Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00230040 Renewal 08/29/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)A self-assessment was not completed for this home.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. DSS residential team will complete the self- assessment form for this home. 10/09/2023 Implemented
6400.67(b)There is an old toilet tissue holder bracket that is protruding from the bathroom wall creating a cutting hazard. Floors, walls, ceilings and other surfaces shall be free of hazards.Toilet tissue holder has been removed. 09/28/2023 Implemented
6400.110(c)There is no smoke detector in a common area of the second floor of the apartment. The only smoke detector on this floor is located inside of a bedroom.The smoke detectors specified in subsections (a) and (b) shall be located in common areas or hallways. The smoke detector was relocated outside of the bedroom on the second floor in the common area. 09/25/2023 Implemented
6400.141(a)Individual #1 did not have a physical on file completed within 12 months prior of 12/2022 admission.An individual shall have a physical examination within 12 months prior to admission and annually thereafter. Individual#1 has a current physical on file. 09/28/2023 Implemented
6400.141(c)(7)Individual #1's physical does not include a gynecological exam.The physical examination shall include: A gynecological examination including a breast examination and a Pap test for women 18 years of age or older, unless there is documentation from a licensed physician recommending no or less frequent gynecological examinations. Individual#1 did have a GYN examination for 10/8/22 on file. 08/29/2023 Implemented
6400.151(c)(4)Staff #3's 3/28/23 physical does not include information of medical problems, if any. Staff #4's 2/17/23 physical does not include information of medical problems, if any.The physical examination shall include: Information of medical problems which might interfere with the health of the individuals.Staff# 4 is no longer employed at DSS. HR staff will send the staffing agency DSS¿S physical form to be completed for staff#3. 10/02/2023 Implemented
6400.24Staff #1 hired 5/21/23 and staff #2 hired 12/30/22 did not have an attestation that they have resided in the Commonwealth of PA for the past two years, nor was an FBI check completed.The home shall comply with applicable Federal and State statutes and regulations and local ordinances.Staff #1 did have an attestation document on file dated 3/17/23. Staff#2 Completed an attestation form on 9/28/23 09/28/2023 Implemented
6400.51(a)(3)Staff #4 hired 7/8/23, has not completed the required orientation trainings.Prior to working alone with individuals, and within 30 days after hire, the following shall complete the orientation as described in subsection (b): Direct service workers, including full-time and part-time staff persons.Staff# 4 is no longer employed at DSS. 09/25/2023 Implemented
6400.161(a)Individual #1 whom self-medicates, had an expired medication present in their medication box and hand-written onto the medication administration record. Prescribed medication cyclobenzaprine 10 mg was dispensed on 3/13/23 to individual #1 with directions to take three times a day as needed for up to 14 days. Any unused doses of this medication should have been disposed of after 3/27/23.The home shall provide an individual who has a prescribed medication with assistance, as needed, for the individual's self-administration of the medication.Individual #1¿s Cyclobenzaprine was discontinued. 09/01/2023 Implemented
SIN-00210372 Renewal 08/31/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)A self-assessment was not completed for this location.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. DSS CEO, Program Specialist and HR Resource is scheduled to meet to complete the agency¿s Self-Assessment for this location on 10/14/22 10/30/2022 Implemented
6400.64(a)There was an accumulation of dust on mini blinds throughout the apartment. There was an accumulation of dust and debris on baseboards around the entire perimeter of the apartment.Clean and sanitary conditions shall be maintained in the home. Mini blinds were taken down and cleaned on 9/26/22. The mini blinds will be put on the staff chore list to be dusted every week by staff. The House manager will be responsible to ensure that this is being done when she completes her monthly onsite home evaluation checklist. checklist will be completed on or before the 5th of every month. The House Manager will submit the completed home safety evaluation checklist and a maintenance request form (if applicable) to Program Specialist and CEO for final review 09/26/2022 Implemented
6400.67(a)The refrigerator door handle is broken off and needs to be replaced.Floors, walls, ceilings and other surfaces shall be in good repair. On 10/3/22 CEO contacted company and ordered a replacement door handle for the refrigerator door. 10/03/2022 Implemented
6400.67(b)The free standing kitchen microwave interior lining is rusted in two areas and is a fire hazard. This microwave needs to be replaced immediately. Floors, walls, ceilings and other surfaces shall be free of hazards.On 9/15/22, CEO purchased new microwave in the kitchen 09/15/2022 Implemented
6400.67(b)The wall electrical outlet adjacent to the refrigerator is not securely affixed to the wall and is protruding out. Floors, walls, ceilings and other surfaces shall be free of hazards.On 9/10/22, Maintenance came out to secure the wall electrical outlet. 09/10/2022 Implemented
6400.68(b)The water temperature in the bathroom measured 125 degrees Fahrenheit. Hot water temperatures in bathtubs and showers may not exceed 120°F. On 9/10/22, The water heater temperature has been lowered. The water temp was tested twice after the adjustment to ensure the reading was below 120 degrees. 09/10/2022 Implemented
6400.104Notification was not provided to the fire department for this location.The home shall notify the local fire department in writing of the address of the home and the exact location of the bedrooms of individuals who need assistance evacuating in the event of an actual fire. The notification shall be kept current. CEO updated the notification letter to be sent to the fire department for this location. A copy was emailed to the department on 10/3/2022. CEO is waiting for letter to be signed and sent back. CEO will follow up to ensure letter is received and filed. 10/03/2022 Implemented
6400.110(a)The second floor does not have a smoke detector. A home shall have a minimum of one operable automatic smoke detector on each floor, including the basement and attic. On 9/10/22, DSS maintenance put a smoke detector on the wall in front of the 2nd floor bedroom at this location. 09/10/2022 Implemented
6400.111(a)The fire extinguisher on the second floor is a classification 1-A rating, which is smaller than the 2-A minimum required size.There shall be at least one operable fire extinguisher with a minimum 2-A rating for each floor, including the basement and attic. On 9/15/22, CEO purchased a 2-A fire extinguisher for second floor at this location and got it inspected in accordance to regulations. 09/15/2022 Implemented
6400.111(c)There is no fire extinguisher in the kitchen. The only fire extinguisher on the first floor of this apartment is in the living room. A fire extinguisher with a minimum 2A-10BC rating shall be located in each kitchen. The kitchen extinguisher meets the requirements for one floor as required in subsection (a). On 9/10/22, DSS Maintenance relocated fire extinguisher on the wall in the kitchen area. 09/10/2022 Implemented