Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00215070 Renewal 11/21/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(f)Two of the outside trash cans did not have a lid on them. The trash can that did have a lid attached was overflowing with trash and the lid could not be securely affixed to it.Trash outside the home shall be kept in closed receptacles that prevent the penetration of insects and rodents.Associate Director replaced the outside trash cans with those with lids on 11/21/22. (ATTACHMENT #25 ) 11/21/2022 Implemented
6400.67(a)A desk in the basement had a side that was detached from the desk and a sharp connector piece was exposed.Floors, walls, ceilings and other surfaces shall be in good repair. Associate Director and staff on shift repaired the desk on 11/21/22 which required a nail to be to be hammered back in and ensured that there was no longer a potential hazard to individual in the home and the staff. 11/21/2022 Implemented
6400.67(b)The basement water heater ceiling component is encased with a Styrofoam housing that is melting and decaying from the heat emitted from the hot water heater. This poses a safety and fire hazard. Floors, walls, ceilings and other surfaces shall be free of hazards.Associate Director immediately contacted the landlord to report the concern on 11/21/22. The landlord responded on 11/24/22. The landlord removed the decaying Syrofoam on 11/30/22 and determined that there was no potential safety and fire hazard as the heater component was not easily accessible to others and it was not generating excess heat that would be a fire hazard. (ATTACHMENT #28) 11/30/2022 Implemented
6400.67(b)There are exposed live electrical wires in the basement ceiling that can be reached by an average height person. Floors, walls, ceilings and other surfaces shall be free of hazards.Associate Director immediately contacted the landlord to report the concern on 11/21/22. The landlord responded on 11/24/22 to make arrangement to replace the missing tile. Replacement tile was installed to cover the exposed wire on 11/30/22 (ATTACHMENT#29) 11/30/2022 Implemented
6400.77(a)There were no scissors or tape in the first aid kit. A home shall have a first aid kit. Associate Director immediately replaced the missing items on the day of inspection, 11/21/22, and ensured that the first aid kit was complete and in compliance. Please see ATTACHMENT # 30 of new First Aid kit that includes scissors, tape as well as all other required First Aid supplies. 11/21/2022 Implemented
SIN-00197341 Renewal 11/22/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.67(b)There was a large amount of dryer lint on the floor around the dryer. The amount was approximately several (3) full lint traps. Floors, walls, ceilings and other surfaces shall be free of hazards.* The lint was immediately removed at the time of the inspection by the staff on shift *The daily cleaning task list was updated to include a weekly check of the home¿s laundry area to ensure that there is no lint/debris in the area. 01/28/2022 Implemented
6400.68(b)The water temperature in the home was tested and found to be 136. Hot water temperatures in bathtubs and showers may not exceed 120°F. * Associate Director immediately contacted the landlord who determined that the temperature on the water heater needed to be adjusted to bring the water to the proper temperature of not higher than 120 degrees. Temperature of water in individuals¿ bathtub was taken again at regular intervals and each time read under the required 120 degrees temperature *Although the individual living in this home is the only person and per his assessment can regulate water temperature, with the agreement of the landlord, Service Director contacted outside plumber to install temperature regulator on individual¿s bathtub/shower waterline and work is scheduled to be completed by 2/5/2022. 02/05/2022 Implemented
6400.32(h)The closet in the living room by the front door is used to store the medications and program books for individual #1. The closet does not have a locking mechanism which is required to keep that information private.An individual has the right to privacy of person and possessions.* A file cabinet was purchased, with a lock system, to ensure the individual¿s records are kept safe and confidential, while also ensuring the staff and individual have easy access to the documentation as needed. This new system was implemented on 1/25/22. All staff received communication that program books are to remain secured in the locked file cabinet effective 1/25/2022. 01/25/2022 Implemented
SIN-00153166 Renewal 03/27/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(a)The kitchen range hood had grease on its surface.Clean and sanitary conditions shall be maintained in the home. Upon recognition of this area of non-compliance, Values Into Action's Service Coordinator ensured all homes had thorough cleaning of range hoods that day (3/28/19). Within one week (by 4/4/19), Values Into Action Service Coordinator visited each home to ensure that range hoods were cleaned to expected standards. Values Into Action Clinical Support Director has revised the Daily Cleaning List to ensure this cleaning is completed on a regular and ongoing basis in the future; Service Coordinator has ensured the new cleaning list is at each home and is being completed by completing bi-weekly checks. A copy of this Daily Cleaning List is available through Attachment #1. 04/04/2019 Implemented
SIN-00126271 Renewal 12/14/2017 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.67(b)THERE WERE SEVERAL GAS CONTAINERS WITH GAS IN THEM IN THE GARAGE UNLOCKED AND ACCESSIBLE WHICH PRESENTS A FIRE HAZARD. Floors, walls, ceilings and other surfaces shall be free of hazards.The Clinical Support Director instructed this individual's support staff to immediately remove the gas containers from the home. This was completed the day of inspection. The individual living in this home will be trained in safe storage techniques for his landscaping business. Values into Action has purchased a lockable outdoor storage area for the individual to store his supplies in moving forward. The Team Coordinator with conduct regular inspections of the home to ensure ongoing compliance with this regulation. 12/15/2017 Implemented
6400.112(c)THE TIME OF THE FIRE DRILL CONDUCTED ON 10/26/2017 WAS NOT RECORDED ON THE FIRE DRILL RECORD.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. The Team Coordinator who conducted this fire drill has received individual feedback regarding the error made on this form. The time has been updated on the form to make sure it is reflective of the fire drill time according to the Team Coordinator's time clock in for the date the drill was completed. A formal training for all Team Coordinators who perform fire drills will be conducted by the Clinical Support Director to ensure that all team members are properly trained and follow protocol moving forward. The Customer Service Liaison will complete a monthly audit of fire drills to ensure ongoing compliance with this regulation. 01/16/2018 Implemented
SIN-00109997 Renewal 12/19/2016 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(a)The bathroom on the second floor had a black substance that was consistent with dirt on the floor. Clean and sanitary conditions shall be maintained in the home. Values Into Action immediately ensured the bathroom floor was thoroughly cleaned and santized. Moving forward, the Team Coordinator at this location will ensure that the cleaning schedule for the home is carried out as expected and will also complete regular inspections on at least a quarterly basis to ensure ongoing compliance with this regulation. Service Director & Project Director will also perform unnanounced visits to monitor for ongoing compliance. 04/06/2017 Implemented
6400.67(a)The light fixture in the second floor bathroom had a missing cover over the light bulb.Floors, walls, ceilings and other surfaces shall be in good repair. Values Into Action will work to contract a handyman to replace this light fixture, as the property owner declined to perform this. Values Into Action will ensure proper precaution is taken by staff and the individual living in this home is taken to prevent injury and will ensure the light fixture is replaced as soon as possible. Moving forward, Values Into Action's Team Coordinators will conduct quarterly home inspections to ensure issues such as this can be identified and resolved immediately. 05/05/2017 Implemented
6400.164(c)Ketaconazol cream 2% and siler sulfa cream 1% were both found in individual #1's medication box but were not listed on the medication administration record. A list of prescription medications, the prescribed dosage and the name of the prescribing physician shall be kept for each individual who self-administers medication.Values Into Action immediately corrected the list of medications for Individual #1 to ensure that all current medications were reflected on the list (including PRN's). Team Coordinators will be retrained on this regulation and Values Into Action's process to ensure compliance with this regulation and ongoing health and safety of all individual's supported. On a Monthly basis, the Service Director will audit Medication Profiles to ensure ongoing compliance with this regulation and Values Into Action's process. Project Director will also complete unnanounced, periodic reviews as well. 04/06/2017 Implemented
6400.165During inspection on 12/20/16 a single pill identified as Depakote was found in the blister pack for individual #1 from the previous night on 12/19/16. No report was made as of that time. Documentation of medication errors and follow-up action taken shall be kept. Values Into Action immediately reported this Medication Error into the Enterprise Incident Management system and took corrective actions to ensure proper follow up. Staff responsible for overseeing Individual taking medications on the night they were missed was provided with additional training and performance counseling. To prevent future occurrences, Values Into Action will provide additional training to all staff working on this individual's team. 04/30/2017 Implemented
6400.183(4)Individual #4 has increased supervision with no reduction plan. The ISP, including annual updates and revisions under § 6400.186 (relating to ISP review and revision), must include the following: A protocol and schedule outlining specified periods of time for the individual to be without direct supervision, if the individual's current assessment states the individual may be without direct supervision and if the individual's ISP includes an expected outcome which requires the achievement of a higher level of independence. The protocol must include the current level of independence and the method of evaluation used to determine progress toward the expected outcome to achieve the higher level of independence. Values Into Action has addressed this issue with the Individual's ISP team. A request has been made for the Supports Coordinator to update the ISP with the Reduction Plan developed by Individual and his team. Moving forward, the Program Specialist will ensure that this part of the ISP is thoroughly reviewed during the Quarterly Review for each individual supported to ensure that it is correct and reflective of regulatory standards. Service Director has been provided additional training on this regulation to ensure ongoing compliance. 04/17/2017 Implemented
SIN-00082212 Renewal 07/27/2015 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.73(a)The home has 3 steps leading to the front door. There is no handrail.Each ramp, and interior stairway and outside steps exceeding two steps shall have a well-secured handrail. Values Into Action understands the importance of ensuring that any stairway that exceeds two steps shall have a well-secured handrail for the safety of people accepting support. Values Into Action has requested that the property manager of this home add a handrail to the front entry way in order to ensure safe entry & egress from the home. The property manager responded and declined performing this work. Thus, Values Into Action has contracted with an independent handyman who will complete the construction of a handrail for this home. The Team Lead will coordinate the work to be completed Values Into Action Page 2 as quickly as possible, but no later than 9/30/15. Service Director will oversee to ensure completion of this correction. Moving forward, Service Director will oversee the completion of Quarterly Physical Site Inspections to ensure that all physical site requirements are met. Inspections will be completed by the Team Lead then results shared with Team Coordinator to ensure issues/repairs are resolved. Service Director will track progress & oversee completion of needs noted. 09/30/2015 Implemented
6400.110(e)The home has 3 floors which include the basement, main floor, and second floor. The smoke detectors are not interconnected. If the home serves four or more individuals or if the home has three or more stories including the basement and attic, there shall be at least one smoke detector on each floor interconnected and audible throughout the home or an automatic fire alarm system that is audible throughout the home. The requirement for homes with three or more stories does not apply to homes licensed in accordance with this chapter prior to November 8, 1991. Values Into Action understand the importance of ensuring homes with more than three stories have operable interconnected smoke alarms to protect health and safety in the event of a fire emergency. The installation company was called to repair the alarms immediately and served them on 8/26/15. At that time, Values Into Action was made aware that due to the age of the alarms, the company recommended that a wireless interconnected system be added as an upgrade. Values Into Action opted to have the wireless system installed as soon as possible. The installation for the wireless system is scheduled to occur as soon as possible but no later than 9/15/15. This should prevent issues with connectivity moving forward. The Team Lead will oversee completion of the installation of wireless smoke detectors with Service Director monitoring. Monthly unannounced fire drills will continue to be completed by the Team Lead & Team Coordinator, which will help to ensure the alarms are working in an effort to additionally prevent any future occurrences. 09/15/2015 Implemented
SIN-00064364 Renewal 06/02/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.67(a)The basement steps are covered in carpeting. The 3rd step from the bottom has torn carpeting creating a tripping hazard.Floors, walls, ceilings and other surfaces shall be in good repair. Values Into Action understand the importance of ensuring floors, walls, ceilings, and other surfacs are in good repair within the homes of people accepting support in order to protect health and safety. The basement steps in this home were covered in carpeting which was torn near the bottom of the staircase creating a potential tripping hazard. VIA immediately corrected this issue by removing all carpeting from the entire stairway and adding a non-slip surface to ensure safety. Training occurred on 9/9/14 where lead staff members in the home were trained on how to perform inspections of the home. This will occur quarterly at a minimum and lead staff will notify the Team Coordinator of any issues. The Team Coordinator will then notify the Managing Director who will ensure that any repairs needed are performed in a timely manner. 09/09/2014 Implemented