| Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
| 6400.21(a) | Staff #1 DOH was 11/15/17 and the criminal background check was completed on 12/18/17. | An application for a Pennsylvania criminal history record check shall be submitted to the State Police for prospective employes of the home who will have direct contact with individuals, including part-time and temporary staff persons who will have direct contact with individuals, within 5 working days after the person's date of hire.
| Prior to the inspection all corrective actions were taken to update employees files and A proper hiring procedure had been put in place to avoid any omission/delay to minimize the risk of non compliance of this regulation. |
12/18/2017
| Implemented |
| 6400.68(b) | The water temperature in the home was tested and found to be 133.7. | Hot water temperatures in bathtubs and showers may not exceed 120°F. | Unfortunately we could not direct any corrective action plan considering that we rent this property.
However, A water thermometer is available in the house to indicate the water temperature before usage. |
12/21/2017
| Implemented |
| 6400.71 | There was emergency numbers listed by the telephone in the home. | Telephone numbers of the nearest hospital, police department, fire department, ambulance and poison control center shall be on or by each telephone in the home with an outside line.
| A list of all emergency numbers was elaborated and made available to the house.
In addition, as a preventive action a weekly checklist has been created to make sure the list is available at all time and to ensure that employees are aware of protocols in case of emergency. |
12/27/2017
| Implemented |
| 6400.111(c) | The fire extinguisher in the kitchen was not rated 2a-10-BC. | 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). | A new fire extinguisher rated 2a-10-BC was bought to replace the existing one.
The initial purchase receipt is kept to submit in one year for the fire extinguisher inspection complying with the regulations. |
12/28/2017
| Implemented |
| Article X.1007 | 16 new hires that became employed in 2017 did not have FBI background checks conducted and did not have proof of residency for 2 years. | When, after investigation, the department is satisfied that the applicant or applicants for a license are responsible persons, that the place to be used as a facility is suitable for the purpose, is appropriately equipped and that the applicant or applicants and the place to be used as a facility meet all the requirements of this act and of the applicable statutes, ordinances and regulations, it shall issue a license and shall keep a record thereof and of the application. | Staff had signed an affidavit of residence form as proof of residency and those who had not been in the state of PA had submitted a FBI clearance. |
01/03/2018
| Implemented |