Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00275416 Renewal 10/08/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.142(a)Individual #1 most recently had a dental examination performed by a licensed dentist on 05/08/24. No documentation of an additional examination more recently was provided. 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. The dental exam had already been scheduled, and a new exam date has been established. The next appointment will be set based upon the dental recomendations. 06/30/2026 Implemented
6400.181(e)(1)Individual #1's assessment dated 03/25/25 did not include the following information: preferences of the individual. The assessment must include the following information: Functional strengths, needs and preferences of the individual. The individual's assessment will be edited and include more depth and explanation to describe: Functional strengths, needs and preferences of the individual. 06/30/2026 Implemented
6400.181(e)(4)Individual #1's assessment dated 03/25/25 did not include the following information: the individual's need for supervision. This section was completely blank. The assessment must include the following information: The individual's need for supervision. The individual's assessment will be edited and updated to include The individual's need for supervision. 06/30/2026 Implemented
6400.181(e)(5)Individual #1's assessment dated 03/25/25 did not include the following information: the individual's ability to self-administer medication; the assessment simply indicated, "{Individual #1] has completed the necessary training to be self-medicating." The individual does not self-administer medication.The assessment must include the following information:  The individual's ability to self-administer medications.The individual's assessment will be edited and updated to include: The individual's ability to self-administer medications. 06/30/2026 Implemented
6400.181(e)(6)Individual #1's assessment dated 03/25/25 did not include the following information: the individual's ability to safely use or avoid poisonous materials, when in the presence of poisonous materials; the assessment simply checked a box that the individual had "adequate awareness".The assessment must include the following information: The individual's ability to safely use or avoid poisonous materials, when in the presence of poisonous materials.The individual's assessment will be edited and updated to include: The individual's ability to safely use or avoid poisonous materials, when in the presence of poisonous materials. 06/30/2026 Implemented
6400.181(e)(14)Individual #1's assessment dated 03/25/25 did not include the following information: The individual's knowledge of water safety and ability to swim; the assessment simply checked a box indicating the individual had an "Adequate Awareness."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.The individual's assessment will be edited and updated to include 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. 06/30/2026 Implemented
6400.166(a)(4)Individual #1's Medication Administration Record for October 2025 did not include the following information for the medications: name of medication for Cyanocobalamin 1,000 MCG and Hydroxyzine HCL 10 MG Tab.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Name of medication.The MAR was edited immediately to include the names of the medications. 06/30/2026 Implemented
6400.166(a)(5)Individual #1's Medication Administration Record for October 2025 did not include the following information for the medications: Strength of medication for Cyanocobalamin 1,000 MCG and Hydroxyzine HCL 10 MG Tab.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Strength of medication.The MAR was immediately edited to include: Strength of the medications. 06/30/2026 Implemented
6400.166(a)(6)Individual #1's Medication Administration Record for October 2025 did not include the following information for the medications: Dosage form of medication for Cyanocobalamin 1,000 MCG and Hydroxyzine HCL 10 MG Tab.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Dosage form.The MAR was immediately edited to include: Dosage form. 06/30/2026 Implemented
6400.166(a)(9)Individual #1's Medication Administration Record for October 2025 did not include the following information for the medications: frequence of administration for medication for Cyanocobalamin 1,000 MCG and Hydroxyzine HCL 10 MG Tab.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Frequency of administration.The MAR was immediately edited to include: Frequency of administration. 06/30/2026 Implemented
6400.166(a)(11)Individual #1's Medication Administration Record for October 2025 did not include the following information for the medications: diagnosis or purpose for medication Cyanocobalamin 1,000 MCG and Hydroxyzine HCL 10 MG Tab.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 MAR was immediately edited to include Diagnosis or purpose for the medication, including pro re nata. 06/30/2026 Implemented
6400.207(5)(I)On 10/9/25 at 9:35am Individual #2 had an assist bar inserted between the mattress, with legs that extended to the floor. It was explained that the assist bar was purchased after hip surgery to help position the individual in bed. This assist bar was not prescribed by a medical professional.A mechanical restraint, defined as a device that restricts the movement or function of an individual or portion of an individual's body. A mechanical restraint includes a geriatric chair, a bedrail that restricts the movement or function of the individual, handcuffs, anklets, wristlets, camisole, helmet with fasteners, muffs and mitts with fasteners, restraint vest, waist strap, head strap, restraint board, restraining sheet, chest restraint and other similar devices. A mechanical restraint does not include the use of a seat belt during movement or transportation. A mechanical restraint does not include a device prescribed by a health care practitioner for the following use or event: Post-surgical or wound care.A doctor's order was given by the PCP and put the usage of the bar in compliance. 06/30/2026 Implemented
SIN-00255327 Renewal 10/22/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(a)Individual #1's assessment dated September 12, 2024, indicates the individual is unsafe to be around poisonous materials. On October 23, 2024, at 9:50am several poisons were unlocked and accessible under the kitchen cabinet. These poisons included Pure Bright Germicidal Ultra Bleach, Lysol power clean, Resolve Carpet cleaner, and Easy off oven cleaner.Poisonous materials shall be kept locked or made inaccessible to individuals. Poisonous materials were immediately locked up and made inaccessible to individuals in the house. Reassess all individuals in this house and if one is found to be unsafe around poisonous materials then those poisons will be locked up and made inaccessible to the individual. 11/21/2024 Implemented
6400.181(a)Individual#1 had a completed assessment signed and dated 9/12/2024, by staff #1. Staff#1 does not meet the qualifications as a program specialist. 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. Individuals' assessment will be reviewed and signed by a qualified Program Specialist.. 11/21/2024 Implemented
6400.181(e)(8)Individual #1's assessment, dated 9/12/24, indicates that Individual #1 is both independent and needing physical prompts to evacuate in case of a fire.The assessment must include the following information: The individual's ability to evacuate in the event of a fire. The assessments will indicate the ability to evacuate in the event of a fire. 11/21/2024 Implemented
6400.186Individual #1's, Individual Service Plan, dated 12/18/2023 indicates, "The individual has a bed shaker to assist with evacuation, but she ignores the bed shaker." During the fire alarm inspection on 10/23/2024 at 10:16 am the individual's bed shaker was not operable.The home shall implement the individual plan, including revisions.Individuals plan was implemented immediately, and bed shaker was fixed and now in working order. Staff will reread the plan and implement the fire evacuation plan to include bed shakers. Fire drill forms now have "number of bed shakers" and "bed shakers in working order" on the monthly fire drill sheet conducted by supervisors. 11/21/2024 Implemented
SIN-00102277 Renewal 10/13/2016 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.44(b)(1)The program specialist did not complete Individual #1's assessment dated 7/11/16.The program specialist shall be responsible for the following: Coordinating and completing assessments. The Program Specialists will complete all individuals' annual assessments, sign and date. Annual calendars will be developed by Program Specialist and approved by CEO by 11/1/16. A quality assessment tool will be completed by Program Specialist and reviewed by CEO beginning on 11/1/16 and each month thereafter. An in-service occurred on 10/31/16, attended by all Program Specialists. In-service done on 10/31/16 included all of the above requirements. Documentation of in-service done. In-service signed and dated by all Program Specialists. 11/03/2016 Implemented
6400.112(c)The written fire drill record did not include the exit route used for the fire drill conducted on 7/21/16. 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. 10/31/16 CEO met with Program Specialist on a violation of 6400.112( c). A written fire drill record shall be kept of the date, time, the amount of time it took for evacuation, the exit route uses, problems encountered and whether the fire alarm or smoke detector was operative. A new fire drill report was completed on 10/31/16. All areas of the fire drill form must be completed monthly and all areas completed, no blank sections are acceptable. Beginning on 11/1/16 quality assessment checks on all monthly fire drills will be done. CEO and Program Specialist must sign and date each monthly fire drill report. 10/31/16 an in-service was completed with Program Specialist. The in-service included all of the above information. By 11/8/16, Program Specialist will have completed in-services with all residential supervisors. On 11/16/16, a mandatory staff meeting will be held to discuss new fire drill documentation. In-service will be signed and dated by all staff members. 11/03/2016 Implemented
6400.112(h)The fire drills conducted on 1/15/16 and 7/21/16 did not indicate if the individuals met at the designated meeting place during the drill; 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.A new fire drill report form completed on 10/31/16. All areas of fire drill form must be completed monthly and all areas completed, no blank sections are acceptable. Beginning on 11/1/16 quality assessment checks on all fire drills will be completed each month. CEO and Program Specialist must sign and date each individual fire drill report. On 10/31/16 an in-service conducted with Program Specialist was completed. In-service included all of the above. By 11/8/16 a mandatory staff meeting will be held to discuss new fire drill documentation. In-service will be signed and dated by all staff in attendance. 11/03/2016 Implemented
6400.141(c)(6)Individual #1 had a Tuberculin skin test read on 12/12/12 and then again on 1/23/15.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. On 10/31/16 CEO met with Program Specialist to discuss 6400.141(c )(6). The Program Specialist will develop new calendars to track every 2 year physical requirements, including Tuberculin skin testing by Mantoux method with negative results. If Tuberculin skin test is positive, an initial chest x-ray with results noted. An in-service occurred on 10/31/16 with all Program Specialists on the above requirement. Documentation of in-service done and signed and dated by all Program Specialists. A quality assessment tool will be completed by Program Specialist and forwarded to CEO for review beginning on 11/1/16 and each month thereafter. 11/03/2016 Implemented
6400.181(a)Individual #1 had an assessment completed on 6/8/15 and then again on 7/11/16. 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. CEO met with all Program Specialists on requirement 6400.181(a). Each individual must have an initial assessment within 1 year prior to or 60 calendar days after admission to our residential home and an updated annual assessment annually thereafter. The initial assessment must include assessments of adaptive behavior and level of skills completed within 6 months prior to admission to our residential homes. A quality assessment tool on all new admissions will be completed to assure that all the above requirements have been met. This tool to begin 11/1/16 and will be forwarded to CEO for compliance. In-service done by CEO on 10/31/16 with all Program Specialists. Documentation of in-service done, signed and dated by all Program Specialists. 11/03/2016 Implemented
6400.181(d)The program specialist did not sign and date Individual #1's assessment dated 7/11/16.The program specialist shall sign and date the assessment. The Program Specialists will complete all individuals' annual assessments, sign and date. Annual calendars will be developed by Program Specialist and approved by CEO by 11/1/16. A quality assessment tool will be completed by Program Specialist and reviewed by CEO beginning on 11/1/16 and each month thereafter. An in-service occurred on 10/31/16, attended by all Program Specialists. In-service done on 10/31/16 included all of the above requirements. Documentation of in-service done. In-service signed and dated by all Program Specialists. 11/03/2016 Implemented
SIN-00234304 Renewal 11/07/2023 Compliant - Finalized
SIN-00215086 Renewal 11/08/2022 Compliant - Finalized
SIN-00181609 Renewal 01/19/2021 Compliant - Finalized
SIN-00162675 Renewal 09/04/2019 Compliant - Finalized
SIN-00122872 Renewal 10/11/2017 Compliant - Finalized
SIN-00060230 Renewal 09/18/2014 Compliant - Finalized
SIN-00048355 Renewal 04/17/2013 Compliant - Finalized