Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00278981 Unannounced Monitoring 10/14/2025 Needs Verification
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.16Individual #1 has a diagnosis of diabetes. The individual requires twice daily blood glucose checks, a fasting test in the morning and another test before bedtime, to ensure safe blood glucose levels. There was a protocol in place instructing staff what to do with each range of blood glucose. Individual #1 received multiple daily medications until 10/16/25 to control their blood glucose levels. At this time, Individual #1 became insulin dependent. Individual #1 had a total of 24 staff work in their home between 5/1/25 and 10/21/25. Only 5 of these staff were trained in the individual's blood glucose protocol. 16 of these staff did not receive any training on Individual #1's plans and protocols. As described in the Licensing Inspection Summary below, there were many dates where Individual #1's blood glucose levels were not tested and recorded properly. Additionally, there were 5 staff who administered medications to Individual #1 that were not medication administration trained. On 10/11/25, Individual #1 had a blood glucose reading of over 600 that led to 911 being contacted and a short hospitalization. This is when Individual #1 was prescribed insulin, as further steps were needed to properly control the individual's blood glucose levels. Failure to train staff and follow medical protocols led to conditions conducive to serious harm for Individual #1.Abuse of an individual is prohibited. Abuse is an act or omission of an act that willfully deprives an individual of rights or human dignity or which may cause or causes actual physical injury or emotional harm to an individual, such as striking or kicking an individual; neglect; rape; sexual molestation, sexual exploitation or sexual harassment of an individual; sexual contact between a staff person and an individual; restraining an individual without following the requirements in this chapter; financial exploitation of an individual; humiliating an individual; or withholding regularly scheduled meals.Although Individual #1 is no longer in our care, we have implemented agency-wide improvements to prevent similar issues when supporting individuals with complex medical needs. We identified that training documentation for staff was mishandled, so we are standardizing all training records through the Training and Development Coordinator and the agency Medication Administration Trainer. This includes creating a centralized tracking system for individualized protocol training, medication administration certification, and competency validations. Going forward, staff will not be scheduled to work with individuals requiring specialized health plans until training is documented and verified in this system. Additionally, we will conduct regular audits of training records and medication administration compliance to ensure accuracy and accountability. These measures strengthen our operational processes and guarantee that staff are properly trained and documented before providing care to individuals with complex health needs. 12/22/2025 Accepted
6400.144Individual #1 has a blood glucose protocol in place. The individual's blood sugar is to be taken twice daily -- before breakfast (fasting) and at bedtime. If the individual's blood sugar was over 400, the PCP was to be contacted. If the individual's blood sugar was less than 70, the individual was to be given juice or glucose tabs. If the individual was unresponsive, 911 was to be called. From 5/1/25 through 10/21/25, Individual #1's blood glucose was rarely noted as taken while fasting. Additionally, there were 33 days when the individual's blood glucose was checked only once and 21 days when the individual's blood glucose was not checked at all. This does not include the dates where Individual #1 was out of program between 5/1/25 and 10/21/25.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. Although Individual #1 is no longer in our care, we identified that the greatest issue was inconsistent documentation of blood glucose checks, particularly when the individual was out of program for home visits, appointments, or hospitalization. Staff were also documenting in both paper and electronic records, which caused gaps and confusion. To correct this at the operational level, we have standardized documentation procedures so that all health data is recorded in one designated system, eliminating duplicate or conflicting entries. Supervisory staff now review documentation daily to ensure accuracy and timeliness, and any discrepancies are addressed immediately. Policies have been created to require clear notation when an individual is unavailable for scheduled checks, and staff have been retrained on these expectations. These changes ensure accurate health monitoring and documentation for any individual with medical protocols in the future. 12/15/2025 Accepted
6400.52(c)(6)Individual #1 has multiple plans and protocols that staff must be trained on before working with the individual. These include: Individual Support Plan (ISP), Behavior Support Plan (BSP), Blood Glucose protocol, Blood Pressure protocol, Crisis and Day Board protocol, Dental Hygiene plan, and a constipation protocol. There were 24 staff who worked with Individual #1 between 5/1/25 and 10/21/25. None of these staff were fully trained in working with Individual #1. The provider agency utilizes a "read and acknowledge" training system, which is not an approved method of training for Individual plans and protocols. · Staff persons #1, 3, 4, 7, 8, 9, 12, 13, 15, 17, 18, 19, 20, 22, 23, and 24 were not trained in any plans and protocols. · Staff persons #2 and #6 were only trained in the constipation protocol, crisis and day board protocol and blood glucose protocol. · Staff persons #14, 16, and 21 were only trained in the crisis and day board protocol. · Staff persons #5, 10, and 11 were only trained in the constipation protocol and blood glucose protocol.The annual training hours specified in subsections (a) and (b) must encompass the following areas: Implementation of the individual plan if the person works directly with an individual.Although Individual #1 is no longer in our care, we have identified that our previous approach of "read and acknowledge" for individual plans and protocols was not compliant and did not ensure staff competency. Lead Program Specialist and Training and Development Coordinator will identify any other such inadequate trainings and correct the documentation and re-train on said policies per our new process. 12/22/2025 Accepted
6400.162(b)(2)(ii)Staff persons #6, 8, and 24 have not been trained in administering topical medication. These staff persons administered topical medication to Individual #1.A prescription medication that is not self-administered shall be administered by one of the following: A person who has completed the medication administration course requirements as specified in § 6400.168 (relating to medication administration training) for the administration of the following: Topical medications.Although Individual #1 is no longer in our care, we identified that poor record-keeping contributed to staff administering topical medication without documented training. To correct this, the Training and Development Coordinator and the agency Medication Administration Trainer will pull all medication administration training records and confirm accurate completion and remedy any deficient training packets through correcting the documentation or re-training. 12/22/2025 Accepted
6400.165(c)Individual #1's prescription for Rybelsus indicates that the medication is to be given "30 minutes before first food, beverages, or other oral medications." On the following dates, this medication was administered at the same time as Individual #1's 8am medications: · 5/2/25 · 5/16/25 · 6/15/25 · 6/27/25 · 7/1/25 · 7/19/25A prescription medication shall be administered as prescribed.Although Individual #1 is no longer in our care, we recognize the importance of following specific medication administration instructions. Operationally, if we support an individual with a prescription that requires timing adjustments---such as Rybelsus, which must be given 30 minutes before food or other medications---we will request clarification from the prescribing provider to ensure exact timing requirements are documented. Our Medication Administration Trainer will update the MAR and staff instructions to reflect these requirements, and staff will be trained on the adjusted schedule before administering the medication. These steps will ensure compliance with prescription directions and prevent timing errors in the future. 12/22/2025 Accepted
6400.167(a)(4)The following medications were administered to Individual #1 more than one hour before or after the prescribed time: · 5/17/25 -- 730am meds given at 221pm · 5/24/25 -- 730am meds given at 1107am · 6/30/25 -- 8am meds given at 210pm · 7/28/25 -- 8am meds given at 1146amMedication errors include the following: Failure to administer a medication at the prescribed time, which exceeds more than 1 hour before or after the prescribed time.Although Individual #1 is no longer in our care, we identified that the issue was late documentation during the transition to an electronic MAR, not late medication administration. To correct this operationally, we have implemented a policy requiring that if medication is signed off outside the prescribed time window, a supervisory note must confirm whether it was a documentation error versus an administration error. Additionally, the agency will maintain a record of these identified documentation errors and notify staff via email or Therap message to make the correction only after confirming that the medication was administered at the correct time. Staff have been retrained on timely documentation expectations, and supervisors will review these notes daily to ensure accuracy and accountability. These steps ensure medication records accurately reflect administration times and prevent similar discrepancies in the future. 12/15/2025 Accepted
6400.169(a)There is no documentation verifying that Staff Persons #1, 2, 7, 9, and 12 have completed the Medication Administration Training Course. These staff persons have administered medications to Individual #1.A staff person who has successfully completed a Department-approved medications administration course, including the course renewal requirements may administer medications, injections, procedures and treatments as specified in § 6400.162 (relating to medication administration).To correct this operationally, the Training and Development Coordinator and the agency Medication Administration Trainer have implemented a centralized system to track all medication administration certifications and competency validations. Staff who do not have verified documentation will be scheduled for retraining and competency validation to ensure compliance. 12/22/2025 Accepted
6400.207(4)(I)Individual #1 was administered PRN Trazodone 50mg for agitation on 10/15/25, 10/16/25, 10/24/25, and 10/25/25 with no written protocol in place from the physician or CEO approval for the administration. This constitutes a chemical restraint.A chemical restraint, defined as use of a drug for the specific and exclusive purpose of controlling acute or episodic aggressive behavior. A chemical restraint does not include a drug ordered by a health care practitioner or dentist for the following use or event: Treatment of the symptoms of a specific mental, emotional or behavioral condition.Although Individual #1 is no longer in our care, we identified that PRN Trazodone was administered without a written protocol from the prescribing physician or CEO approval, which constitutes a chemical restraint. To prevent this in the future, the Director of Operations will be responsible for verifying all prescriptions during intake to ensure that any PRN medication includes a physician-approved protocol. For psychotropic PRN medications specifically, the Executive Director and agency nursing team will reconcile the prescription and confirm that all required documentation and approvals are in place before administration. These steps will be documented in the individual's record and reviewed by supervisory staff prior to implementation. This process ensures that PRN medications are administered only in accordance with regulatory requirements and approved protocols. 12/15/2025 Accepted
SIN-00263663 Renewal 04/14/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)The self-assessments were to be completed between 10/23/24-1/23/25 and/or 10/11/24-1/11/25) and the self-assessment for this home was completed 1/13/25-1/24/25.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.Since the timeframe for the submission of the 2024 self-assessment has passed, the agency can not correct this specific violation. The plan to maintain compliance outlines the plan for prevention and future compliance. 04/23/2025 Implemented
6400.151(c)(3)For staff #3, the 8/7/24 physical exam does not indicate if this staff person is free from communicable diseases. The physical examination shall include: A signed statement that the staff person is free of communicable diseases or that the staff person has a communicable disease but is able to work in the home if specific precautions are taken that will prevent the spread of the disease to individuals. Staff #3 was scheduled for a physical from the agency's preferred provider, Concentra. The authorization is from 4/22/2025 and to be completed no later than 05/02/2025. The results should be received no later than 5/5/2025. 05/05/2025 Implemented
6400.181(a)Individual #1's new admission assessment was completed on 2/19/25 which was not completed within 60 days of the individual's date of admission of 12/19/24. 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. This violation cannot be rectified as the timeline for compliant submission has passed; this was submitted outside of that window. 04/23/2025 Implemented
6400.18(b)(2)There were eleven occurrences that Individual #1 was not administered their medications, and an incident report was not initiated: 1/16/25 and 1/17/25 8am dose of Farxiga 10 mg 1/18/25 8 am and 12 pm doses of Clonazepam 1 mg 1/19/25 8 am dose of Divalproex 500mg 1/29/25 8 pm dose of Propranolol 10 mg 2/2/25 8 pm dose of Haloperidol 2 mg 2/13/25 4 pm doses of Gabapentin 400 mg and Metformin 1,000 mg 2/14/25 8 am and 12 pm doses of Clonazepam 1 mg (signed, not given) 2/28/25 8 pm doses of Divalproex 500 mg, Lamotrigine 150 mg, Lithium Carbonate 300 mg, Propranolol 10 mg, Benztropine 1 mg, Clonazepam 1 mg, Gabapentin 400 mg, Haloperidol 2 mg, Melatonin 3 mg, and Trazadone 100 mgThe home shall report the following incidents, alleged incidents and suspected incidents through the Department's information management system or on a form specified by the Department within 72 hours of discovery by a staff person: A medication error as specified in § 6400.166 (relating to medication errors), if the medication was ordered by a health care practitioner.This medication error occurred in the past and cannot be corrected. EIMs have been entered for the occurrences of medication administration errors. Verifiable documentation errors have been corrected. 05/01/2025 Implemented
6400.34(a)Individual #1 was not informed of right 33b on the 1/29/25 Individual Rights form.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.The Individuals Rights' acknowledgement was updated by the Lead Program Specialist. This was then distributed to each program, to be reviewed by the individuals with the RS or Lead Program Specialist and then signed and filed. 04/28/2025 Implemented
6400.167(a)(1)There were eleven occurrences that Individual #1 was not administered their medications: 1/16/25 and 1/17/25 8am dose of Farxiga 10 mg 1/18/25 8 am and 12 pm doses of Clonazepam 1 mg 1/19/25 8 am dose of Divalproex 500mg 1/29/25 8 pm dose of Propranolol 10 mg 2/2/25 8 pm dose of Haloperidol 2 mg 2/13/25 4 pm doses of Gabapentin 400 mg and Metformin 1,000 mg 2/14/25 8 am and 12 pm doses of Clonazepam 1 mg (signed, not given) 2/28/25 8 pm doses of Divalproex 500 mg, Lamotrigine 150 mg, Lithium Carbonate 300 mg, Propranolol 10 mg, Benztropine 1 mg, Clonazepam 1 mg, Gabapentin 400 mg, Haloperidol 2 mg, Melatonin 3 mg, and Trazadone 100 mgMedication errors include the following: Failure to administer a medication.This medication error occurred in the past and cannot be corrected. EIMs have been entered for the occurrences of medication administration errors. Verifiable documentation errors have been corrected. 05/01/2025 Implemented
6400.167(d)(1)Individual #1 was prescribed Penicillin 500mg 1 tab twice daily for 10 days and was given the medication December 31, 2024- January 9, 2025, for the 8 am and 8 pm doses; however, it is documented that an extra dose was administered on Jan 10 at 8 pm.A medication error shall be reported to the prescriber under any of the following conditions: As directed by the prescriber.This medication error occurred in the past and cannot be corrected. EIMs have been entered for the occurrences of medication administration errors. Verifiable documentation errors have been corrected. 05/01/2025 Implemented
6400.213(1)(i)Individual #1's record did not include if the individual had any identifying marks.Each individual's record must include the following information: Race, height, weight, hair color, eye color, and identifying marks.This violation was addressed during the inspection by the Lead Program Specialist. 04/25/2025 Implemented
6400.141(d)The TB test that was completed on 7/25/23 for Individual #1 does not indicate the results of the test when it was read on 7/27/23 and did not have a signature of the person reading the test.Immunizations, vision and hearing screening and tuberculin skin testing may be completed, signed and dated by a registered nurse or licensed practical nurse instead of a licensed physician, certified nurse practitioner or licensed physician's assistant.Individual #1 is scheduled for a PCP appointment on 4/28/2025. At this appointment, their blood will be drawn for a blood TB test. The results will be added to his file when made available. 05/02/2025 Implemented