Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00250793 Renewal 08/29/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.72(a)At 12:14PM, there was not a screen in the window behind the bed in Individual #1's bedroom.Windows, including windows in doors, shall be securely screened when windows or doors are open. Window screens were promptly ordered and installed in the Individual's bedroom windows. 09/04/2024 Implemented
6400.72(b)At 12:16PM, there was an eight-inch by one-inch tear in the screen in the window on the right side of Individual #1's bedroom. Screens, windows and doors shall be in good repair. New screens were promptly ordered and installed in the Individual's bedroom windows, replacing the screen that had a tear. 09/04/2024 Implemented
6400.80(b)At 12:36PM, numerous items, including but not limited to, two large ladders, a smaller ladder, buckets of paint, two wooden sawhorses, a hose, pipes, a paint tray, pieces of wood, bins, and other miscellaneous items, were in front of the attached garage in the back of the home. The outside of the building and the yard or grounds shall be well maintained, in good repair and free from unsafe conditions.The outside of the building was cleaned up so that no unsafe conditions exist. All items in front of the garage area behind the home were removed so that it is free and clear. 09/02/2024 Implemented
6400.106The home is equipped with a boiler heating system that has not been cleaned or inspected.Furnaces shall be inspected and cleaned at least annually by a professional furnace cleaning company. Written documentation of the inspection and cleaning shall be kept. A HVAC professional performed an inspection and cleaning of the residential boiler heating system. Details of the service completed are listed on the service invoice. 09/06/2024 Implemented
6400.107At 12:29PM, a portable space heater was on a shelf in the attached garage of the home.Portable space heaters, defined as heaters that are not permanently mounted or installed, are not permitted in any room including staff rooms. The space heater has been removed and disposed of properly. It is no longer in the garage. Agency supervisor talked with the building owner who uses the garage for storage, and explained that space heaters are not allowed to be stored on the premises. He has agreed to not store them there in the future. 09/02/2024 Implemented
6400.112(f)The front door was used as the exit route for all monthly fire drills held between August 2023 and August 2024.Alternate exit routes shall be used during fire drills. The Program Specialist has developed a plan to work on the Individual being willing to use the back door as an exit during a fire drill. The plan has been shared with the Individual and his team. It has been implemented, and we will be working towards the goal for a successful fire drill by the end of the 2024. 09/01/2024 Implemented
6400.181(f)Program Specialist #1 provided Individual #1's assessment, completed 4/15/2024, to the plan team members on 4/22/2024 for the annual Individual Plan meeting on 5/7/2024.The program specialist shall provide the assessment to the individual plan team members at least 30 calendar days prior to an individual plan meeting.Going forward, the Program Specialist will provide the assessment to the team 30+ days before the ISP meeting. 08/30/2024 Implemented
SIN-00212714 Renewal 10/06/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.166(a)(11)Individual #1's October 2022 Medication Administration Record does not include the diagnosis or purpose for Lexapro 20MG tablet, Lexapro 10MG tablet and Aripiprazole.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.The purpose/diagnosis for each medication has been added to the MAR. For October, I wrote it in the medication blocks. In the future, it will be pre-printed as we have altered the form. 10/12/2022 Implemented
SIN-00196081 Renewal 11/15/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.181(f)There was no documentation to show that the program specialist provided Individual #1's assessment completed on 4/1/21 to the plan team for the individual plan meeting held on 5/5/21.The program specialist shall provide the assessment to the individual plan team members at least 30 calendar days prior to an individual plan meeting.We did not have a system in place for keeping track of who received the Assessments and when. Now, I have edited the Assessment cover page so that this information can be recorded on the document. Program Specialist shall be responsible for recording this information after delivery to the ISP team. 11/23/2021 Implemented
SIN-00180700 Renewal 12/11/2020 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.111(f)The date of the inspection was not on the fire extinguisher in the kitchen of the home. A fire extinguisher shall be inspected and approved annually by a fire safety expert. The date of the inspection shall be on the extinguisher. In the future, if I purchase the fire extinguisher online, I will print out the invoice to attach to the fire extinguisher. If I purchase the annual fire extinguisher inside a store, I will also attach to the fire extinguisher. I will keep the previous year and current year receipt to show that we purchase a new one every year in lieu of having it inspected by a fire safety expert. During the inspection, I printed the invoice and attached to the fire extinguisher. The previous years receipts were already present and posted on the wall next to the fire extinguisher. I have taken the most recent and attached to the extinguisher. Proof of purchase was previously submitted. [Immediately, the CEO or designee shall educate all staff persons of the requirement that the date of the inspection and approval shall be on all fire extinguishers. At least quarterly, the CEO or designee shall audit all fire extinguisher to ensure that the date of the inspection and approval is on all fire extinguishers. (DPOC by AES,HSLS on 12/22/20)] 12/11/2020 Implemented
SIN-00101474 Renewal 09/30/2016 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.141(c)(15)Individual #1's physical examination, dated 1-25-2016 did not include special instructions for individual's diet; this section was left blank. The physical examination shall include:Special instructions for the individual's diet. The physician has completed a new physical form with this blank filled in. In the future, we will closely review the physical to be sure that there are no blank spaces left on the form. [Prior to entering into the individual's record the physical examination shall be reviewed by the CEO or program specialist to ensure all required information is present including special instructions for the individual's diet and there are no required areas left blank. Missing information will be immediately obtained. (AS 10/25/16)] 10/13/2016 Implemented
SIN-00231888 Renewal 09/21/2023 Compliant - Finalized
SIN-00161157 Renewal 08/22/2019 Compliant - Finalized
SIN-00141196 Renewal 09/07/2018 Compliant - Finalized
SIN-00121402 Renewal 09/20/2017 Compliant - Finalized
SIN-00079686 Renewal 09/28/2015 Compliant - Finalized
SIN-00068143 Renewal 09/22/2014 Compliant - Finalized
SIN-00051245 Renewal 07/25/2013 Compliant - Finalized