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This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the...

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This document was prepared by Residential Care Services for the Locator website.
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Page 1: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's

This document w

as prepared by Residential Care Services for the Locator website.

Page 2: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's

Residential Care Services Investigation Summary Report

Provider/Facility: Faith Family Home (1121365) Intake ID(s): 3660405

License/Cert. #: AF753548Investigator: Hajek, Susan Region/Unit: RCS Region 2/Unit J Investigation

Date(s):07/24/201908/07/2019

through

Complainant Contact Date(s): 07/23/2019Allegations:#1. The adult family home failed to respond to requests for records.

Investigation Methods:Sample: Closed records Observations: Residents, internal and

external environmentInterviews: Entity Rep, Collateral

contactsRecord Reviews: Closed records

Allegation Summary:#1.Record review for two former residents showed the facility had not retained complete records for these former residents.

Unalleged Violation(s): Yes No

Conclusion /Action:

Failed Provider Practice Identified /Citation(s) Written

Failed Provider Practice Not Identified /No Citation Written

Citation written. See Statement of Deficiency dated 08/07/2019.

Page 1 of 1

This document was prepared by Residential Care Services for the Locator website.

Page 3: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's

This document w

as prepared by Residential Care Services for the Locator website.

Page 4: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's
Page 5: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's

This document w

as prepared by Residential Care Services for the Locator website.

Page 6: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's

This document w

as prepared by Residential Care Services for the Locator website.

Page 7: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's

This document w

as prepared by Residential Care Services for the Locator website.

Page 8: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's
Page 9: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's
Page 10: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's
Page 11: This do cument - Access Washington Home · Review of Department records on 07/23/19 showed the adult family home was licensed to this Entity on 01/03/2018. Review ofResident #2's

This document w

as prepared by Residential Care Services for the Locator website.


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