Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00204279 Renewal 04/27/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.68(b)The water temperature was 140 degrees Fahrenheit. Hot water temperatures in bathtubs and showers may not exceed 120°F. On 5/14/22, Program Manager submitted a modification request form to the apartment complex manager requesting to install a hot water regulator to maintain compliance with state licensing. Please see attachment #1. The apartment complex manager responded on 5/17/22 to state that she will forward the request and notify Agape if it is approved . Please see email correspondence in attachment #2. 05/14/2022 Implemented
6400.144Dental extraction for individual #1 scheduled for 12/15/2021 indicated a follow up appointment was required. No verification provided to determine specific outcome of the appointment or documentation to support if appointment was held, cancelled or rescheduled. Orthopedic apointment for individual #1 was scheduled 8/27/21 with follow up apt in six weeks. Follow up appointment was not held until 4/12/2022. Visit scheduled for a 3 month follow up not completed timely. Follow up was not done timeHealth 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. Program Supervisor immediately contacted dental office for letter of cancelled appointment by the dental office for appointment scheduled on 5/9/22. Dental office faxed letter but incorrectly spelled individual #1's name. Program Administrator has called the dental office twice to amend the error on the letter; however, the amended letter is still pending fax to Program Administrator. Scheduled dental appointment was made at a different practice for 5/16/22. Please see appointment visit form on attachment #5. 05/16/2022 Implemented
6400.183(7)(iv)Attendance form for ISP. There is no documentation provided to indicate individual #1 participated or declined attending the ISP meeting on January 24, 2022The ISP, including annual updates and revisions under § 6400.186 (relating to ISP review and revision), must include the following: Assessment of the individual's potential to advance in the following: Competitive community-integrated employment. Program Manager contacted SC to notify of the error on ISP attendance form on 4/28/2022. Also, Program Administrator contacted SC on 5/16/2022 to readdress the issue, and the SC acknowledged the error and has fixed it and emailed the Program Specialist the corrected attendance form on 5/16/2022. Please see attachment #7. 05/16/2022 Implemented
SIN-00159074 Renewal 07/11/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.21(a)Staff person # 1's date of hire is 10/16/18, and their criminal background check was completed on 12/17/18.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. Staff persons #1 has a current criminal background check. Moving forward, Administrator will ensure that all prospective employees of Agape Family Home including part-time and temporary staff persons who will have direct contact with individuals receive a criminal history record check submitted to the State Police within 5 working days after the person's date of hire. (Attachment 5) 07/11/2019 Implemented
6400.67(a)The Ceiling in the left corner of the kitchen was damaged and not in good repair. The previous work to repair ceiling was not fully completed.Floors, walls, ceilings and other surfaces shall be in good repair. The Ceiling in the left corner of the kitchen has been fully repaired. Work order was completed for previous damage. Moving forward, Property manager and house manager will conduct quarterly inventory checks on all Screens, windows and doors to ensure that they are in good repair. If Screens, windows and doors need repaired or replaced, the house manager will complete a work order and submit to the administrator. Repairs will be made within 7 calendar days. (POC Attachment 13) 07/20/2019 Implemented
SIN-00130312 Renewal 04/03/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.111(c)The fire extinguisher in the kitchen was 1A-10-BC rating. 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). The fire extinguisher was replaced that same day and the quality insurance will complete a weekly check. 04/05/2018 Implemented
6400.141(c)(15)Individual #1's annual physical examination dated 6/7/17 did not include special diet instructions.The physical examination shall include:Special instructions for the individual's diet. On 2/28/2018 individual #1 physical was corrected by the PCP. The new program specialist will check to always make sure all information is filled out completely. 04/05/2018 Implemented
6400.161(e)Portia-28 prescribed for Individual #1 was discontinued but was not disposed of. Medication was still in the medication box.Discontinued prescription medications shall be disposed of in a safe manner.Medication was removed from individual #1 med box an discarded. The quality insurance will check all medication on a weekly basis. The medication was taken back to the pharmacy of a plan of corrections. 04/05/2018 Implemented
6400.163(c)There was no documentation to show that Individual #1's Psychiatric medications were reviewed for the period 11/23/17 and 1/23/18. If a medication is prescribed to treat symptoms of a diagnosed psychiatric illness, there shall be a review with documentation by a licensed physician at least every 3 months that includes the reason for prescribing the medication, the need to continue the medication and the necessary dosage.on Feb 18, 2017 the consumer had her med review and also on May 7th she had another medication review. Agape's new program specialist will compete documentation on all medication reviews. 05/09/2018 Implemented
6400.167(b)Individual #1's medication review reveals that Chlorpromoziho 100mg was not at administered 4/1/18 at 5pm. The medication was still in the medication box. Prescription medications and injections shall be administered according to the directions specified by a licensed physician, certified nurse practitioner or licensed physician's assistant.Individual #1 medications was disposed of, the medication was corrected on the Mar, the staff was trained on the 6400 167(b) regulation on giving meds on the correct time the medication should be administered. The quality insurance will check meds on a weekly basis. 04/04/2018 Implemented