Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
6400.44(b)(12) | The program specialist did not review the ISP reviews completed 9/30/18 and 3/31/18 with Individual #1. | The program specialist shall be responsible for the following: Reviewing the ISP with the individual as required under § 6400.186. | Retraining on the significant compliance measures for the ISP Review and the review with the participant. The document will be generated and approved by the Program Specialist; with the signature acknowledgment of the development of the ISP review. Any updates for the ISP have already been completed for this measure and will be entered accordingly to upcoming ISP Reviews effectively immediately. Retraining on this procedural change was discussed during supervision with the Program Specialist on 6/26/2018. The mentioned reviews were reviewed by the Program Specialist with the individual on 6/29/2018. 12 [Immediately, upon hire and continuing at least annually, the CEO shall educate the program specialists of the responsibilities of the program specialist position as per 6400.44(b)(1)-(19) Documentation of the trainings shall be kept. At least quarterly for 1 year, the CEO shall audit a 25% sample of individual ISP review to ensure program specialist has reviewed the ISP revie3ws with the individual as required under 6400.186 (DPOC by AES,HSLS on 8/23/18)] |
06/29/2018
| Implemented |
6400.68(b) | On 6/7/18 at 9:18AM, the hot water temperatures measured 123.3°F in the bathtub in the bathroom adjacent to bedroom #1. | Hot water temperatures in bathtubs and showers may not exceed 120°F. | The temperature at leased buildings within Pathways Community Living presently have limited access to the hot water tank; as the building is a part of a large apartment complex. It will be the protocol of the residential sites to continue to monitor the water temperature on a weekly basis. Routinely, when the temperature presents with an above 120-degree Fahrenheit reading, staff will monitor the water temperatures twice daily until, the temperature is properly regulated. Spikes in the temperature can vary based on the logistics of the residential sites being in an apartment building. However, alerting maintenance of such a need can require extended wait times to modify the temperature. A water temperature gauge will be added to each bathroom shower to ensure a reading a of the water is taken prior to an individual getting into the shower or bath. This measure will ensure that residential staff are aware of the importance of tempering the water prior to participant use. Employees will receive documentation of the Water Temperature Back-Up plan during the upcoming staff meeting on 7/17/2018 and 7/20/2018. Actual temperature of the water at the specified site has been regulated since the time of the inspection. [On 7/30/18 the hot water temperature measured 107.4 at 12:14PM. Immediately, the CEO shall review the responsibilities of the positon as per 6400.43(b)(1)-(4) including compliance with this chapter and the 6400 regulations. Immediately, the CEO shall develop and implement policies and procedures to ensure the hot water temperature does not exceed 120°F at all times and train all staff persons on the aforementioned procedures. The policies and procedures shall include daily water temperature checks after the water temperature has been adjusted until the hot water temperature does not exceed 120°F for 14 consecutive days and then continuing at least weekly, immediate notification of the CEO if the hot water temperature measurement exceeds 120°F, documentation of the water temperature check and reviews of measurements at least monthly by the CEO. Documentation of the policies and procedures and trainings shall be kept. (DPOC by AES,HSLS on 8/29/18)] |
07/08/2018
| Implemented |
6400.112(a) | An unannounced fire drill was not held in September 2017. | An unannounced fire drill shall be held at least once a month. | The completion of fire drills remains important to the overall health and safety of the participants. A weekly review of fire drills and the necessity of accurate documentation of completion has been addressed with all residential site supervisors as of 6/27/2018. An all staff in service training will occur on both 7/17/2018 and 7/20/2018 to retrain on the importance of this matter. The fire drill in mention was completed yet documentation was not clear concerning the details of the drill. An extensive retraining on fire safety documentation standards was conducted by the Program Specialist in June 2018. Program Specialist will monitor that the proper documentation is provided by each site referencing a drill. The report will be sent to the CEO monthly as of July 2018. [Documentation of audits of fire drill record by the Program Specialist and the CEO shall be kept.(DPOC by AES,HSLS on 8/23/18)] |
06/27/2018
| Implemented |
6400.112(c) | The written fire drill record for the fire drill held on 7/19/17 did not indicate the amount of time it took for evacuation. This section was blank. | 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. | Actual time of the fire drill was not circled on the sheet of the drill record. The document will be redesigned to provide clear indications of pertinent information that must be filled in on the form. An extensive training was conducted in review of this compliance measure on 6/27/2018. An all staff in service training will occur on both 7/17/2018 and 7/20/2018 to retrain on the importance of this matter. Program Specialist will monitor that the proper documentation is provided by each site referencing a drill. [At least quarterly, the CEO shall audit all fire drill records to ensure fire drills are conducted and documented as required. Documentation of audits of fire drill record by the Program Specialist and the CEO shall be kept.(DPOC by AES,HSLS on 8/23/18)] |
06/27/2018
| Implemented |
6400.112(d) | The fire drill held on 10/26/17 had an evacuation time of 3 minutes and 25 seconds. The fire drill held on 4/17/18 had an evacuation time of 2 minutes and 35 seconds. The home does not have a extended evacuation time in writing in the past year by a fire safety expert. (Repeated Violation-6/21/17, et al) | Individuals shall be able to evacuate the entire building, or to a fire safe area designated in writing within the past year by a fire safety expert, within 2 1/2 minutes or within the period of time specified in writing within the past year by a fire safety expert. The fire safety expert may not be an employee of the home or agency. Staff assistance shall be provided to an individual only if staff persons are always present at the home while the individual is at the home. | Fire drills which exceed 2 1/2 minutes must be redone and provided with an indication of what occurred to support a change in helping the participants evacuate in a significant amount of time. An all staff in service training will occur on both 7/17/2018 and 7/20/2018 to retrain on the importance of this matter. An extensive training was conducted in review of this compliance measure on 6/27/2018 with all residential site supervisors. Program Specialist will monitor that the proper documentation is provided by each site referencing a drill. [Fire drills conducted in July 2018 had evacuation times within 2 /12 minutes as required. At least quarterly, the CEO shall audit all fire drill records to ensure fire drills are conducted and documented as required. Documentation of audits of fire drill record by the Program Specialist and the CEO shall be kept.(DPOC by AES,HSLS on 8/23/18)] |
06/27/2018
| Implemented |
6400.161(e) | Lorazepam 0.5mg, take 1 tablet by mouth once as needed for anxiety prescribed for Individual #1 was reportedly discontinued 5/31/18 remained in the home. | Discontinued prescription medications shall be disposed of in a safe manner. | The identified prescription medication that was discontinued; was newly discontinued within the previous week. The noncompliance with the regulatory standard occurred for one week, being that it was present in the medication box. House Supervisors have been instructed to complete a weekly review of medication boxes to ensure appropriate medication is present for the participant. Medication administration recorders (MAR) are going to be crossed checked to the Medication blister packs and medication original labeled containers once a week by supervisors and the medication administration trainer. Also, during site inspections, the expiration dates of all medication will be checked. If any medication is expired it will be properly disposed of. A review of the medication will occur monthly by the Medication Trainer, with a report submitted to the Program Specialist based on findings. The Medication Trainer will be responsible for random checks of the medication boxes to be completed on a bi-weekly basis to improve quality control measures. The medication trainer was made aware of this procedural change as of 7/6/2018. [On 7/30/18, the Department viewed the discontinuation order dated 5/24/18 for Lorazepam .5mg: Take 1 tablet by mouth as needed for anxiety prescribed for Individual #1. The medication was present in the home. There were dates of 6/14/18, 6/15/18, 6/16/18 and initials on bubble pack. There were initials but no dates on 6 other bubbles that had been popped. Individual #1's June MAR did not document that the medication was administered. On 7/31/18, the Lorazepam was removed and disposed by the house supervisor and verified by the program coordinator on 8/3/18. Immediately, the CEO and a certified medication trainer shall educated all staff person responsible for the aforementioned auditing of medications in the policies and procedures for the safe disposal of discontinued and expired medication and the procedures for auditing all individuals medications, medication administration records (MARs) and physician's order to ensure medications are administered as prescribed, documented as required and discontinued and expired medications are disposed of in a safe manner. Documentation of the trainings shall be kept. At least weekly, a designate trained staff persons shall audit all individuals' medications, MARs and physicians orders to ensure medications are administered as prescribed, documented as required and discontinued and expired medications are disposed of in a safe manner. Documentation of the audits shall be kept and reviewed by the CEO at least monthly for 6 months and then continuing at least quarterly. (DPOC by AES,HSLS on 8/28/18)] |
07/06/2018
| Implemented |
6400.186(a) | The program specialist did not complete the ISP reviews completed 9/30/17 and 3/31/18 for Individual #1. The reviews were completed and signed by the residential supervisor. | The program specialist shall complete an ISP review of the services and expected outcomes in the ISP specific to the residential home licensed under this chapter with the individual every 3 months or more frequently if the individual's needs change which impacts the services as specified in the current ISP. | The ISP review was historically completed by the House Supervisor, and then submitted for approval by the Program Specialist. The document will be generated and approved by the Program Specialist; with the signature acknowledgment of the development of the ISP review. Any updates for the ISP have already been completed for this measure and will be entered accordingly to upcoming ISP Reviews effectively immediately. Retraining on this procedural change was discussed during supervision with the Program Specialist on 6/26/2018. [The program specialist completed an ISP review ending on 6/30/18 which was signed by the program specialist and Individual #1 on 7/13/18. [Immediately, upon hire and continuing at least annually, the CEO shall educate the program specialists of the responsibilities of the program specialist position as per 6400.44(b)(1)-(19) Documentation of the trainings shall be kept. At least quarterly for 1 year, the CEO shall audit a 25% sample of individual ISP reviews to ensure program specialist has completed the ISP reviews, timely. (DPOC by AES,HSLS on 8/23/18)] |
06/26/2018
| Implemented |