| Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
| 6400.113(a) | Individual 1 has not completed required Fire Safety training - no record present. | An individual, including an individual 17 years of age or younger, shall be instructed in the individual's primary language or mode of communication, upon initial admission and reinstructed annually in general fire safety, evacuation procedures, responsibilities during fire drills, the designated meeting place outside the building or within the fire safe area in the event of an actual fire and smoking safety procedures if individuals smoke at the home. | Individual #1 was trained on general fire safety, evacuation procedures, responsibilities during fire drill on 12/5/2024 |
12/02/2024
| Implemented |
| 6400.52(a)(3) | Staff #2 did not complete 24 hours of annual training in the reviewed training year. | The following shall complete 24 hours of training related to job skills and knowledge each year: Program specialists. | Staff member signed up for job skills and knowledge training to be completed 24 hours. |
12/20/2024
| Implemented |
| 6400.52(c)(2) | Staff #1 and Staff #2 last training for Prevention, detection and reporting Abuse, recognizing, and reporting incidents, individual rights was completed in September 2023 - Staff cannot be their own trainer. | The annual training hours specified in subsections (a) and (b) must encompass the following areas: The prevention, detection and reporting of abuse, suspected abuse and alleged abuse in accordance with the Older Adults Protective Services Act (35 P.S. §§ 10225.101-10225.5102). The child protective services law (23 Pa. C.S. §§ 6301-6386) the Adult Protective Services Act (35 P.S. §§ 10210.101 - 10210.704) and applicable protective services regulations. | The staff were retrained on Prevention, detection, and reporting abuse, recognizing and reporting incidents, individual rights on 12/10/2024. |
12/10/2024
| Implemented |
| 6400.52(c)(3) | Staff #1 and Staff #2 last training for Prevention, detection and reporting Abuse, recognizing, and reporting incidents, individual rights was completed in September 2023 - Staff cannot be their own trainer. | The annual training hours specified in subsections (a) and (b) must encompass the following areas: Individual rights. | The staff were retrained on Prevention, detection, and reporting abuse, recognizing and reporting incidents, individual rights on 12/10/2024. |
12/10/2024
| Implemented |
| 6400.52(c)(4) | Staff #1 and Staff #2 last training for Prevention, detection and reporting Abuse, recognizing, and reporting incidents, individual rights was completed in September 2023 - Staff cannot be their own trainer. | The annual training hours specified in subsections (a) and (b) must encompass the following areas: Recognizing and reporting incidents. | The staff were retrained on Prevention, detection, and reporting abuse, recognizing and reporting incidents, individual rights on 12/10/2024. |
12/10/2024
| Implemented |