/2016

through

Complainant Contact Date(s):Allegations:1. Allegations of verbal abuse by staff to a named resident2. Allegations of misappropriation of belongings of a named resident

Investigation Methods:Sample: one former named

residenttwo current residents

Observations: two current residents andinteractions with staffduring care deliveryobservation of staffpreparing a meal forresidents

Interviews: one former residenttwo current residentstwo staff members

Record Reviews: chart review of twocurrent residentschart review of oneformer resident

Allegation Summary:1. In separate and repeated interviews, each of the current residents denied verbal abuse by staff. Each resident stated they feltsafe in the Adult Family Home (AFH). Observation of staff-resident interactions during delivery of care services found nodisrespect or raised voices to residents by staff members.2. Observation within the AFH found no storage of any belongings described by the former resident. In separate interviews, eachstaff member reported all belongings of the former resident were packed and sent to the new address for that resident. Reviewof the chart of the former resident revealed no signature and date at discharge for receipt of all belongings. Staff reported theformer resident refused to sign the document during the discharge process. Additional review of the chart of the former residentrevealed diagnoses including and sporadic refusal of medications prescribed this condition.

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Residential Care Services Investigation Summary Report

Unalleged Violation(s):WAC 388-76-10255 - lack of written policy and consistent implementation of food handling practices, specifically hand washingstandards.WAC 388-76-10375 - lack of compliance to obtain signature of residents for care plan initiation and update in a timely mannerWAC 388-76-10430 - lack of process for meeting resident needs for medication documentation in a timely manner for as neededpain relief medication administration and follow-up

Yes No

Conclusion /Action:

Failed Provider Practice Identified /Citation(s) Written

Failed Provider Practice Not Identified /No Citation Written

WAC 388-76-10255WAC 388-76-10375WAC 388-76-10430

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