Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00215196 Renewal 11/01/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.142(a)Individual #1 had a dental examination completed on 1/13/2021 and then again on 3/22/2022. This exceeds the annual requirement.An individual 17 years of age or younger shall have a dental examination performed by a licensed dentist semiannually. An individual 18 years of age or older shall have a dental examination performed by a licensed dentist annually. All Specialists and Supervisors will be re-trained to ensure that they are keeping a chart of all medical appointment due dates for each person that they support. Should an appointment not occur as scheduled, the Specialist/Supervisor responsible for the appointment will obtain documentation from the physician/dentist immediately as the change in appointment occurs. This documentation will include the reason for the appointment change; the new appointment date/time; and signature of the physician/dentist. This documentation will be filed in the medical section of the person¿s record. The Supervisor will immediately notify the Specialist of the details of the appointment change. The Specialist will be responsible to monitor appointments on a monthly basis and ensure that all appointments have occurred as required/scheduled and if there has been any change in date that the appropriate documentation from the physician/dentist has been obtained immediately and is in the person¿s record. [Documentation of training for Specialists and Supervisors, dated 12/9/2022 and 1/3/2023, related to medical and dental appointments scheduling were received on 1/25/2023 and reviewed 1/25/2023. Documentation of monthly review of individual appointments by Specialist was received on 1/25/2023 and reviewed 1/25/2023. DPOC by HDKP, HSLS, on 1/25/2023]. 12/09/2022 Implemented
SIN-00105255 Renewal 12/13/2016 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.67(b)The grab bar attached to the wall below the shower head in the shower in the hallway bathroom was loose. Floors, walls, ceilings and other surfaces shall be free of hazards.The grab bar was replaced on 12/13/16. This grab bar became unattached on 12/12/16 and a work order was placed for repair, which occurred the next day on 12/14/16. Specialists continue to report all needed repairs as they occur, so that they are completed as soon as possible. [The grab bar was repaired on 12/13/16. Immediately, the vice president, residential supports shall ensure all staff persons working in community home shall be educated that floors, walls, ceilings and other surfaces shall be free of hazards and to check the homes throughout the course of their daily duties to monitor for hazards and to follow agency procedures to ensure repairs are completed immediately. At least monthly, the program specialist(s) shall complete an onsite walk through of the homes to ensure floors, walls, ceilings and other surfaces are free of hazards. Documentation of trainings and home checks shall be kept. (AS 1/12/17)] 01/10/2017 Implemented
6400.141(c)(14)The physical examination completed 10/21/16 for Individual #1 did not include medical information pertinent to diagnosis and treatment in case of an emergency. This section was left blank.The physical examination shall include: Medical information pertinent to diagnosis and treatment in case of an emergency. The Physical Examination form has been re-formatted, so that it is more user friendly for the physician to complete. It is now more clearly defined that "medical information pertinent to diagnosis and treatment in case of an emergency" is a separate question. On 1/9/17, an email was sent to all Supervisors reminding them to ensure that nothing is left unanswered on the physical examination form prior to leaving the appointment. [Individual #1' physical examination was updated. Immediately, the vice president residential supports shall train all supervisors of the required information to be included in individuals' physical examination as per 6400.141(c)(1)-(15). Documentation of training shall be kept. Within 30 days of receipt of the plan of correction, and upon completion, the supervisors shall review all individuals' current physical examinations to ensure all required information is present and there are not any areas of required information left blank and will immediately obtain missing information from the complete physician. Documentation of all reviews shall be kept. At least quarterly for 1 year, the program specialist shall review a 25% sample of physical examinations completed that quarter to ensure all required information is present and there are not any areas of required information left blank. (AS 1/24/17) 01/10/2017 Implemented
SIN-00051288 Renewal 09/05/2013 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.80(a)The landing outside of the basement door, between the screen door and basement door and on 8 outside steps leading from the basement to ground level of the yard was covered with dried grass, dirt and leaves.(a) Outside walkways shall be free from ice, snow, obstructions and other hazards. On 9/4/2013, all dried grass, dirt and leaves were removed from the landing outside of the basement door, between the screen door and basement door and on 8 outside steps leading from the basement to ground level of the yard. Pictures of this area will be submitted. On 9/16/2013, The Facilities Director reviewed with the lawn service company the expectations for lawn service and clean up to prevent a re-occurrence.On a monthly basis, the Community Homes Supervisor will utilize the portion of the LII related to Physical Site & Fire Safety as a resource to ensure that the home is in compliance. If any areas need addressed, the Community Homes Supervisor will make corrections to meet the regulations. If a correction needs to be made, they will e-mail this information to their Specialist. On the next visit to the home, the Community Homes Specialist will review the correction to ensure that it was completed and meets the regulations. On a quarterly basis, the Community Homes Specialist will complete the Quarterly Physical Site & Fire Safety Inspection form to ensure that the home is in compliance and submit this to the Residential Director. Should the Quarterly Physical Site & Fire Safety Inspection form reflect any concerns that need addressed in the work order system, the Community Homes Specialist will promptly enter the repair request. When the repair is completed, this will be documented on the form and submitted to the Residential Director. 09/22/2013 Implemented
SIN-00156721 Renewal 06/04/2019 Compliant - Finalized