Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › GENERAL › Section 388-78A-2020 - Definitions

Current through Register Vol. 24-14, July 15, 2024
"Abandonment"
means action or inaction by a
					 person with a duty of care for a vulnerable adult that leaves the vulnerable
					 person without the means or ability to obtain necessary food, clothing,
					 shelter, or health care.
"Abuse"
means the willful action or inaction
					 that inflicts injury, unreasonable confinement, intimidation, or punishment on
					 a vulnerable adult. In instances of abuse of a vulnerable adult who is unable
					 to express or demonstrate physical harm, pain, or mental anguish, the abuse is
					 presumed to cause physical harm, pain, or mental anguish. Abuse includes sexual
					 abuse, mental abuse, physical abuse, and personal exploitation of a vulnerable
					 adult, and improper use of restraint against a vulnerable adult, which have the
					 following meanings:
(1)
"Sexual abuse"
means any form of
					 nonconsensual sexual conduct, including, but not limited to, unwanted or
					 inappropriate touching, rape, sodomy, sexual coercion, sexually explicit
					 photographing, and sexual harassment. Sexual abuse also includes any sexual
					 conduct between a staff person, who is not also a resident or a client, of a
					 facility or a staff person of a program authorized under chapter 71A.12 RCW,
					 and a vulnerable adult living in that facility or receiving service from a
					 program authorized under chapter 71A.12 RCW, whether or not it is
					 consensual.
(2)
"Physical abuse"
means the willful action
					 of inflicting bodily injury or physical mistreatment. Physical abuse includes,
					 but is not limited to, striking with or without an object, slapping, pinching,
					 choking, kicking, shoving, or prodding.
(3)
"Mental abuse"
means a willful verbal or
					 nonverbal action that threatens, humiliates, harasses, coerces, intimidates,
					 isolates, unreasonably confines, or punishes a vulnerable adult. Mental abuse
					 may include ridiculing, yelling, or swearing.
(4)
"Personal exploitation"
means an act of
					 forcing, compelling, or exerting undue influence over a vulnerable adult
					 causing the vulnerable adult to act in a way that is inconsistent with relevant
					 past behavior, or causing the vulnerable adult to perform services for the
					 benefit of another.
(5) "
Improper use of restraint
" means the
					 inappropriate use of chemical, physical, or mechanical restraints for
					 convenience or discipline or in a manner that:
(a) Is inconsistent with federal or state licensing or
					 certification requirements for facilities, hospitals, or programs authorized
					 under chapter 71A.12 RCW;
(b) Is not medically authorized; or
(c) Otherwise constitutes abuse under the section.
"Activities of daily living"
means the
					 following tasks related to basic personal care: Bathing; toileting; dressing;
					 personal hygiene; mobility; transferring; and eating.
"Administrator"
means an assisted living
					 facility administrator who must be in active administrative charge of the
					 assisted living facility as required in this chapter. Unless exempt under
					 RCW
					 18.88B.041, the administrator must complete
					 long-term care training and home care aide certification.
"Adult day services"
means care and services
					 provided to a nonresident individual by the assisted living facility on the
					 assisted living facility premises, for a period of time not to exceed ten
					 continuous hours, and does not involve an overnight stay.
"Ambulatory"
means capable of walking or
					 traversing a normal path to safety without the physical assistance of another
					 individual:
(1)
"Nonambulatory"
means unable to walk or
					 traverse a normal path to safety without the physical assistance of another
					 individual;
(2)
"Semiambulatory"
means physically and
					 mentally capable of traversing a normal path to safety with the use of mobility
					 aids, but unable to ascend or descend stairs without the physical assistance of
					 another individual.
"Applicant"
means a person, as defined in this
					 section, that has submitted, or is in the process of submitting, an application
					 for an assisted living facility license.
"
Assisted living facility
" means any home or
					 other institution, however named, that is advertised, announced, or maintained
					 for the express or implied purpose of providing housing, basic services, and
					 assuming general responsibility for the safety and well-being of the residents,
					 and may also provide domiciliary care, consistent with this chapter to seven or
					 more residents after July 1, 2000. However, an assisted living facility that is
					 licensed for three to six residents prior to or on July 1, 2000, may maintain
					 its assisted living facility license as long as it is continually licensed as
					 an assisted living facility. "Assisted living facility" may also include
					 persons associated with the assisted living facility to carry out its duties
					 under this chapter. "Assisted living facility" does not include facilities
					 certified as group training homes under
					 RCW
					 71A.22.040, nor any home, institution, or
					 section that is otherwise licensed and regulated under state law that provides
					 specifically for the licensing and regulation of that home, institution, or
					 section. "Assisted living facility" also does not include independent senior
					 housing, independent living units in continuing care retirement communities, or
					 other similar living situations including those subsidized by the U.S.
					 Department of Housing and Urban Development.
"Basic services"
means housekeeping services,
					 meals, nutritious snacks, laundry, and activities.
"Bathing fixture"
means a bathtub, shower or
					 sit-down shower.
"Bathroom"
means a room containing at least
					 one bathing fixture.
"Building code"
means the building codes and
					 standards adopted by the Washington state building code council.
"Caregiver"
means anyone providing direct
					 personal care to another person including, but not limited to: Cuing,
					 reminding, or supervision of residents, on behalf of an assisted living
					 facility, except volunteers who are directly supervised.
"Construction review services"
means the
					 office of construction review services within the Washington state department
					 of health.
"Continuing care contract"
means, as stated in
					 RCW
					 70.38.025, a contract providing a person, for
					 the duration of that person's life or for a term in excess of one year, shelter
					 along with nursing, medical, health-related, or personal care services, which
					 is conditioned upon the transfer of property, the payment of an entrance fee to
					 the provider of such services, or the payment of periodic charges for the care
					 and services involved. A continuing care contract is not excluded from this
					 definition because the contract is mutually terminable or because shelter and
					 services are not provided at the same location.
"Continuing care retirement community"
means,
					 as stated in
					 RCW
					 70.38.025, an entity which provides shelter
					 and services under continuing care contracts with its members and which
					 sponsors or includes a health care facility or a health service.
"Contractor"
means an agency or person who
					 contracts with a licensee to provide resident care, services, or
					 equipment.
"Crimes relating to financial exploitation"
means the same as "crimes relating to financial exploitation" as defined in
					 RCW
					 43.43.830 or
					 43.43.842.
"Department"
means the Washington state
					 department of social and health services.
"Dietitian"
means an individual certified
					 under chapter 18.138 RCW.
"Direct supervision"
means oversight by a
					 person on behalf of the assisted living facility who has met training
					 requirements, demonstrated competency in core areas, or has been fully exempted
					 from the training requirements, is on the premises, and is quickly and easily
					 available to the caregiver.
"Document"
means to record, with signature,
					 title, date, and time:
(1) Information about medication administration, medication
					 assistance or disposal, a nursing care procedure, accident, occurrence or
					 change in resident condition that may affect the care or needs of a resident;
					 and
(2) Processes, events, or activities that are required by
					 law, rule, or policy.
"Domiciliary care"
means:
(1) Assistance with activities of daily living provided by
					 the assisted living facility either directly or indirectly;
(2) Health support services, if provided directly or
					 indirectly by the assisted living facility; or
(3) Intermittent nursing services, if provided directly or
					 indirectly by the assisted living facility.
"Enforcement remedy"
means one or more of the
					 department's responses to an assisted living facility's non-compliance with
					 chapter 18.20 RCW and this chapter, as authorized by
					 RCW
					 18.20.190.
"Financial exploitation"
means the illegal or
					 improper use, control over, or withholding of the property, income, resources,
					 or trust funds of the vulnerable adult by any person or entity for any person's
					 or entity's profit or advantage other than for the vulnerable adult's profit or
					 advantage. Some examples of financial exploitation are given in RCW
					 74.34.-020(6).
"Food service worker"
means according to
					 chapter 246-217 WAC, an individual who works (or intends to work) with or
					 without pay in a food service establishment and handles unwrapped or unpackaged
					 food or who may contribute to the transmission of infectious diseases through
					 the nature of the individual's contact with food products or equipment and
					 facilities. This does not include persons who simply assist residents with
					 meals.
"General responsibility for the safety and well-being
					 of the resident"
means the provision of any one or more of the
					 following:
(1) Prescribed general low sodium diets;
(2) Prescribed general diabetic diets;
(3) Prescribed mechanical soft foods;
(4) Emergency assistance;
(5) Monitoring of the resident;
(6) Arranging health care appointments with outside health
					 care providers and reminding residents of such appointments as
					 necessary;
(7) Coordinating health care services with outside health
					 care providers consistent with WAC
					 388-78A-2350;
(8) Assisting the resident to obtain and maintain glasses,
					 hearing aids, dentures, canes, crutches, walkers, wheelchairs, and assistive
					 communication devices;
(9) Observation of the resident for changes in overall
					 functioning;
(10) Blood pressure checks as scheduled;
(11) Responding appropriately when there are observable or
					 reported changes in the resident's physical, mental, or emotional
					 functioning;
(12) Medication assistance as permitted under
					 RCW
					 69.41.085 and as described in
					 RCW
					 69.41.010 and chapter 246-888 WAC.
"Harm"
means a physical or mental or emotional
					 injury or damage to a resident including those resulting from neglect or
					 violations of a resident's rights.
"Health support services"
means any of the
					 following optional services:
(1) Blood glucose testing;
(2) Puree diets;
(3) Calorie controlled diabetic diets;
(4) Dementia care;
(5) Mental health care;
(6) Developmental disabilities care.
"Independent living unit"
means:
(1) Independent senior housing;
(2) Independent living unit in a continuing care retirement
					 community or other similar living environments;
(3) Assisted living facility unit where domiciliary
					 services are not provided; or
(4) Assisted living facility unit where one or more items
					 listed under "general responsibilities" are not provided.
"Independent senior housing"
means an
					 independent living unit occupied by an individual or individuals sixty or more
					 years of age.
"Infectious"
means capable of causing
					 infection or disease by entrance of organisms into the body, which grow and
					 multiply there, including, but not limited to, bacteria, viruses, protozoans,
					 and fungi.
"Licensee"
means a person, as defined in this
					 section, to whom the department issues an assisted living facility
					 license.
"Licensed resident bed capacity"
means the
					 resident occupancy level requested by a licensee and approved by the
					 department. All residents receiving domiciliary care or the items or services
					 listed under general responsibility for the safety and well-being of the
					 resident as defined in this section count towards the licensed resident bed
					 capacity. Adult day services clients do not count towards the licensed resident
					 bed capacity.
"Long-term care worker"
or
					 "
caregiver
" means the same as "long-term care workers" is defined
					 in
					 RCW
					 74.39A.009.
"Majority owner"
means any person that
					 owns:
(1) More than fifty percent interest;
(2) If no one person owns more than fifty percent interest,
					 the largest interest portion; or
(3) If more than one person owns equal largest interest
					 portions, then all persons owning those equal largest interest portions.
"Manager"
means a person, as defined in this
					 section, that provides management services on behalf of a licensee.
"Management agreement"
means a written,
					 executed agreement between a licensee and manager regarding the provision of
					 certain services on behalf of the licensee.
"Mandated reporter:
"
(1) Is an employee of the department, law enforcement
					 officer, social worker, professional school personnel, individual provider,
					 employee of a facility, operator of a facility, employee of a social service,
					 welfare, mental health, adult day health, adult day care, home health, home
					 care, or hospice agency, county coroner or medical examiner, Christian Science
					 practitioner, or health care provider subject to chapter 18.130 RCW; and
(2) For the purpose of the definition of mandated reporter,
					 "facility" means a residence licensed or required to be licensed under chapter
					 18.20 RCW (assisted living facility), chapter 18.51 RCW (nursing homes),
					 chapter 70.128 RCW (adult family homes), chapter 72.36 RCW (soldiers' homes),
					 chapter 71A.20 RCW (residential habilitation centers), or any other facility
					 licensed by the department.
"Maximum facility capacity"
means the maximum
					 number of individuals that the assisted living facility may serve at any one
					 time, as determined by the department.
(1) The maximum facility capacity includes all residents,
					 respite care residents, and adult day services clients.
(2) The maximum facility capacity is equal to the lesser
					 of:
(a) The sum of the number of approved bed spaces for all
					 resident rooms (total number of approved bed spaces), except as specified in
					 subsection (3) of this section;
(b) Twice the seating capacity of the dining area(s)
					 consistent with WAC
					 388-78A-2300(1)(h);
(c) The number of residents permitted by calculating the
					 ratios of toilets, sinks, and bathing fixtures to residents consistent with WAC
					 388-78A-3030;
(d) For assisted living facilities licensed on or before
					 December 31, 1988, the total day room area in square feet divided by ten square
					 feet, consistent with WAC
					 388-78A-3050; or
(e) For assisted living facilities licensed after December
					 31, 1988, the total day room area in square feet divided by twenty square feet,
					 consistent with WAC
					 388-78A-3050.
(3) For the purposes of providing adult day services
					 consistent with WAC
					 388-78A-2360,
					 one additional adult day services client may be served, beyond the total number
					 of approved bed spaces, for each additional sixty square feet of day room area
					 greater than the area produced by multiplying the total number of approved bed
					 spaces by twenty square feet, provided that:
(a) There is at least one toilet and one hand washing sink
					 accessible to adult day services clients for every eight adult day services
					 clients or fraction thereof;
(b) The total number of residents and adult day services
					 clients does not exceed twice the seating capacity of the dining area(s)
					 consistent with WAC
					 388-78A-2300(1)(h);
					 and
(c) The adult day services program area(s) and building do
					 not exceed the occupancy load as determined by the local building official or
					 state fire marshal.
"Medication administration"
means the direct
					 application of a prescribed medication whether by injection, inhalation,
					 ingestion, or other means, to the resident's body by an individual legally
					 authorized to do so.
"Medication assistance"
means assistance with
					 self-administration of medication rendered by a nonpractitioner to a resident
					 of an assisted living facility in accordance with chapter 246-888 WAC.
"Medication organizer"
means a container with
					 separate compartments for storing oral medications organized in daily
					 doses.
"Medication service"
means any service
					 provided either directly or indirectly by an assisted living facility related
					 to medication administration, medication administration provided through nurse
					 delegation, medication assistance, or resident self-administration of
					 medication.
"Neglect"
means:
(1) A pattern of conduct or inaction resulting in the
					 failure to provide the goods and services that maintain physical or mental
					 health of a resident, or that fails to avoid or prevent physical or mental harm
					 or pain to a resident; or
(2) An act or omission by a person or entity with a duty of
					 care that demonstrates a serious disregard of consequences of such a magnitude
					 as to constitute a clear and present danger to the resident's health, welfare,
					 or safety, including but not limited to conduct prohibited under
					 RCW
					 9A.42.100.
"Nonresident individual"
means an individual
					 who resides in independent senior housing, independent living units in
					 continuing care retirement communities, other similar living environment, or an
					 unlicensed room located within an assisted living facility. A nonresident
					 individual must not receive from the assisted living facility:
(1) Domiciliary care directly or indirectly; or
(2) Items or services listed in the definition of "general
					 responsibility for the safety and well-being of the resident," except as
					 allowed under WAC
					 388-78A-2032
					 or when the person is receiving adult day services.
"Nonpractitioner"
means any individual who is
					 not a practitioner as defined in WAC 388-78A-2020 and chapter 69.41 RCW.
"Nurse"
means an individual currently licensed
					 under chapter 18.79 RCW as either a:
(1)
Licensed practical nurse
(LPN); or
(2)
Registered nurse
(RN).
"Over-the-counter (OTC) medication"
means any medication that may
					 be legally purchased without a prescriptive order, including, but not limited
					 to, aspirin, antacids, vitamins, minerals, or herbal preparations.
"Person"
means any individual, firm,
					 partnership, corporation, company, association, joint stock association or any
					 other legal or commercial entity.
"Physician"
means an individual licensed under
					 chapter 18.57 or 18.71 RCW.
"Practitioner"
includes a licensed physician,
					 osteo-pathic physician, podiatric physician, pharmacist, licensed practical
					 nurse, registered nurse, advanced registered nurse practitioner, dentist, and
					 physician assistant. Refer to chapter 69.41 RCW for a complete listing of
					 practitioners.
"Prescribed medication"
means any medication
					 (legend drug, controlled substance, and over-the-counter) that is prescribed by
					 an authorized practitioner.
"Prescriber"
means a health care practitioner
					 authorized by Washington state law to prescribe drugs.
"Problem"
means a violation of any WAC or RCW
					 applicable to the operation of an assisted living facility:
(1)
"Recurring problem"
means, for all
					 purposes other than those described in
					 RCW
					 18.20.400, that the department has cited the
					 assisted living facility for a violation of WAC or RCW and the circumstances of
					 either (a) or (b) of this subsection are present. If the previous violation in
					 (a) or (b) of this subsection was pursuant to WAC or RCW that has changed at
					 the time of the new violation, citation to the equivalent current WAC or RCW
					 section is sufficient. When there is a change in licensees between the first
					 and the second or third citations, the new licensee must accept, and the
					 department will consider, the prior licensee's compliance and enforce-men t r
					 ec ord as par t of the n ew licensee's compliance record at that assisted
					 living facility if any person affiliated with the new licensee was affiliated
					 with the prior licensee at the same assisted living facility. A person is
					 considered affiliated with the licensee if the person is an applicant for the
					 assisted living facility license, or is listed on the license application as a
					 partner, officer, director, or majority owner of the applicant.
(a) The department previously imposed an enforcement remedy
					 for a violation of the same section of WAC or RCW for substantially the same
					 problem following any type of inspection within the preceding thirty-six
					 months.
(b) The department previously cited a violation under the
					 same section of WAC or RCW for substantially the same problem following any
					 type of inspection on two occasions within the preceding thirty-six
					 months.
(2)
"Serious problem"
means that there has
					 been a violation of a WAC or RCW and:
(a) The resident was significantly harmed; or
(b) It is likely that the resident will be significantly
					 harmed or die.
(3)
"Uncorrected problem"
means the department
					 has cited a violation of WAC or RCW following any type of inspection and the
					 violation remains uncorrected at the time the department makes a subsequent
					 inspection for the specific purpose of verifying whether such violation has
					 been corrected. When there is a change in licensee, the new licensee is
					 responsible for correcting any remaining violations that may exist, including
					 complying with any plan of correction in effect immediately prior to the change
					 in licensee.
"Prospective resident"
means an individual who
					 seeks admission to a licensed assisted living facility and has completed and
					 signed an application for admission, or the individual's legal representative
					 or designated representative, if any, completed and signed the application on
					 their behalf.
"Reasonable accommodation"
or
"reasonably accommodate"
have the meaning given in federal and
					 state antidiscrimination laws and regulations which include, but are not
					 limited to, the following:
(1) Reasonable accommodation means that the assisted living
					 facility must:
(a) Not impose admission criteria that excludes individuals
					 unless the criteria is necessary for the provision of assisted living facility
					 services;
(b) Make reasonable modification to its policies, practices
					 or procedures if the modifications are necessary to accommodate the needs of
					 the resident;
(c) Provide additional aids and services to the resident.
					 (2) Reasonable accommodations are not required if:
(a) The resident or individual applying for admission
					 presents a significant risk to the health or safety of others that cannot be
					 eliminated by the reasonable accommodation;
(b) The reasonable accommodations would fundamentally alter
					 the nature of the services provided by the assisted living facility; or
(c) The reasonable accommodations would cause an undue
					 burden, meaning a significant financial or administrative burden.
"RCW"
means Revised Code of Washington.
"Records"
means:
(1)
"Active records"
means the current,
					 relevant documentation regarding residents necessary to provide care and
					 services to residents; or
(2)
"Inactive records"
means historical
					 documentation regarding the provision of care and services to residents that is
					 no longer relevant to the current delivery of services and has been thinned
					 from the active record.
"Resident"
means an individual who:
(1) Chooses to reside in an assisted living facility,
					 including an individual receiving respite care;
(2) Is not related by blood or marriage to the operator of
					 the assisted living facility;
(3) Receives basic services; and
(4) Receives one or more of the services listed in the
					 definition of "general responsibility for the safety and well-being of the
					 resident," and may receive domiciliary care or respite care provided directly,
					 or indirectly, by the assisted living facility. Whereas, a nonresident
					 individual may receive services that are permitted under WAC
					 388-78A-2032.
"Resident's representative"
means one of the
					 following:
(1) The legal representative who is the person or persons
					 identified in
					 RCW
					 7.70.065 and who may act on behalf of the
					 resident pursuant to the scope of their legal authority. The legal
					 representative must not be affiliated with the licensee, assisted living
					 facility, or management company, unless the affiliated person is a family
					 member of the resident.
(2) If there is no legal representative, a person
					 designated voluntarily by a competent resident in writing, to act in the
					 resident's behalf concerning the care and services provided by the assisted
					 living facility and to receive information from the assisted living facility if
					 there is no legal representative. The resident's representative must not be
					 affiliated with the licensee, assisted living facility, or management company,
					 unless the affiliated person is a family member of the resident. The resident's
					 representative under this subsection must not have authority to act on behalf
					 of the resident once the resident is no longer competent. The resident's
					 competence must be determined using the criteria in
					 RCW
					 11.88.010(1)(e).
"Respite care"
means short-term care for any
					 period in excess of twenty-four continuous hours for a resident to temporarily
					 relieve the family or other caregiver of providing that care.
"Restraint"
means any method or device used to
					 prevent or limit free body movement, including, but not limited to:
(1) Confinement, unless agreed to as provided in WAC
					 388-78A-2370;
(2)
"Chemical restraint"
means the
					 administration of any drug to manage a vulnerable adult's behavior in a way
					 that reduces the safety risk to the vulnerable adult or others, has the
					 temporary effect of restricting the vulnerable adult's freedom of movement, and
					 is not standard treatment for the vulnerable adult's medical or psychiatric
					 condition.
(3)
"Mechanical restraint"
means any device
					 attached or adjacent to the vulnerable adult's body that they cannot easily
					 remove and restricts freedom of movement or normal access to the vulnerable
					 adult's body. "Mechanical restraint" does not include the use of devices,
					 materials, or equipment that are:
(a) Medically authorized, as required, and;
(b) Used in a manner that is consistent with federal or
					 state licensing or certification requirements for facilities, hospitals, or
					 programs authorized under chapter 71A.12 RCW.
(4) "
Physical restraint
" means the application
					 of physical force without the use of any device, for the purpose of restraining
					 the free movement of a vulnerable adult's body. "Physical restraint" does not
					 include:
(a) Briefly holding without undue force a vulnerable adult
					 in order to calm or comfort the vulnerable adult; or
(b) Holding a vulnerable adult's hand to safely escort the
					 vulnerable adult from one area to another.
"Room"
means a space set apart by floor to
					 ceiling partitions on all sides with all openings provided with doors or
					 windows.
(1)
"Sleeping room"
means a room where a
					 resident is customarily expected to sleep and contains a resident's bed.
(2)
"Resident living room"
means the common
					 space in a resident unit that is not a sleeping room, bathroom, or
					 closet.
"Significant change"
means a change in the
					 resident's physical, mental, or psychosocial status that causes either
					 life-threatening conditions or clinical complications.
"Special needs"
means a developmental
					 disability, mental illness, or dementia.
"Staff person"
means any assisted living
					 facility employee, temporary employee, or contractor, whether employed or
					 retained by the licensee or any management company or volunteer.
"State fire marshal"
means the director of
					 fire protection under the direction of the chief of the Washington state
					 patrol.
"Toilet"
means a disposal apparatus used for
					 urination and defecation fitted with a seat and flushing device.
"Volunteer"
means an individual who interacts
					 with residents without reimbursement.
"Vulnerable adult"
includes a person:
(1) Sixty years of age or older who has the functional,
					 mental, or physical inability to care for themselves;
(2) Found incapacitated under chapter 11.88 RCW;
(3) Who has a developmental disability as defined under
					 RCW
					 71A.10.020;
(4) Admitted to any facility, including any assisted living
					 facility;
(5) Receiving services from home health, hospice, or home
					 care agencies licensed or required to be licensed under chapter 70.127
					 RCW;
(6) Receiving services from an individual provider;
					 or
(7) For the purposes of requesting and receiving background
					 checks pursuant to
					 RCW
					 43.43.832, includes a person who is an adult
					 of any age who lacks the functional, mental, or physical ability to care for
					 themselves.
"WAC"
means Washington Administrative
					 Code.
"Wellness program"
means an educational
					 program provided by the assisted living facility. It is a proactive and
					 preventative approach to assist residents and nonresident individuals in
					 achieving optimal levels of health, social, and emotional functioning. A
					 wellness program does not include medical care or interventions.
"Willful"
means the deliberate, or
					 nonaccidental action or inaction by an alleged perpetrator that the alleged
					 perpetrator knows or reasonably should have known could cause a negative
					 outcome, including harm, injury, pain, or anguish.
"WISHA"
means the Washington Industrial Safety
					 and Health Act, chapter 49.17 RCW administered by the Washington state
					 department of labor and industries.
Statutory Authority: Chapter 18.20 RCW. WSR 12-21-070,
						§ 388-78A-2020, filed 10/18/12, effective 11/18/12; WSR 12-08-004, §
						388-78A-2020, filed 3/22/12, effective 4/22/12. Statutory Authority:
						RCW
						18.20.090 and chapters 18.20 and
						74.34 RCW. WSR 08-05-099, §
						388-78A-2020, filed 2/15/08, effective 3/17/08. Statutory Authority:
						RCW
						18.20.090 and 2006 c 242. WSR 06-13-028,
						§ 388-78A-2020, filed 6/13/06, effective 7/14/06. Statutory Authority:
						RCW
						18.20.090. WSR 06-01-047, §
						388-78A-2020, filed 12/15/05, effective 1/15/06. Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2020, filed 7/30/04, effective
						9/1/04.