Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00159115 Renewal 07/16/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(a)Grease was found on the surface of the kitchen exhaust fan and on its adjoining cabinets.Clean and sanitary conditions shall be maintained in the home. The exhaust fan and adjoining cabinets were cleaned. See attachments # 34. The House Supervisor is responsible to conduct monthly Physical Plant Walk-Through of home. The form includes ¿kitchen free of grease¿. Form to be given to Program Manager by 10th of each month. See attached procedure for physical Plant Walk-Through # 04 and completed form attachment # 33. 07/23/2019 Implemented
6400.76(a)The soft arm chairs fabric was damaged. The bedroom for individual #1 had a dresser knob missing. Furniture and equipment shall be nonhazardous, clean and sturdy. The chair was removed and the knob was replaced. See attachment # 32and. The House Supervisor is responsible to conduct monthly Physical Plant Walk-Through of home. The form includes ¿knobs are present¿. Form to be given to Program Manager by 10th of each month. See attached procedure for physical Plant Walk-Through # 04 and completed form attachment # 33. 07/23/2019 Implemented
SIN-00093758 Unannounced Monitoring 11/13/2015 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(a)Fabulouso , Comet, Lysol wipes, GV disinfectant bathroom cleaner, and Lysol toilet bowl cleaner, which indicated to contact poison control if ingested, were found unlocked in the bathroom closet. Poisonous materials shall be kept locked or made inaccessible to individuals. All cleaning products were secured properly. A new training tool has been created to better educate direct care staff on the requirements of the regulation. This training is incorporated into orientation and has been posted for all current staff to review. (Program staff will check the home to ensure poisonous substance are locked daily which will be documented. The residential manager will walk through the home weekly to ensure poisonous substances are locked D.S 06.10.2016) 06/06/2016 Implemented
6400.64(a)A black substance consistent with mildew was found on the tiles located at the bottom of the shower. There were stains approximately a foot in diameter and multiple spots consistent with dipping found on the carpet in the living room. Stains consistent with a heavily traffic area were found on the carpet from the entrance of the home through the sunroom/computer room to the kitchen area. Clean and sanitary conditions shall be maintained in the home. The bathroom has been cleaned. A new training tool has been created to better educate direct care staff on the requirements of the regulation. This training is incorporated into orientation and has been posted for all current staff to review. (The program staff will walk through the home daily to ensure that the bathrooms are clean. Bathrooms found unclean will be cleaned immediately. The residential manager will walk through the home weekly to ensure that bathrooms are clean. DS 06.10.16) 06/06/2016 Implemented
6400.76(a)A tennis ball size of lint was found in the dryer. Furniture and equipment shall be nonhazardous, clean and sturdy. The lint was removed from the dryer. A new training tool has been created to better educate direct care staff on the requirements of the regulation. This training is incorporated into orientation and has been posted for all current staff to review.(The program staff will check the lint trap in the home daily. Lint found will be removed immediately. The residential manager will walk through the home weekly to ensure lint trap remain clean. DS 06.10.16) 06/06/2016 Implemented
6400.101A black recliner was blocking an exit door in the living room.Stairways, halls, doorways, passageways and exits from rooms and from the building shall be unobstructed. The recliner was moved so the exit was clear. A new training tool has been created to better educate direct care staff on the requirements of the regulation. This training is incorporated into orientation and has been posted for all current staff to review.(The program staff will walk through the home daily to ensure exits remain unobstructed. If an exit is obstructed, it will be cleared immediately. The residential manager will walk through the home weekly to ensure all exits remain unobstructed and accessible. DS 06.10.16) 06/06/2016 Implemented
SIN-00108152 Renewal 02/01/2017 Compliant - Finalized