Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00232782 Renewal 09/12/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.112(c)Written fire drill records shall record the date, time of day, evacuation time and exit route used. The fire drill record for the drills held on 8/24/23 did not document the time of day that the drills occurred.A written fire drill record shall be kept of the date, time, the amount of time it took for evacuation, the exit route used, problems encountered and whether the fire alarm or smoke detector was operative. Program Manager's will be retrained on fire safety and fire drill requirements under Chapter 6400.112 (c). Program Managers will review all fire drill records and provide individual feedback to employees of missing or incorrect data. IHRS's Quality Assurance and Regulatory Compliance Manager will be responsible to collect and review all sites fire drill records on a monthly basis. 12/06/2023 Implemented
SIN-00177216 Unannounced Monitoring 09/09/2020 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(a)Dial brand antibacterial hand soap, labeled "contact poison control if ingested," was found unlocked and accessible next to the sinks in the kitchen and the hall bathroom. Individuals reside in the home who have not been assessed to be safe with poisons.Poisonous materials shall be kept locked or made inaccessible to individuals. IHRS has issued a memo to all sites regarding appropriate hand soaps. All soaps have been assessed to ensure they are safe to be unlocked. IHRS compliance department assisted Program Specialists in calling the CLA's to ensure proper soap was accessible to the clients. 10/23/2020 Implemented
6400.66Several lightbulbs in the basement were burned out.Rooms, hallways, interior stairways, outside steps, outside doorways, porches, ramps and fire escapes shall be lighted to assure safety and to avoid accidents. All light sin the basement have been replaced. Program Specialist reviewed physical site checklist with Lead Worker and reminded them that this is an area of compliance that they sign off on monthly. Compliance department will also add to their checklist. Memo sent to all sites regarding the need for working light bulbs. 10/31/2020 Implemented
6400.111(a)The fire extinguisher located on the basement level of the home was not charged and the pin had been removed.There shall be at least one operable fire extinguisher with a minimum 2-A rating for each floor, including the basement and attic. Fire extinguisher was serviced and replaced the same day. Work order sent to ODP licensing. Staff were reminded to make sure they are checking fire extinguishers to ensure that they are charged and in working order. 10/31/2020 Implemented
SIN-00172783 Unannounced Monitoring 01/09/2020 Non Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.32(c)According to Individual #1's Individual Support Plan, Individual #1 requires a chopped diet. On 12/23/19, Staff #1 gave Individual #1 a whole bear claw while in the van during transport from Individual #1's day program to his home. Individual #1 shoved the bear claw in his mouth and began to choke. 911 was contacted and Individual #1 was transported to Wilkes-Barre General Hospital by EMS. Individual #1 passed away on 12/31/19. Individual #1 was neglected as Staff #1 served him food not prepared appropriately to his dietary needs.An individual may not be abused, neglected, mistreated, exploited, abandoned or subjected to corporal punishment.The target was suspended while an investigation was conducted. The target has since been terminated following investigation. Staff will be retrained on what is considered abuse and or neglect. Additionally, staff will be retrained on special dietary needs. ((Institute for Human Resources and Services has the immediate responsibility to ensure that food is being prepared properly by trained staff. Institute for Human Resources and Services will review records of all individuals residing in Chapter 6400 homes to determine required dietary needs including but not limited to proper food preparation and supervision. This review will be completed by 5/8/20. All staff will receive training in dietary needs, food preparation, and supervision by 5/30/20. Food preparation training shall include a demonstration of equipment use and proper food consistency as necessary. Documentation of the reviews and training shall be kept. -CH 5/4/2020)) 04/10/2020 Not Implemented
6400.186According to Individual #1's Individual Support Plan, Individual #1 requires a chopped diet. On 12/23/19, Staff #1 gave Individual #1 a whole bear claw while in the van during transport from Individual #1's day program to his home. Individual #1 shoved the bear claw in his mouth and began to choke. 911 was contacted and Individual #1 was transported to Wilkes-Barre General Hospital by EMS. Individual #1 passed away on 12/31/19. Staff #1 failed to implement the Individual Support Plan as she served Individual #1 food that was not prepared according to his dietary needs.The home shall implement the individual plan, including revisions.All IHRS staff will continue to receive training on the ISP of any client they are working with. Program Department and the IHRS Training Department will continue to give individualized and specialized training in areas that address client specific needs. ((Institute for Human Resources and Services has the immediate responsibility to ensure that food is being prepared properly by trained staff. Institute for Human Resources and Services will review records of all individuals residing in Chapter 6400 homes to determine required dietary needs including but not limited to proper food preparation and supervision. This review will be completed by 5/8/20. All staff will receive training in dietary needs, food preparation, and supervision by 5/30/20. Food preparation training shall include a demonstration of equipment use and proper food consistency as necessary. Documentation of the reviews and training shall be kept. -CH 5/4/2020)) 04/10/2020 Not Implemented
SIN-00160704 Renewal 08/27/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)The self-assessment was completed late. The expiration date of the Agency's certificate of compliance is 8/01/2019 and the self-assessment was completed on 7/31/2019.The agency shall complete a self-assessment of each home the agency operates serving eight or fewer individuals, within 3 to 6 months prior to the expiration date of the agency¿s certificate of compliance, to measure and record compliance with this chapter. IHRS will develop a protocol that requires all self assessments to be completed by May 1st of the current calendar year. This will ensure that all homes are assessed prior to the expiration date of our certificate of compliance. Our compliance manager, will ensure that these assessments are completed. 10/31/2019 Implemented
6400.112(e)Fire drills were not held during sleeping hours at least every six months. A drill was held during sleeping hours on 10/12/18, then not again until 5/30/19.A fire drill shall be held during sleeping hours at least every 6 months. IHRS will ensure that fire drills are completed during sleeping ours every 6 months. Each Program Manager will keep a schedule of when asleep fire drill are expected. This will be communicated to the home for execution of the drill. Furthermore, our compliance department will monitor that drills are being completed in appropriate time frames as outlined by the regulation. 10/31/2019 Implemented
SIN-00055774 Unannounced Monitoring 10/01/2013 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.22(c)Staff Person #1 was given $1300.00 in cash to purchase items for the three individuals who reside in the home, # 1, #2 and #3. Staff later reported the money missing and the agency reported the incident to local law enforcement. The agency reimbursed individuals #1 #2 and #3 the full amount of the missing money.(c) Individual funds and property shall be used for the individual's benefit. The money was reimbursed to the three individuals by IHRS. The incident was reported to the Sugar Notch police department. The employee signed a promissory note to reimburse the money to IHRS since she was responsible for the money and did not follow IHRS's incident reporting & financial policies. 09/26/2013 Implemented
SIN-00082846 Renewal 08/25/2015 Compliant - Finalized