Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00220377 Renewal 03/08/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.144In march 2022 individual 1 was seen for annual exam. At this time a further evaluation for vision screen was supposed to be completed. Individual 1 did not follow up for exam until 3/8/2023. Follow up on the most recent physical for individual number 1 indicated follow up for 4-month weight check. Weight check should have been completed in July 2022Health services, such as medical, nursing, pharmaceutical, dental, dietary and psychological services that are planned or prescribed for the individual shall be arranged for or provided. This individual was seen by a specialist vision doctor in March 2021 where she was asked to return in two years. In March 2022 during the annual exam for this individual, her PCP asked her to follow up with vision. However, the provider operated under the specialist instruction of returning in two years and scheduled the vision follow up for 03/08/2023. Please see attachment 16 03/15/2023 Implemented
SIN-00185595 Renewal 03/03/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.67(a)The dresser located in Individual #4 was missing a knob.Floors, walls, ceilings and other surfaces shall be in good repair. The knob on this dresser has been replaced as of 03/05/2021. Please see attachment # 5. 03/05/2021 Implemented
6400.67(a)The dresser in Individual #1 bedroom was missing a knob.Floors, walls, ceilings and other surfaces shall be in good repair. The knob on this dresser has been replaced as of 03/05/2021. Please see attachment #6. 03/05/2021 Implemented
6400.77(b)The first aid kit did not contain scissors and antiseptic. 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. The missing scissors and antiseptic has been replaced in the kit as of 03/04/2021. Please see Attachment # 7. 03/04/2021 Implemented
6400.111(f)The fire extinguisher located in the hallway of the home was last inspected by a fire safety expert on Oct 2019, based on the inspection tag. A fire extinguisher shall be inspected and approved annually by a fire safety expert. The date of the inspection shall be on the extinguisher. The fire equipment company came out and serviced this fire extinguisher on 03/08/2021. Please see attachment #8. 03/08/2021 Implemented
6400.111(f)The fire extinguisher in the basement was not approved annually by a fire safety expert, the inspection label was not completed. (it could not be determined when the extinguisher was inspected). A fire extinguisher shall be inspected and approved annually by a fire safety expert. The date of the inspection shall be on the extinguisher. The fire equipment company came out and serviced this fire extinguisher on 03/08/2021. Please see attachment #9. 03/08/2021 Implemented
6400.141(c)(12)On the Annual Physical Examination Form for Individual #1 dated 12/31/2020 the Limitations or restriction portion was left blank.The physical examination shall include: Physical limitations of the individual. The Annual Physical Examination form for this individual has been updated with the missing pertinent information as of 04/15/2021. Please see attachment #10. 04/15/2021 Implemented