Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00264230 Renewal 04/01/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.21(a)Staff Member #1 had a date Of Hire of 6/5/24, however the date of their criminal background check was 6/17/24 which is greater than 5 days after the date of hire.An application for a Pennsylvania criminal history record check shall be submitted to the State Police for prospective employes of the home who will have direct contact with individuals, including part-time and temporary staff persons who will have direct contact with individuals, within 5 working days after the person's date of hire. Staff member # 1 criminal background check will now be monitored for future purposes. Moving forward, the human resources manager will make sure all staff criminal background check will be completely done before hiring. 04/25/2025 Implemented
6400.64(b)The home had insect traps which may be a sign of a potential infestation. Documentation reflecting this was requested but not recieved.There may not be evidence of infestation of insects or rodents in the home. The insect traps has been removed from the home and it is free of infestation. 04/25/2025 Implemented
6400.67(b)The following areas are in need of repair: -The floor in the basement shows current signs of flooding at the base of the steps and in the bathroom; no visible water was coming from the sink with the water running. -The wall in the office has a significant crack as evidence of prior water damage. -The ceiling in the office shows signs of water damage. -The cabinets in the kitchen are missing doors. Floors, walls, ceilings and other surfaces shall be free of hazards.The basement floor and the bathroom floor have been checked and fixed. 04/25/2025 Implemented
6400.72(b)There are no doors to the closet in Individual #1's room. Additionally in the other individual's bedroom The window is missing the handle needed to open/close it. Screens, windows and doors shall be in good repair. Individual # 1 closet door has been installed 04/25/2025 Implemented
6400.80(b)The grounds of the home must be free of unsafe conditions. The yard contains a pile of tree branches which present obstructed access. 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 and the yard has been thoroughly cleaned 04/25/2025 Implemented
6400.82(f)There was no soap in the bathroom.Each bathroom and toilet area that is used shall have a sink, wall mirror, soap, toilet paper, individual clean paper or cloth towels and trash receptacle. The soap has been replaced 04/25/2025 Implemented
6400.101The framing of the entryway door is unsecured and presents as a tripping hazard.Stairways, halls, doorways, passageways and exits from rooms and from the building shall be unobstructed. The framing of the outside door has been fixed. 04/25/2025 Implemented
6400.113(a)Individual #1 had annual fire safety training on 2/07/25, however his previous fire safety training took place on 4/10/23, which is greater than 1 year apart. 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 annual fire safety training was done but the document was misplaced. 04/25/2025 Implemented
6400.142(a)Most recent dental examination for individual #1 is dated 10/18/23 which is greater than 1 year old.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. Individual #1 dental appointment has been scheduled for a follow up appointment. 04/25/2025 Implemented
6400.152(a)Physical Exam for staff #3 dated 8/30/24 does not state if they are free of communicable disease. If a staff person or volunteer has a serious communicable disease as defined in 28 Pa. Code § 27.2 (relating to specific identified reportable diseases, infections and conditions) or a medical problem which might interfere with the health, safety or well-being of the individuals, written authorization from a licensed physician is required for the person to be present at the home. Staff #3 has been instructed to do another physical exam. 04/25/2025 Implemented
6400.181(a)Most Recent Annual Assessment for individual #1 was written on 3/24/25, however the previous one was written on 8/3/23, greater than 1 year apart Each individual shall have an initial assessment within 1 year prior to or 60 calendar days after admission to the residential home and an updated assessment annually thereafter. The initial assessment must include an assessment of adaptive behavior and level of skills completed within 6 months prior to admission to the residential home. Assessment for individual #1will be properly done and examined by the director before submission. 04/25/2025 Implemented
6400.217There were no signed consents on file for individual #1.Written consent of the individual, or the individual's parent or guardian if the individual is 17 years of age or younger or legally incompetent, is required for the release of information, including photographs, to persons not otherwise authorized to receive it. Individual #1 consent form has been updated. 04/25/2025 Implemented
6400.34(a)Individual #1 does not have a signed individual rights statement on record.The home shall inform and explain individual rights and the process to report a rights violation to the individual, and persons designated by the individual, upon admission to the home and annually thereafter.Individual #1 right statement has been updated 04/25/2025 Implemented
6400.46(d)The most recent CPR Certification for Staff Member #2 Expired on 3/31/23.Program specialists, direct service workers and drivers of and aides in vehicles shall be trained within 6 months after the day of initial employment and annually thereafter, by an individual certified as a training by a hospital or other recognized health care organization, in first aid, Heimlich techniques and cardio-pulmonary resuscitation.The CPR certificate for staff member#2 has been updated 04/25/2025 Implemented
6400.52(a)(1)Staff Member#2 had only 14 hours of trainings for most recent training year of 6/1/23 -- 5/31/24The following shall complete 24 hours of training related to job skills and knowledge each year: Direct service workers.Staff member #2 has completed all required trainings. 04/25/2025 Implemented
6400.181(f)There is no documentation at individual #1's annual assessment was sent to the team 30 days prior to his ISP meeting.The program specialist shall provide the assessment to the individual plan team members at least 30 calendar days prior to an individual plan meeting.Individual #1 annual assessment has been done. 04/25/2025 Implemented
SIN-00242148 Renewal 04/02/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)All self-assessments must be completely filled out.The agency shall complete a self-assessment of each home the agency operates serving eight or fewer individuals, within 3 to 6 months prior to the expiration date of the agency¿s certificate of compliance, to measure and record compliance with this chapter. The Agencies self assessment has been completed Implemented
6400.64(a)The shower stall has significant buildup of what appears to be mold & mildew around the caulk line. This should be cleaned thoroughly, possibly re-caulked as well.Clean and sanitary conditions shall be maintained in the home. The shower stall has been cleaned and the sides are all caulked around the tub. 04/17/2024 Implemented
6400.67(a)The kitchen counter is not anchored to the lower cabinets. The kitchen sink faucet is broken and comes off when turned on. There is peeling drywall on the ceiling of the dining room. There are gaps in the floorboards of the first floor; the floor itself is sticky and in need of cleaning. There is a broken blind in the individual's bedroom (#2).Floors, walls, ceilings and other surfaces shall be in good repair. the Kitchen Counter is now anchored to the lower cabinet, the Kitchen sink faucet that is broken, had also been replaced. all the peeling drywalls on the celling in the dinning room has also been fixed, and the gap in the floorboard of the first floor also has been cleaned. Also, the broken blinds on the individual bedroom (#2) replaced. 04/29/2024 Implemented
6400.72(b)One of the screens on the first floor living room window has a large rip in it. The basement door has significant damage near the top of its frame. Screens, windows and doors shall be in good repair. the screen on the first floor living room window has been replaced and the basement door also has been replaced. 04/29/2024 Implemented
6400.111(a)The second-floor fire extinguisher is rated 1-A. There should be a minimum 2-A rating extinguisher per floor of the home.There shall be at least one operable fire extinguisher with a minimum 2-A rating for each floor, including the basement and attic. A 2-A rating extinguisher has been placed on the second floor of the home. 04/17/2024 Implemented
6400.212(b)Lifetime medical for individual #2, not dated. Entries in an individual's record shall be legible, dated and signed by the person making the entry. A life-time medical for individual #2 has been dated. 04/17/2024 Implemented
6400.217No written consents available for individual #1 or individual #2.Written consent of the individual, or the individual's parent or guardian if the individual is 17 years of age or younger or legally incompetent, is required for the release of information, including photographs, to persons not otherwise authorized to receive it. The written consents are all completed with both the individual #1 and #2 signatories 04/17/2024 Implemented
6400.51(b)(1)Staff Member #3 orientation training did not include the application of person-centered practices, community integration, individual choice and supporting individuals to develop and maintain relationships.The orientation must encompass the following areas: The application of person-centered practices, community integration, individual choice and supporting individuals to develop and maintain relationships.Training for person centered practices, community integration, individual choice and supporting individuals to develop and maintain relationships has been completed and record placed in the staff #3 file. 04/17/2024 Implemented
6400.163(h)Individual #1 (PRN) Flovent 44mcg inhaler was found in the med box, but not listed on the MAR. Discontinued medications must be appropriately disposed of.Prescription medications that are discontinued or expired shall be destroyed in a safe manner according to Federal and State statutes and regulations.A call has been made to the prescribing doctor for the PRN medications Flovent 44mcg and a correction has been made on the discontinuation of the medication. 04/17/2024 Implemented
6400.166(a)(13)Individual #1 Olanzapine 15mg tab (8AM dose) was administered but not signed on the MAR, for 4/2. Divalproex 500mg tab (8PM dose) was administered but not signed on the MAR, for 4/1.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Name and initials of the person administering the medication.The staff who administered the medication on that day has been retrained on the medications administration and documentation. 04/17/2024 Implemented
SIN-00222120 Renewal 04/03/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.22(d)(1)The home shall keep an up-to-date financial and property record for each individual that includes the following: (1) Personal possessions and funds received by or deposited with the home. There is no record of personal possessions received by the home for individual #1The home shall keep an up-to-date financial and property record for each individual that includes the following: Personal possessions and funds received by or deposited with the home. An up-to-date Financial and Property record for the individual has been corrected, 05/09/2023 Implemented
6400.22(f)There may be no commingling of the individual's personal funds with the home or staff person's funds. Ind. #1 is receiving home and board during his first year and did not have the funds to cover room and board. Edomite staff allowed individual #1 to continue with housing and services free of charge until SSI started, however, there is no documentation to substantiate this statement. Edomite staff withdraws $1000 monthly to cover prior costs of room and board from Ind. #1 account.There may be no commingling of the individual's personal funds with the home or staff person's funds. Individual #1 Account has been corrected 05/10/2022 Implemented
6400.64(a)Clean and sanitation condition is needed in the homes bathroom upstairs, the tub is soiled.Clean and sanitary conditions shall be maintained in the home. The bathroom tub upstairs has been cleaned and will be kept in good sanitary conditions 05/10/2023 Implemented
6400.64(b)There is evidence of infestation in the home, in the kitchen cabinets and bathroom there were roaches observed.There may not be evidence of infestation of insects or rodents in the home. the kitchen cabinets and bathroom has been cleaned and infested 05/10/2023 Implemented
6400.67(a)The window located in the upstairs bathroom was cracked and would not remain open when attempting to open it.Floors, walls, ceilings and other surfaces shall be in good repair. the Window at the upstairs bathroom has been replaced and can now be open and close. 05/10/2023 Implemented
6400.67(a)The bathtub in the upstairs bathroom is damaged the water would not drain and the knob is missing/damaged.Floors, walls, ceilings and other surfaces shall be in good repair. the bathtub in the upstairs bathroom has been fixed and the water drain knob is free. 05/10/2023 Implemented
6400.67(b)The kitchen chair is damaged, the seat is not secured to the chair which could result in injury. Floors, walls, ceilings and other surfaces shall be free of hazards.the Kitchen chair has been replaced with a new chair. 05/10/2023 Implemented
6400.68(b)The water in the bathtub measured 126.3*, this was to be corrected within 24hrs. Hot water temperatures in bathtubs and showers may not exceed 120°F. the Water temperature was reduced the same day. New, the bathtubs and shower is below 120 05/10/2023 Implemented
6400.110(e)The home has three stories, but the smoke detectors are not operating properly, staff must hold the detector down continually and the sound is low.If the home serves four or more individuals or if the home has three or more stories including the basement and attic, there shall be at least one smoke detector on each floor interconnected and audible throughout the home or an automatic fire alarm system that is audible throughout the home. The requirement for homes with three or more stories does not apply to homes licensed in accordance with this chapter prior to November 8, 1991. A new interconnected smoke detector has been purchased and replaced in a proper working condition. 05/10/2023 Implemented
6400.141(a)For Ind. #1 there is more than one year between physicals. Last physical dated January 19, 2022. Current physical dated 3.29.23An individual shall have a physical examination within 12 months prior to admission and annually thereafter. individual #1 physical has been corrected 05/10/2023 Implemented
6400.141(c)(6)No TB result for Ind. #1 is not completed every two years. Last dated tested was read 5.19.2019. Most recent physical dated 3.29.23 does not have TB reading. TB result box indicated "QuantiFERON pending"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. the TB result for individual #1 has been corrected 05/10/2023 Implemented
6400.144No follow up from psychiatrist. As indicated by his last two physicals dated 1/19/2022 and 3/29/2023. There is no quarterly psychotropic review.Health services, such as medical, nursing, pharmaceutical, dental, dietary and psychological services that are planned or prescribed for the individual shall be arranged for or provided. the individual Psychiatrist quarterly review has been done and up-to-date in the file. 05/10/2023 Implemented
6400.151(a)Staff #1 did not have a physical before having direct contact with individuals, staff was hired on 07/02/2022 and physical not completed until 07/06/2022. A staff person who comes into direct contact with the individuals or who prepares or serves food, for more than 5 days in a 6-month period, including temporary, substitute and volunteer staff, shall have a physical examination within 12 months prior to employment and every 2 years thereafter. Staff #1 Physical has been corrected and placed in the file 05/10/2023 Implemented
6400.34(b)No signed individual rights in the record for individual #1 and Ind. #2The home shall keep a copy of the statement signed by the individual, or the individual's court-appointed legal guardian, acknowledging receipt of the information on individual rights.the individual rights were at the office during the time of the inspection but has been put in the individuals record file 05/10/2023 Implemented
6400.51(a)(3)Staff #1 did not complete orientation prior to working with the individuals. (Verification was not provided at time of inspection)Prior to working alone with individuals, and within 30 days after hire, the following shall complete the orientation as described in subsection (b): Direct service workers, including full-time and part-time staff persons.Staff #1 did complete his Orientation prior to working with the individual but was not placed on his record file. it is now placed on his record file 05/10/2023 Implemented
6400.181(f)The ISP invitation letter is not in the record for individual #2 file or provided during the inspection.The program specialist shall provide the assessment to the individual plan team members at least 30 calendar days prior to an individual plan meeting.A Correction has been made, and the ISP invitation letter is placed on the individual record. 05/10/2023 Implemented
SIN-00203731 Renewal 04/12/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.77(b)The First Aid Kit did not contain tweezers at time of inspection. A first aid kit shall contain antiseptic, an assortment of adhesive bandages, sterile gauze pads, a thermometer, tweezers, tape, scissors and syrup of Ipecac, if an individual 4 years of age or younger, or an individual likely to ingest poisons, is served. A tweezer has been replaced on the first aid 05/16/2022 Implemented
6400.110(e)The home has three stories, and the smoke detectors are not interconnected. and audible throughout the home or have an automatic fire alarm system that can be heard throughout the home.If the home serves four or more individuals or if the home has three or more stories including the basement and attic, there shall be at least one smoke detector on each floor interconnected and audible throughout the home or an automatic fire alarm system that is audible throughout the home. The requirement for homes with three or more stories does not apply to homes licensed in accordance with this chapter prior to November 8, 1991. The house is now replaced with a smoke detectors that is interconnected with one another and all the alarm can now go off at the same time throughout the house. 05/17/2022 Implemented
6400.112(c)The fire drill dated 12/29/2021 omitted the evacuation time and the meeting place.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. the fire drill dated 12/29/2021 has been addressed. 05/18/2022 Implemented
6400.141(c)(4)Portions of the Physical Examination Form for Individual #1 was not completed by the physician, vision screen and immunizations were omitted.The physical examination shall include: Vision and hearing screening for individuals 18 years of age or older, as recommended by the physician. the Physical Examination Form for the individual have been rescheduled to be completed by the physician 05/18/2022 Implemented
6400.141(c)(6)The TB screening for Individual #1 was left blank on his current physical examination form.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. the TB screening for the individual #1 have been completed on the current physical examination form. 05/18/2022 Implemented
6400.151(a)Staff #2 did not have a physical examination every two years, current physical provided is dated 04/24/202, and no previous physical exam was in the record.. A staff person who comes into direct contact with the individuals or who prepares or serves food, for more than 5 days in a 6-month period, including temporary, substitute and volunteer staff, shall have a physical examination within 12 months prior to employment and every 2 years thereafter. Staff #2 physical examination form have been replace with a completed current physical examination physical form. 05/16/2022 Implemented
6400.46(b)Staff #2 is not being trained in Fire safety annually, last training completed was 07/16/2019 and current training was completed 04/04/2022.Program specialists and direct service workers shall be trained annually by a fire safety expert in the training areas specified in subsection (a).Staff #2 Annual fire safety training have been done and has been place on the file. 05/17/2022 Implemented