Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00270498 Renewal 09/08/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.24(d)(1)Individual #1 has end of month bank statements instead of an up-to-date financial record. Up-to-date is defined as "extending up to the present time". Additionally, the bank statements do not provide an up to date balance which would allow Individual #1 to know how much money is available to spend. An up-to-date financial and property record shall be kept for each indivudal that includes the personal possessions and funds received by or deposited with the family or agency.All individuals that are not their own rep payees. A form will be created for a daily record of receipts and spending. 10/02/2025 Implemented
6500.109(d)The fire drill records for the home do not include problems encountered on the fire drill records.A written fire drill record shall be kept of the date, time, the amount of time it took for evacuation, the exit route used, problems encountered and whether the smoke detector was operative.Fire training form will be updated. 10/02/2025 Implemented
6500.151(e)(14)Individual #1's assessment dated 7/25/2025 does not specify their ability to swim. It references supervision level around bodies of water but does not assess the ability to swim. The assessment must include the following information: The individual's knowledge of water safety and ability to swim.Update individuals' assessment to ensure this is updated. 09/19/2025 Implemented
6500.181(b)(1)Individual #1's emergency contact information does not include the relationship of the person to be contacted in case of an emergency. In this case, it is the Family Living Provider.Emergency information for an individual shall include the following: The name, address, telephone number and relationship of a designated person to be contacted in case of emergency.Updated the individual emergency face sheet. 09/30/2025 Implemented
6500.136(a)(7)The September 2025 MAR for Individual #1 reads Mucus DM ER 600-30mg, however, the MAR reads Mucinex DM-ER 30-6000mg. The prescription dosage and the MAR dosage do not match.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Dose of medication.Mar will be fixed to note the correct dosage. 09/30/2025 Implemented
6500.151(f)Individual #1's annual assessment was sent to plan team members on 7/25/2025. The ISP meeting was held on 8/22/2025. Plans must be provided to team members at least 30 days prior to an upcoming ISP meeting.The life sharing specialist shall provide the assessment to the individual plan team members at least 30 calendar days prior to an individual plan meeting.Check spreadsheet to confirm no upcoming changes to assessments Program Specialist will be trained on this regulation. 09/30/2025 Implemented
SIN-00255811 Renewal 12/03/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.24(e)(3)Receipts for purchases over $15 for individual #1 are not being kept.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.Provider did not collect receipts for the previous licensing year. Provider has completed a retraining with FLP and Life Sharing Specialist on the regulation. 12/05/2024 Implemented