Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00199814 Renewal 02/08/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)The self-assessment, dated 06/16/21, was not complete. The following sections of the self-assessment were left blank: General Requirements 6400.11 through 6400.25(d); Individual Rights 6400.31(a) through 6400.34(b); Staffing 6400.42 through 6400.52(c)(6); Individual Health 6400.141(a) through 6400.145(3); Staff Health 6400.151(a) through 6400.152(c); Medications 6400.161(a) through 6400.169(d); Nutrition 6400.171 through 6400.176; Assessments 6400.181(a) through 6400.181(f); Plan Development/Process/Content 6400.182(a) through 6400.209; Home Services 6400.188(a) through 6400.188(d); Day Services/Recreational and Social Services 6400.189(a) through 6400.190(c); Restrictive Procedures 6400.191 through 6400.208(f); and Individual Records 6400.211(a) through 6400.217.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. In response to this violation of 6400.15(a) discovered during the licensing inspection for the McGuire Memorial Community Home program held from 2/8 to 2/10 of 2022, the plan of correction is as follows: Effective immediately, the program specialists of the McGuire Memorial community home program will be trained to utilize the ¿self-assessment licensing inspection instrument¿ that is featured in the ODP 6400 Regulatory Compliance Guide as appendix A. The program specialists will be responsible for completing these self-assessments, including marking ¿NA¿ for any areas that do not apply to the house that they are assessing. Once completed, these self-assessment forms will be submitted to the Director and Assistant Director of Community Homes for their review. These self-assessments will occur within 3 to 6 months prior to the expiration date of the agency¿s current certificate of compliance. [Training on Self-Assessments, dated 3/29/22, received on 4/4/22 and reviewed on 4/19/22 by HDKP, HSLS]. 03/09/2022 Implemented
SIN-00127150 Renewal 01/03/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(c)On 1/4/18 at 10:48AM, a gallon plastic bottle, with the manufacture label reading purified water, containing an unidentified blue liquid, on the floor of the furnace room neat the cold air return.Poisonous materials shall be stored in their original, labeled containers. The gallon plastic bottle with the blue liquid was removed from the home. All poisonous materials shall be stored in their original, labeled containers. All professionals and direct support staff have been in-serviced that all poisonous materials must be in their original labeled container. The House Managers are responsible to complete monthly house inspections to ensure that all poisonous materials are stored in their original, labeled containers. Any poisonous item found in the home that is not in its original labeled container will be disposed of immediately upon discovery. The Director/Assistant Director will review the monthly house inspections for completeness and to ensure that any unlabeled poison that are not in their original container are disposed of and will conduct unannounced quarterly house inspections to ensure that all poisonous materials are in their original labeled containers. 01/25/2018 Implemented
6400.66The bulb for the flood light near the door on the back porch of the home was missing. There was no other source of light in this area.Rooms, hallways, interior stairways, outside steps, outside doorways, porches, ramps and fire escapes shall be lighted to assure safety and to avoid accidents. The missing light bulb was immediately corrected by maintenance. All community home and direct care staff have been in-serviced that all rooms, hallways, interior stairways, outside steps, outside doorways, porches, ramps and fire escapes are lighted to assure safety and avoid accidents. The house managers must conduct monthly house inspections which includes all lighting inside and outside of the home. Maintenance request is to be completed for any light needing changed. All professional and direct support staff have been in-serviced to report any lights that are not in working order to maintenance. The Director/Assistant Director will audit the monthly house inspections to ensure there are no lighting issues and will conduct quarterly house inspections to ensure that lights inside and outside of the home are in working order. 01/25/2018 Implemented
SIN-00096258 Renewal 11/24/2015 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.71The telephone numbers of the nearest police department and ambulance were not on or by the telephones in the home. Telephone numbers of the nearest hospital, police department, fire department, ambulance and poison control center shall be on or by each telephone in the home with an outside line. The telephone number for the police was added to every phone with an outside line in addition to the numbers for fire, ambulance, the nearest hospital and the poison control center. A copy of the new postings were given to the inspector prior to the end of the survey. The Community Home Managers will inspect the phones monthly and document this on the Monthly House Inspection. The monthly house inspections are reviewed by the Program Specialist and the Director and Assistant Director of Community Homes. 07/02/2016 Implemented
SIN-00167136 Renewal 12/04/2019 Compliant - Finalized
SIN-00056118 Renewal 10/10/2013 Compliant - Finalized