Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00232904 Renewal 10/11/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.65On 10/12/2023 at 10:40 AM, the bathroom located in the basement of the home did not have a window or mechanical ventilation.Living areas, recreation areas, dining areas, individual bedrooms, kitchens and bathrooms shall be ventilated by at least one operable window or by mechanical ventilation. Mechanical ventilation was installed on 10/16/2023. 10/16/2023 Implemented
SIN-00196538 Renewal 11/23/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.141(c)(1)Individual #1's physical examination completed 8/30/21 did not include a review of previous medical history.The physical examination shall include: A review of previous medical history. ¿ Nurse scheduled appointments for the individual who file was non-complaint. The individual has an appointment scheduled for 1/27/2022. 01/27/2022 Implemented
6400.141(c)(4)Individual #1's physical examination completed 8/30/21 did not include a vision or hearing screening.The physical examination shall include: Vision and hearing screening for individuals 18 years of age or older, as recommended by the physician. ¿ Nurse scheduled appointments for the individual that was non-compliant so his physical forms can be updated with all required information The individual appointment has ne scheduled for 1/27/2022. 01/27/2022 Implemented
6400.141(c)(11)Individual #1's physical examination completed 8/30/21 did not include heath maintenance needs, medication regimen and the need for blood work at recommended intervals.The physical examination shall include: An assessment of the individual's health maintenance¿ Nurse scheduled appointments for the individual that was non-compliant so his physical forms can be updated with all required information The individual appointment has ne scheduled for 1/27/2022. 01/27/2022 Implemented
6400.141(c)(14)Individual #1's physical examination completed 8/30/21 did not include medical information pertinent to diagnosis and treatment in case of an emergency.The physical examination shall include: Medical information pertinent to diagnosis and treatment in case of an emergency. ¿ Nurse scheduled appointments for the individual that was non-compliant so his physical forms can be updated with all required information The individual appointment has ne scheduled for 1/27/2022. 01/27/2022 Implemented
6400.141(c)(15)Individual #1's physical examination completed 8/30/21 did not include special instructions for the individual's diet.The physical examination shall include:Special instructions for the individual's diet. ¿ Nurse scheduled appointments for the individual that was non-compliant so his physical forms can be updated with all required information The individual appointment has ne scheduled for 1/27/2022. 01/27/2022 Implemented
6400.142(a)Individual #1, date of admission 08/08/2020, did not have a dental examination performed by a licensed dentist since admission.An individual 17 years of age or younger shall have a dental examination performed by a licensed dentist semiannually. An individual 18 years of age or older shall have a dental examination performed by a licensed dentist annually. The individual has a dental exam scheduled for 2/16/2022. 02/16/2022 Implemented
SIN-00174702 Unannounced Monitoring 08/05/2020 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.21(a)The Program Specialist #1, date of hire 04/22/20, had a Pennsylvania criminal history record check submitted to the State Police on 05/28/19.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. o Human Resource Director was trained on all required items that need to be completed prior to staff being hired. (6/5/2020, immediate) Completed o Management team created a procedure which includes all staff files to be checked prior to working on the floor with individuals. (6/5/2020, Immediate) Completed o Human Resource Director created a spreadsheet to track all required staff paperwork and due dates. (6/5/2020, Immediate) Completed [Upon completion and then continuing at least quarterly for 1 year, the CEO or designated management staff person shall audit all back ground checks and the aforementioned procedures and tracking documentation to ensure completion as required. Documentation of audits shall be kept. (DPOC by AES,HSLS on 8/20/20)] 06/05/2020 Implemented
6400.151(a)Direct Service Worker #2, date of hire 03/01/20, had a physical examination completed on 03/03/20. A staff person who comes into direct contact with the individuals or who prepares or serves food, for more than 5 days in a 6-month period, including temporary, substitute and volunteer staff, shall have a physical examination within 12 months prior to employment and every 2 years thereafter. o Human Resource Director was trained on all required items that need to be completed prior to staff being hired. (6/5/2020, immediate) Completed o Management team created a procedure which includes all staff files to be checked prior to working on the floor with individuals. (6/5/2020, Immediate) Completed o Human Resource Director created a spreadsheet to track all required staff paperwork and due dates. (6/5/2020, Immediate) Completed [Upon completion and then continuing at least quarterly for 1 year, the CEO or designated management staff person shall audit all staff persons physical examinations to ensure timely completion with all required information and the aforementioned procedures and tracking documentation to ensure completion. Documentation of audits shall be kept. (DPOC by AES,HSLS on 8/20/20)] 06/05/2020 Implemented
6400.151(a)The Program Specialist #1, date of hire 04/22/19, had a physical examination completed on 05/12/20. A staff person who comes into direct contact with the individuals or who prepares or serves food, for more than 5 days in a 6-month period, including temporary, substitute and volunteer staff, shall have a physical examination within 12 months prior to employment and every 2 years thereafter. o Human Resource Director was trained on all required items that need to be completed prior to being hired. (6/5/2020, immediate) Completed o Management team created a procedure which includes all staff files to be checked prior to working on the floor with individuals. (6/5/2020, Immediate) Completed o Human Resource Director created a spreadsheet to track all required staff paperwork and due dates. (6/5/2020, Immediate) Completed [Upon completion and then continuing at least quarterly for 1 year, the CEO or designated management staff person shall audit all staff persons physical examinations to ensure timely completion with all required information and the aforementioned procedures and tracking documentation to ensure completion. Documentation of audits shall be kept. (DPOC by AES,HSLS on 8/20/20)] 06/05/2020 Implemented
SIN-00162045 Initial review 09/05/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.68(b)At 10:17AM, the hot water temperature at the bathtub in the bathroom near the bedrooms of the home measured 123.8°F. Hot water temperatures in bathtubs and showers may not exceed 120°F. Response to water temperature exceeding 120 F. (Water temperature was adjusted to an appropriate temperature on 9-5-2019) The Chief Executive Officer retrained all current managers of Divine Collaborative Care on 55 PA Code Chapter 6400.68(b). Training was conducted on 9-5-2019 at 6pm. (Please review attached training sheet) The Chief Operating Officer will monitor and log water temperature to ensure water temperature does not exceed 120 F. (Please review attached form) The Compliance Officer will audit water temperature logs quarterly. 09/05/2019 Implemented
6400.71The telephone number of the nearest hospital was not on or by the telephone in the staff office of the home. The telephone numbers of the nearest hospital, police department, fire department, ambulance and poison control center were not on or by the telephone in the basement of 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. Response to telephone of the nearest hospital not being on or by the telephones located at in the home. (Stickers obtaining all emergency contacts were placed on the phone on 9-5-2019) ¿ The Chief Executive Officer retrained all current managers of Divine Collaborative Care on 55 PA Code Chapter 6400.71. Training was conducted on 9-5-2019 at 6pm. (Please review attached training sheet)¿ The Executive Director reviewed all emergency contact numbers (nearest hospital, police department, fire department, ambulance and poison control center) that are required to be on phones in the homes. ¿ Stickers with all of the required information were created and placed on all phones. ¿ A form was created to ensure that there is always a legible sticker on the phone. (Please review attached form). ¿ Staff will be trained on 55 PA Code Chapter 6400.71. ¿ Staff will complete form atleast 1/weekly to ensure there are legible contact stickers that obtain all of the required information on the phone. ¿ Compliance Director will review forms monthly to make sure program is always in compliance. 09/05/2019 Implemented
6400.77(b)The first aid kit did not contain a thermometer. 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. Response to first aid kit not containing a thermometer. (Thermometer was placed in first aid kit on 9-5-2019) ¿ The Chief Executive Officer retrained all current managers of Divine Collaborative Care on 55 PA Code Chapter 6400.77(b). Training was conducted on 9-5-2019 at 6pm. (Please review attached training sheet) ¿ The Executive Director reviewed all items that are required to be in the first aid kit and created a first aid checklist that will be completed weekly to ensure the kit has all required contents (please review the attached form). ¿ All staff will be trained on PA Code Chapter 6400.77(b). ¿ The first aid checklist/kit will be reviewed and completed by nighttime staff. ¿ The Compliance Director will audit the first aid kit/checklist monthly to make sure the kit had all required content. 09/05/2019 Implemented
SIN-00213384 Renewal 10/18/2022 Compliant - Finalized
SIN-00181102 Renewal 01/05/2021 Compliant - Finalized