| Inspection ID | Reason for Inspection | Inspection Date | Inspection Status | |
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SIN-00268778
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Renewal
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06/17/2025
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Compliant - Finalized
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| Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
| 6400.142(a) | Individual #1 had a dental examination on 11/1/23, and then again on 11/21/24. This exceeds the annual requirement. | 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. | Specific change to be made: Avid Care will implement comprehensive tracking of all medical appointments within its electronic record system Therap.
Person(s) Responsible: RN, Program Specialist
Timeline of changes to be made: August 1, 2025 |
08/01/2025
| Implemented |
| 6400.165(g) | Individual #1 is prescribed medications to treat the symptoms of a diagnosed psychiatric illness. Individual #1 had a psychotropic medication review by a licensed physician on 6/14/24, and then again on 9/30/24. This exceeds the at least every 3-month requirement. | 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. | Specific change to be made: Avid Care will implement comprehensive tracking of all medication reviews within its electronic record system Therap.
Person(s) Responsible: RN, Program Specialist
Timeline of changes to be made: August 1, 2025 |
08/01/2025
| Implemented |
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|
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SIN-00247882
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Renewal
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07/12/2024
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Compliant - Finalized
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|
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| Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
| 6400.101 | At 1:35PM, there was a slide lock on the exit door in the basement leading to the back of the home posing an obstructed egress. | Stairways, halls, doorways, passageways and exits from rooms and from the building shall be unobstructed.
| Changes to be made: The slide lock on the basement exit door will be removed to ensure the door is not obstructed, in compliance with Pennsylvania Code § 6400.101.
Responsible Person: The Maintenance Supervisor will be responsible for removing the slide lock.
Timeline for Change: The slide lock will be removed by 8/1/24
Method of Implementation: The Maintenance Supervisor will remove the slide lock from the basement exit door and verify that the door is fully functional and unobstructed after the removal. |
07/31/2024
| Implemented |
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|
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SIN-00209130
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Renewal
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08/02/2022
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Compliant - Finalized
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| Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
| 6400.181(e)(14) | Individual #1's annual assessment, completed on 6/4/22, does not address the Individual's ability to swim. | The assessment must include the following information:The individual's progress over the last 365 calendar days and current level in the following areas: The individual's knowledge of water safety and ability to swim. | Avid Care will update the applicable section in the assessment under water safety outlining in greater detail the individual's knowledge of water safety and ability to swim. Avid Care will also retrain the Program Specialist on completing an assessment for a individual. |
08/12/2022
| Implemented |
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|
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SIN-00190932
|
Renewal
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08/03/2021
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Compliant - Finalized
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| Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
| 6400.112(c) | The written fire drill record for the fire drill conducted 2/25/2021 did not include the time of the fire drill; an "X" was written were the time was to be documented. The written fire drill record for the fire drill conducted 4/20/2021 did not include problems encountered, this section was left blank. The written record for the fire drill conducted on 6/25/2021 did not include whether the smoke detectors were operative. | 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 fire alarm or smoke detector was operative. | August 10th 2021: The fire drill documentation will be updated with specific details/instructions on how to completely and accurately complete the document to prevent inaccuracies and to ensure each section is completed in its entirety. Additionally, the documentation will be updated to denote if the fire alarm activated was operable at the time of the drill. |
08/16/2021
| Implemented |
| 6400.112(h) | The written fire drill record for the fire drill conducted on 6/4/2021 had a the section that states, "Drill participates met at the designated meeting place: "yes no" this section was left blank; therefore compliance could not be measured. | Individuals shall evacuate to a designated meeting place outside the building or within the fire safe area during each fire drill. | August 10th 2021: The fire drill documentation will be updated with specific details/instructions on how to completely and accurately complete the document to prevent inaccuracies and to ensure each section is completed in its entirety. |
08/16/2021
| Implemented |
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SIN-00228294
|
Renewal
|
07/25/2023
|
Compliant - Finalized
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SIN-00174989
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Initial review
|
08/13/2020
|
Compliant - Finalized
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