Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00253216 Renewal 10/01/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(a)On 10/02/2024 at 10:11 AM, the deep fryer located in the kitchen of the home was covered in grease and debris.Clean and sanitary conditions shall be maintained in the home. The deep fryer was thrown away by management. 10/03/2024 Implemented
6400.106The furnace was cleaned and inspected by a professional furnace cleaning company on 8/10/2023 and again on 9/17/2024.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. The furnace was inspected and cleaned by a professional furnace cleaning company on 9/19/2024 10/02/2024 Implemented
6400.52(b)(5)Direct Service Worker #1, date of hire 7/26/2024, did not complete the following training during orientation: Job Knowledge and Skills.The following shall complete 12 hours of training each year: Paid and unpaid interns who work alone with individuals.Direct Service Worker #1 completed Job Knowledge and Skills training and signed off on the training. 10/03/2024 Implemented
6400.166(a)(6)Individual #1 is prescribed Vitamin D 3 5000 Unit Tab with directions to take 1 tablet by mouth daily for supplement. The October 2024 MAR states to take 1 capsule by mouth daily for supplement.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Dosage form.The MAR was corrected immediately. 10/02/2024 Implemented
SIN-00213385 Renewal 10/18/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.141(a)Individual #1 had a physical examination completed on 7-2-21, and then again on 7-21-22.An individual shall have a physical examination within 12 months prior to admission and annually thereafter. LPN has been retrained on the importance of having physical exams completed annually and before the due date. LPN has systems in place to track the due dates of such. New procedure established - if physician indicates they do not have an available appointment prior to the due date, individual will be taken to a walk-in facility to have exam completed and appointment scheduled with PCP for any concerns. 10/29/2022 Implemented
6400.141(c)(6)Individual #1's Tuberculin skin test was read on 7-8-20, and the next Tuberculin skin test was read on 7-25-22.The physical examination shall include: Tuberculin skin testing by Mantoux method with negative results every 2 years for individuals 1 year of age or older; or, if tuberculin skin test is positive, an initial chest x-ray with results noted. LPN has been retrained on the importance of having TB tests completed every 2 years. LPN has systems in place to track the due dates of such. New procedure established - if physician indicates they do not have an available appointment prior to the due date, individual will be taken to a walk-in facility to have TB test completed. 10/20/2022 Implemented
SIN-00196539 Renewal 11/23/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.141(c)(3)Individual #1 physical examination completed 1/28/21 did not include immunizations as recommended by the United States Public Health Service.The physical examination shall include: Immunizations for individuals 18 years of age or older as recommended by the United States Public Health Service, Centers for Disease Control, Atlanta, Georgia 30333. ¿ Nurse scheduled an appointment for individual 1 for 1/31/2022. 01/31/2022 Implemented
6400.141(c)(4)Individual #1's physical examination completed 1/28/21 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 an appointment for individual 1 for 1/31/2022. 01/31/2022 Implemented
6400.141(c)(14)Individual #1's physical examination completed 1/28/21 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 an appointment for individual 1 for 1/31/2022. 01/31/2022 Implemented
6400.142(a)Individual #1, date of admission 09/28/2020, has not had a dental examination 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 appointment scheduled for 2/9/2022. 02/09/2022 Implemented
SIN-00181103 Renewal 01/05/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.141(c)(9)Individual #1, date of birth 12-12-45, has not had a prostate examination.The physical examination shall include: A prostate examination for men 40 years of age or older. Issues and Responses #1 Individual Physical ¿ 149 (c9) ¿ Program failed to obtain a fully completed physical which included a prostate exam prior to acceptance. ¿ Corrective Action: o Director will review intake packet/checklist to make sure all required documents are completed prior to acceptance. (immediately) o JM sister is his medical power of attorney, she has scheduled an appointment with JM¿s doctor to plan for exam. (immediately) [Individual #1 had Prostate lab testing on 1/13/21. Copy of the testing documentation provided to the Department on 1/15/21. Upon competition of Individual's physical examination, the CEO or designee who is educated in the requirements of individual physical examinations, shall audit the physical examination to ensure all required information is included and health services are arranged and provided. Documentation of all audits shall be kept. (DPOC by AES,HSLS on 1/20/21)] 01/05/2021 Implemented
SIN-00174625 Initial review 08/05/2020 Compliant - Finalized