Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00239290 Renewal 02/27/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.24(e)(3)No receipts were kept for any transactions over $15.If the agency or family assumes the responsibility for an individual's financial resources, the following shall be maintained: documentation, by actual receipt or expense record, of each single purchase exceeding $15 made on behalf of the individual carried out by family members or agency staff.Receipts will be kept starting March 1, 2024. PS, LSP and individual were trained on this regulation and the POC. Training documentation is on file and available upon request. 03/21/2024 Implemented
6500.109(g)The fire drill conducted on 1/6/24 did not indicate the time. It was documented as 10; but clarification was not provided as to if it was a.m.or pm.Fire drills shall be held on different days of the week and at different times of the day and night.LSP clarified that it was an AM Fire drill and corrected the form, with initials and date. (Attachment 5) PS and LSP were trained on this regulation and the POC. Documentation is on file and available upon request. 03/21/2024 Implemented
6500.109(h)On 10/10/23, the individuals were not evacuated to the designated meeting place.Individuals shall evacuate to a designated meeting place outside the home during each fire drill.The lock was placed on the inside of the fence. It is a combination lock and the individuals know the combination. A fire drill was completed using the back door to show that the individuals could evacuate and use the lock to meet at the designated meeting spot. (attachment 6) PS and LSP were trained on this regulation and POC. Training documentation is on file and available upon request. 03/21/2024 Implemented
SIN-00221889 Renewal 04/03/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.109(e)Fire drills were conducted at this home on 12/29/21, 6/16/22, and 10/18/22. None of the fire drills were sleep drills.A fire drill shall be held during sleeping hours at least every 12 months.A root cause analysis determined the PS did not notify LSP that a sleeping drill needed to occur in June 2022. A sleeping drill was conducted on 4/17/23. 04/20/2023 Implemented
SIN-00202794 Renewal 04/05/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.71During the 4/5/22 inspection, there were no emergency numbers listed on or near the telephone in the living room.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.Emergency numbers were posted on 4/12/22. 04/12/2022 Implemented
6500.121(c)(4)Individual #1's 10/13/21 annual physical examination did not include a hearing screening. The physical examination shall include: Vision and hearing screening for individuals 18 years of age or older, as recommended by the physician.Physical form was updated to include explicit instructions for completing the form. 04/12/2022 Implemented
6500.121(c)(13)The allergies and contraindicated medications of Individual #1's 10/13/21 annual physical examination was left blank. The physical examination shall include: Allergies or contraindicated medications.Physical form was updated to include explicit instructions for completing the form. Forms will be pre-filled (the sections that are possible) by the program specialist prior to physical appointments with this information. 04/12/2022 Implemented
6500.121(d)Individual #1's tuberculin test dated 9/17/20 was read by a Certified Medical Assistant.Immunizations, vision and hearing screening and tuberculin skin testing may be completed, signed and dated by a registered nurse or licensed practical nurse instead of a licensed physician, certified nurse practitioner or licensed physician's assistant.A new form was created for TB tests, showing whom may place and read TB tests. 04/12/2022 Implemented
6500.124Individual #1's physician, Dr. Malozzi, ordered monthly blood pressure checks on 8/21/20, with a note indicating "if greater than 140, let me know." Individual #1 had blood pressures greater than 140 on 10/29/21, 12/18/21, and 2/22/22. There is no record indicating that Dr. Malozzi was contacted regarding these readings.Health 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.The medical case note was updated to include a section for ongoing, updates, changes and the discontinuation of standing medical orders. 04/12/2022 Implemented
6500.45(b)Staff person #4 was certified for 2 years in CPR on 9/28/19 and not again until 11/9/21.The primary caregiver shall be trained and certified by an individual certified as a trainer by a hospital or other recognized health care organization, in cardiopulmonary resuscitation, if indicated by the medical needs of the individual, prior to the individual living in the home and annually thereafter.Program Specialist uses an excel spreadsheet to track all reoccurring trainings and due dates. In addition, reminders will be sent to FLP about pending trainings and time frames. 04/19/2022 Implemented
6500.136(a)(2)Individual #1's Medication Administration Records do not include the prescriber's name.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Name of the prescriber.A new form was created for medication administration, including prescribers name. 04/12/2022 Implemented
6500.136(a)(11)Individual #1's Medication Administration Records does not include the diagnosis or purpose for their medications.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Diagnosis or purpose for the medication, including pro re nata.A new form was created for medication administration, including diagnosis/purpose. 04/12/2022 Implemented