Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00215964 Renewal 12/06/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.181(e)(2)Individual #1's initial assessment, completed 9/22/2022 did not include the likes and dislikes of the individual.The assessment must include the following information: The likes, dislikes and interest of the individual. The Individual's (#1) assessment page of likes/dislikes/interests was completed on 12/6/2022 to comply with the above regulation. The assessment sheet was placed in BH's record by Program Specialist. A copy of the assessment sheet will be provided with the Plan of Correction. 12/06/2022 Implemented
SIN-00182844 Renewal 02/08/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.63(a)On 2/9/2021 at 2:02PM, the hot water temperature in the sink in the bathroom outside of the double bedroom in the home measured 123°F.Heat sources, such as hot water pipes, fixed space heaters, hot water heaters, radiators, wood and coal-burning stoves and fireplaces, exceeding 120°F that are accessible to individuals, shall be equipped with protective guards or insulation to prevent individuals from coming in contact with the heat source. A thermometer was purchased for the home. The water was turned down immediately by the program specialist and is now 120 degrees. This was completed on 2/9/2021. A heating and cooling expert was called in to check the water temperature as well and to offer the suggestion that the agency purchase a scald guard feature to permanently correct this non-compliance issue. A water temperature check was also added to the monthly fire drill record to be checked by the staff every month. This will then be reviewed and signed by both program specialist and program director. All Laurel House staff were trained on regulation 6400.63(a). Supporting documentation attached. 02/09/2021 Implemented
SIN-00144561 Renewal 10/31/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.151(c)(2)Direct Service Worker #1, date of hire 5/11/16, had a Tuberculin skin testing by Mantoux method with negative results completed 2/11/16 then again 5/4/18. The physical examination shall include: Tuberculin skin testing by Mantoux method with negative results every 2 years; or, if tuberculin skin test is positive, an initial chest x-ray with results noted. Tuberculin skin testing may be completed and certified in writing by a registered nurse or a licensed practical nurse instead of a licensed physician, licensed physician's assistant or certified nurse practitioner. A form has been created to keep track of when the tuberculin skin test by Mantoux method [TB] is due along with the staff physical, which is due every 2 years. The program director will be responsible for overseeing that the TB test is completed in a timely fashion [every 2 years]. Once this is completed, and documented on the physical form, the date will immediately be documented on the new form that was created to keep track of when the next TB test is due to be administered for each staff. All staff will receive written notification of the due date for the TB test to be administered. The program director will also be responsible for overseeing this notification. Supporting documentation attached. 11/07/2018 Implemented
SIN-00070332 Renewal 10/16/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.74The outside steps leading from the back deck did not have nonskid surfaceInterior stairs and outside steps shall have a nonskid surface. Non-skid surface has been applied to outside deck steps on 10/17/14. Staff and supervisor to check monthly to see that steps remain safe and in good condition. Safety checklist developed and will be used monthly by staff. Any repairs will be reported to and followed up by the supervisor. Staff and supervisor trained on regulation 6400.74 on 10/28/14. Supporting documentation attached. 11/03/2014 Implemented
6400.77(b)The first aid kit did not contain a thermometer. A first aid kit shall contain antiseptic, an assortment of adhesive bandages, sterile gauze pads, a thermometer, tweezers, tape, scissors and syrup of Ipecac, if an individual 4 years of age or younger, or an individual likely to ingest poisons, is served. Thermometer added to first aid kit on 10/28/14. Checklist for first aid supplies to be added to the first aid kit and the fire safety book. The first aid kit will be checked on a monthly basis by staff and the supervisor when each monthly fire drill is completed to ensure all items are available or if items need to be replaced. Staff and supervisor trained on regulation 6400.77(b) on 10/28/14. Supporting documentation attached. 11/03/2014 Implemented
SIN-00198370 Renewal 01/04/2022 Compliant - Finalized
SIN-00164024 Renewal 10/08/2019 Compliant - Finalized
SIN-00124738 Renewal 11/14/2017 Compliant - Finalized
SIN-00104318 Renewal 11/22/2016 Compliant - Finalized
SIN-00085395 Renewal 10/20/2015 Compliant - Finalized
SIN-00069185 Initial review 10/02/2014 Compliant - Finalized