Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00218418 Unannounced Monitoring 01/31/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.67(a)A kitchen drawer handle was broken at the time of inspection.Floors, walls, ceilings and other surfaces shall be in good repair. Maintenance was called about the drawer handle at the time of inspection. 02/01/2023 Implemented
SIN-00210748 Unannounced Monitoring 08/25/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(a)Clean and sanitary conditions are not being maintained in the home. The vent in the bathroom on the main level of the home was covered in a significant layer of dust. (Repeat Violation: 5/12/22, 6/21/22 and 7/25/22)Clean and sanitary conditions shall be maintained in the home. Provider cleaned the bathroom vent. 08/25/2022 Implemented
6400.67(b)The railing on the left side of the wall going down the basement steps is falling out of the wall. The spigot in the bathtub on the main level of the home is lose and falling off of the wall. (Repeat Violation: 3/11/22) Floors, walls, ceilings and other surfaces shall be free of hazards.Provider tightened the loose bolt in the middle of the rail. Faucet tightened in the upstairs bathroom. 08/27/2022 Implemented
6400.111(a)There is not an operable fire extinguisher with a minimum 2-A rating located in the basement of the home.There shall be at least one operable fire extinguisher with a minimum 2-A rating for each floor, including the basement and attic. Provider replaced the fire extinguisher as it fell to the ground and dislodged the pin during a routine inspection. 08/25/2022 Implemented
6400.213(1)(i)213(1)vi Individual #4's medical record that is maintained in the home does not contain a current, dated photograph. The most recent picture was dated 6/22/2021. (Repeat Violation 7/25/22)Each individual's record must include the following information: Personal information, including: (i) The name, sex, admission date, birthdate and Social Security number.Individual #4's current dated picture was placed in the binder. 08/25/2022 Implemented
SIN-00208708 Unannounced Monitoring 06/21/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(b)Licensing inspectors observed a significant number of spider egg sacs attached to webs hanging on the interior of windows located in the garage attached to the kitchen of the home; indicating a current or potential spider infestation in the home.There may not be evidence of infestation of insects or rodents in the home. The garage was emptied and cleaned. Maintenance crew inspected the garage after the cleanup and no spiders or spider eggs were noticed. 08/16/2022 Implemented
6400.67(a)There was a crack or crevice along a window in the home's spare bedroom through which a vine from a plant growing outside was able to enter the home.Floors, walls, ceilings and other surfaces shall be in good repair. The crack was sealed and is in good repair. The maintenance team inspected the home and no other structural concerns were identified. 08/16/2022 Implemented
6400.73(a)There was a broken handrail at the front entrance of the home. The handrail was split, and had pulled away from the exterior wall of the home where it had been attached. Each ramp, and interior stairway and outside steps exceeding two steps shall have a well-secured handrail. The handrail was fixed and in good repair. 08/16/2022 Implemented
6400.80(b)There was garbage and debris in the backyard of the home. The licensing inspectors observed an empty soda bottle, a box from a curtain rod, and a box from a toilet seat strewn about the yard. Additionally, there were several large fallen tree branches, and the yard was overgrown with foliage in places. The outside of the building and the yard or grounds shall be well maintained, in good repair and free from unsafe conditions.The backyard was cleaned and all the fallen tree branches removed. 08/16/2022 Implemented
6400.171There was an unlabeled glass mason jar in the freezer located in the kitchen of the home. The substance in the jar was yellow-white in color, and it could not be determined if the substance was food or how long it had been in the freezer.Food shall be protected from contamination while being stored, prepared, transported and served. The jar was removed from the freezer and disposed of. 08/16/2022 Implemented
SIN-00205221 Unannounced Monitoring 05/12/2022 Non Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.82(e)The basement had a bathroom which also had a shower stall. That shower stall did not have a non-slip mat or surface. Bathtubs and showers shall have a nonslip surface or mat. A nonslip mat was purchased for the basement shower stall. 08/16/2022 Implemented
6400.111(f)At the time of inspection there was a fire extinguished in the garage that was not inspected. Every extinguisher in the home must have an annual inspection. 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 extra uninspected fire extinguisher was removed from the home. 08/16/2022 Not Implemented
SIN-00204067 Unannounced Monitoring 04/08/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.32(r)(4)The locking mechanism on a bedroom door lock shall allow easy and immediate access by the individual and staff persons in the event of an emergency. There is a key lock on Individual #1's bedroom door but staff did not have a key, or know if there was a key available in the home.The locking mechanism shall allow easy and immediate access by the individual and staff persons in the event of an emergency.Staff stated that they forgot to pick individual #1's keys from the office. Provider met with staff and reminded to keep key on person during the entire shift. 04/08/2022 Implemented
6400.166(b)The name and initials of the person administering medication(s) shall be recorded in the Medication Administration Record (MAR) at the time that the medication is administered. On April 1, 2022 through April 8, 2022, staff administered the 8am dose of the medication Metoprolol prescribed for Individual #1, but did not initial the MAR at the time the medication was administered.The information in subsection (a)(12) and (13) shall be recorded in the medication record at the time the medication is administered.Staff involved were retrained on medication documentation. 04/11/2022 Implemented
SIN-00202017 Unannounced Monitoring 03/11/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.22(c)Individual #6's financial record indicated that the individual should have $143.58 available to the individual. The money count only contained $123.58 and there was no documentation or receipts showing that the individual spent any amount of money.Individual funds and property shall be used for the individual's benefit. Money was reconciled with day program receipts. 04/11/2022 Implemented
6400.66There is no light on the stairs leading to the basement and the area is poorly lit.Rooms, hallways, interior stairways, outside steps, outside doorways, porches, ramps and fire escapes shall be lighted to assure safety and to avoid accidents. Provider installed lighting in the stairway. 04/11/2022 Implemented
6400.67(a)The handle on the door of the closet in the bathroom is not in good repair. The handle on the door is broken and falling off.The spigot on the tub in the bathroom on the main level of the home is not in good repair. The spigot is falling off.Floors, walls, ceilings and other surfaces shall be in good repair. The handle on the door of the closet in the bathroom was fixed. The spigot on the tub in the bathroom was fixed. 03/14/2022 Implemented
6400.68(b)The hot water temperature in the home was 123.9 degrees. (Repeat Violation 9/22/21, 12/14/21, 1/25/2022). Hot water temperatures in bathtubs and showers may not exceed 120°F. A scald guard was installed in the shower. Water temperature adjusted and tracked for a few days to make sure it remained at an appropriate temperature. 03/14/2022 Implemented
6400.144Individual #6 is prescribed Ativan 0.5mg 1 tab by mouth two times a day as needed for anxiety. The pharmaceutical label does not include specific symptoms displayed by the individual in order for the medication to be administered. The agency has not provided proper pharmaceutical services. (Repeat Violation 9/22/21, 12/22/21, 1/25/22)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. There is a written PRN protocol that indicates individual #6's symptoms of anxiety. Staff trained on the PRN protocol. 03/11/2022 Implemented
SIN-00199347 Unannounced Monitoring 01/25/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.73(a)The staircase on the right leading from the kitchen to the garage had 3 steps and no handrail. Each ramp, and interior stairway and outside steps exceeding two steps shall have a well-secured handrail. Handrails have been installed. 01/31/2022 Implemented
6400.101The landing and the stairs leading from the kitchen to the garage was blocked with mops, mop buckets and brooms at the time of the inspection.Stairways, halls, doorways, passageways and exits from rooms and from the building shall be unobstructed. The landing and the stairs were cleared of obstruction. 01/31/2022 Implemented
6400.144Individual #1 has been losing weight since admission to the group home. The Individual had a consult with a nutritionist on 12/22/2021 to address the weight loss. One of the recommendations from the nutritionist was that the individual be given two cans of Ensure liquid per day; staff have been giving the Individual 1 can per day.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. Individual #1 is receiving Ensure as prescribed. 01/31/2022 Implemented
6400.165(g)Individual #1 is prescribed psychotropic medication, currently by her primary care physician because she does not currently have a psychiatrist. Psychiatric medication reviews did not occur every three months; and there was no documentation of the reason for prescribing the medication, the need to continue the medication and the necessary dosage.If a medication is prescribed to treat symptoms of a psychiatric illness, there shall be a review by a licensed physician at least every 3 months that includes to document the reason for prescribing the medication, the need to continue the medication and the necessary dosage.Individual #1 has been placed on a waiting list to see a new psychiatrist. An appointment has been scheduled for 3/8/2022 with Geriatric Medicine to seek medication review while she waits to see a psychiatrist. Most psychiatrists declined to see her due to her limited communication. 01/31/2022 Implemented
SIN-00225941 Unannounced Monitoring 06/07/2023 Compliant - Finalized
SIN-00221528 Unannounced Monitoring 03/21/2023 Compliant - Finalized
SIN-00213652 Unannounced Monitoring 10/18/2022 Compliant - Finalized
SIN-00209280 Unannounced Monitoring 07/25/2022 Compliant - Finalized
SIN-00184441 Renewal 02/10/2021 Compliant - Finalized