Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00251410 Renewal 09/12/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.72(b)The screen door at the front of the home was broken with cracks in it. It was also positioned in a way that did not cover the opening to the home. Screens, windows and doors shall be in good repair. Door was replaced on 9/20/24, See Attachment #9. Follow up on maintenance request was reviewed with all managers on 9/13/24, See attachment #2. Maintenance issues was also reviewed with direct care staff on 9/15/24, Attachment #7 09/20/2024 Implemented
SIN-00230706 Renewal 09/12/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.22(e)(1)Individual #1's financials were in an account under house account where money is being submitted and withdrawn on her behalf. If the home assumes the responsibility of maintaining an individual's financial resources, the following shall be maintained for each individual: A separate record of financial resources, including the dates and amounts of deposits and withdrawals. Individual #1 opened up an individual bank account on 10/12/23. See attachment..#32-#33 10/12/2023 Implemented
6400.112(a)This location was missing the August, October, November, and December 2022 fire drills documentation. An unannounced fire drill shall be held at least once a month. Director of Residential Services will ensure that monthly unannounced fire drill is conducted. Fire Drills for September 2023, October 2023, November 2023, December 2023 and January 2024. (Attachment #11 through #15) Attachment #16 and #17 in-service training minutes on fire drills 12/07/2023 Implemented
6400.141(a)There was no annual physical exam completed for individual #1 for the year of 2022.An individual shall have a physical examination within 12 months prior to admission and annually thereafter. Annual Physical for 2023 was completed on 3/15/23. See Attachments #21a and #21b. Annual physical for 2024 scheduled for 3/15/24. See Attachment #22. The nurse will ensure that all appointments are tracked and scheduled. Managment staff trained on12/7/23 on medical appointments. See Attachments 16-17. 12/07/2023 Implemented
6400.141(c)(7)The gyn exam for individual #1 was not completed in the year of 2022.The physical examination shall include: A gynecological examination including a breast examination and a Pap test for women 18 years of age or older, unless there is documentation from a licensed physician recommending no or less frequent gynecological examinations. The annual gyn from 2022 was completed on 9/20/22. See attachment #23. It must have been mixed up with other paperwork. Annual GYN for 2024 is scheduled for 3/4/24, see attachment. #24 09/13/2023 Implemented
6400.142(a)The annual dental exam for individual #1, was not completed in the year of 2022.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. Nurse will ensure that medical appointments and dental exams are monitored and scheduled as per their due dates Next dental is scheduled for 3/4/24, see Attachment #25. Managers were retrained on 12/7/23, See Attachments 16-17. 12/07/2023 Implemented
6400.144The spinal Consultation that was recommended by the PCP for individual #1, on the April 2023 annual physical exam was not competed at the time of the 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. Individual #1 PCP, Julia Kittka, referred her to the Spinal/PT Good Shepherd Penn Partners Specialty Hospital after her annual physical on 3/15/23(Attachment #21an and #21b). She received an initial consultation on 3/29/23 and received services through 5/22/23. See attachment #27-31 09/13/2023 Implemented
6400.217There was not a written consent for release of information for individual #1 on file for the year of 2022.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. Corrected on 9/15/23. See Attachment #34-35, Retraining with managers on written consent on 9/18/23 See attachment #36. 09/18/2023 Implemented
6400.31(b)The individual rights for individual #1was only completed for the year of 2022.The home shall educate, assist and provide the accommodation necessary for the individual to make choices and understand the individual's rights.Individual Rights was completed on 9/15/23. See attachment #37-#38. Retraining with managers on 9/18/23, See attachment #36 09/18/2023 Implemented
6400.186The annual assessment for individual #1, which was due in April of 2022 was not in the records at the time of the review.The home shall implement the individual plan, including revisions.Annual Assessment was completed on 4/30/23. Paperwork was completed prior to inspection and mixed up with other paperwork. See attachment #39-#43. Retraining on 9/18/23, Attachment #36 09/18/2023 Implemented
SIN-00211061 Renewal 09/12/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(f)The outdoor trashcans in the home did not have lids. They all originally had hinged lids which had been broken off or otherwise removed.Trash outside the home shall be kept in closed receptacles that prevent the penetration of insects and rodents.Shared Values will ensure all outdoor trashcans are free from penetration of insects and rodents by having operable lids on each outdoor trash receptacle. Upon inspection, the outdoor trashcans in the home did not have lids; They all originally had hinged lids which had been broken off or otherwise removed. Replacement trashcans have been requested of Abington Township 10/6/2022. The replacement cans are estimated to arrive 1-2 weeks post-request. A new community manager has been onboarded and assigned to the home. We have also on-boarded a new Director of Residential Services. The community manager will be responsible for ongoing maintenance of the property with collaboration of the maintenance team. The community manager will be required to complete a full onsite walk through with the Director of Residential Services every other month in conjunction with their weekly visits. Moving forward Shared Values will ensure to keep the outside of all residential homes well maintained and in good repair. The community manager and program director are conducting full site visits on 10/17/2022 to re-inspect the home and the home's outdoor trash receptacles. 10/17/2022 Implemented
6400.106There was no furnace inspection for the home over the past year.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. Shared Values was non-compliant in regulatory code 6400.106, there was no furnace inspection on file for the home over the past year. Shared Values residential properties are rented, not owned. The furnace inspections have been maintained by the property owners/landlords of the residential sites and newly transitioned administrative staff were unable to locate copies of completed inspections. All property managers for all residential homes were contacted 10/10/2022 in request of completed furnace inspections. Property Managers were given 10 days to produce documentation of completed furnace inspections. If a completed furnace inspection is not produced for any home by 10/20/2022, Shared Values will schedule and have completed all necessary inspections in all applicable residential programs. 10/20/2022 10/20/2022 Implemented
6400.112(h)On 3/15/22 there was no meeting place recorded on the fire drill record. Individuals shall evacuate to a designated meeting place outside the building or within the fire safe area during each fire drill.In review of the citation received, Shared Values was not compliance with 6400.112h. In efforts to ensure compliance, all staff will be trained on completion of fire drills. The mandatory training will take place on Thursday, October 27, 2022. The training will be virtual, facilitated by the Director of Residential Services and two Community Mangers. During this time, supervisory will ensure staff are educated on the importance of completing fire drills in entirety, on-time as scheduled. Management will stress the importance of ensuring staff are signing off on all fire drills completed. Management will also discuss requirements for completion of the fire drills, including but not limited to documenting designated meeting places. All fire drills must be completed under normal staffing conditions and must not exceed 2½ minutes. All new hires will be trained during the on-site residential training on how to complete fire drills. All fire drills will be collected by the community manager and submitted to the Program Director for review. Fire drills will be given to the administrative assistance for filling and documentation purposes. 10/27/2022 Implemented
6400.144The following medication prescribed to Individual 1 was not present at site at the time of inspection: Risperidone 0.5mg to be taken by mouth twice a day as needed for agitation/anxiety. {Repeated Non-Compliance 9/15/2021}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. All employees of Shared Values that work in the 6400-residential program as a Direct Support Professional (DSP) are required to take and pass the Department of Human Services (DHS) Medication Administration Training program. Only staff that have been certified can administer prescription and non-prescription medications to the clients we support. Shared Values policy requires that employees who administer prescription and non-prescription medications to the clients we support review the Medication. The Community Manager has reviewed all medication onsite for individual 1. A review of medication was completed 9/16/2022. Individual 1 PRN Risperidone was located and placed securely into the Individual's medication box. Medication Administration: Direct Support Staff will review the Medication Administration Record (MAR) daily to make sure there are no errors. Medication labels should also be compared to the MAR during this period of review. All staff will be retraining on MAR Reviews during staff meeting scheduled 10/27/2022. Shared Values will ensure all participants receive medication as prescribed by a physician. In response to the licensing inspection, Shared Values has implemented an internal corrective action to the Community Manager whom provides managerial oversight to the residential program. Shared Values will hire a nurse to review MARs and medication administrations, and reconcile medication and/or MAR related discrepancies with the prescribing physician or pharmacy as needed 11/7/2022. All employees who administer medication must be certified with valid up to date training documentation in their file reviewed by the Office Manager. All PRN medication will be reviewed monthly against the medication list received upon the delivery of medication. All expired and unused medication must be removed from the site by the community manager each month with new medication deliveries. An additional community manager has been hired and onboarded for operational oversight 9/26/2022. The community managers will be required to review medication and MARS during each site visit. The community mangers are required to have a minimum of three site visits a week. The program specialist will be required to review medication at all homes at least once a week. The Director of Residential Services will be required to conduct random reviews of MARs at all homes. The Compliance Director has reviewed job descriptions and completed internal training with the community managers with medication oversight of all the residential homes 9/26/2022. The Director of Residential services has begun reviewing the MARs to ensure medication is being reviewed 9/28/2022. 09/16/2022 Implemented
6400.217Individual 1's record did not contain consents for information to be shared.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. It is the obligation of Shared Values to protect the private information of the individuals we support. Each individual, the individual's parent, guardian or advocate if appropriate, must consent to private health information being shared within the parameters of safe practice upon admission, and annually thereafter. There must be a signed and dated statement consenting to sharing private information kept in the client's record. Each individual must be encouraged to exercise his or her rights. Upon completion of inspection, Individual 1 and Individual 2 did not have an updated consent statement. Individuals 1 and 2 will be provided with an updated consent to share information statement 10/17/2022. The Community Managers will review all client records to ensure all are compliant with signed consents 10/17/2022. The program specialist will maintain and update tracking spreadsheets to ensure all forms have been reviewed and signed annually. The compliance director will maintain ongoing monitoring of all Individuals' annually signed consents and notices of rights on a monthly basis. 10/17/2022 Implemented
6400.31(b)Individual 1's record did not contain a copy of signed rights.The home shall educate, assist and provide the accommodation necessary for the individual to make choices and understand the individual's rights.It is the obligation of Shared Values to protect the rights of the individuals we support. Each individual, the individual's parent, guardian or advocate if appropriate, must be informed of the Individual's Rights upon admission, and annually thereafter. There must be a signed and dated statement acknowledging receipt of information on rights kept in the client's record. Each individual must be encouraged to exercise his or her rights. Upon completion of inspection, Individual 1 and Individual 2 did not have an updated rights statement. Individuals 1 and 2 will be provided with an updated individual right statement 10/15/2022. The Community Managers will review all client records to ensure compliance with maintaining an updated annual Individual Rights document that is signed accordingly 10/17/2022. The program specialist will maintain and update tracking spreadsheets to ensure all forms have been reviewed and signed annually. The compliance director will maintain ongoing monitoring of all Individuals' annually signed consents and notices of rights on a monthly basis. 10/17/2022 Implemented
6400.166(b)The following medication prescribed to Individual 1 had no initials or other documentation for its 8am administration time on 9/2/22: Docusate Sodium 100mg: Take one capsule a day by mouth at 8am and 8pm. {Repeated Non-Compliance 9/15/2021}The information in subsection (a)(12) and (13) shall be recorded in the medication record at the time the medication is administered.All employees of Shared Values that work in the 6400-residential program as a Direct Support Professional (DSP) are required to take and pass the Department of Human Services (DHS) Medication Administration Training program. Only staff that have been certified can administer prescription and non-prescription medications to the clients we support. Shared Values policy requires that employees who administer prescription and non-prescription medications to the clients we support review the Medication Administration Record (MAR) daily to make sure there are no errors. Medication labels should also be compared to the MAR during this period of review. Shared Values will ensure all participants receive medication as prescribed by a physician 9/12/2022. In response to the licensing inspection, Shared Values has implemented an internal corrective action to staff who incurred the documentation error in medication administration 9/19/2022. Due to the medication discrepancies and errors, a Med Administration Trainer has been contracted to complete practicum observations on med certified staff to ensure compliance is med administration practices 10/12/2022. Shared Values will hire a nurse to monitor and reconcile medication errors and documentation errors related to med administration 11/7/2022. All employees who administer medication must be certified with valid up to date training documentation in their file reviewed by human resources. Staff are required to initial the MAR accordingly when medication has been given. The community managers have been retrained in medication documentation practices for strengthened operational oversight 9/19/2022. The community managers will be required to review medication and MARS during each site visit. The community mangers are required to have a minimum of three site visits a week. The program specialist will be required to review medication at all homes at least once a week. The program director will be required to conduct random reviews of MARs at all homes. The program director has reviewed job descriptions and completed internal training with the community managers with medication oversight of all the residential homes. Shared Values will hire a nurse by 11/7/2022.The nurse will be responsible for reviewing the MARs, blood sugar logs and additional medical documentation. Upon notification of any medication errors, progressive disciplinary action will be implemented and retraining of staff will be considered as necessary. All Shared Values DSP are expected to be trained and observed in medication administration by Friday, October 21, 2022 09/19/2022 Implemented
6400.207(4)(I)Individual 1 is prescribed Risperidone 0.5mg to be taken by mouth twice a day as needed for agitation/anxiety. A PRN medication for anxiety is listed under the prohibited procedures.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.All employees of Shared Values that work in the 6400-residential program as a Direct Support Professional (DSP) are required to take and pass the Department of Human Services (DHS) Medication Administration Training program. Only staff that have been certified can administer prescription and non-prescription medications to the clients we support. Shared Values policy requires that employees who administer prescription and non-prescription medications to the clients we support review the Medication Administration Record (MAR) daily to make sure there are no errors. Medication labels should also be compared to the MAR during this period of review. Shared Values will ensure all participants receive medication as prescribed by a physician 9/12/2022. In response to the licensing inspection, Shared Values has requested a change in the written script or discontinuation of the medication to the prescribing physician 10/10/2022. Shared Values will follow-up with the prescribing physician every 2 business days until the medication's script is appropriately revised or discontinued. Due to the medication discrepancies and errors, a Med Administration Trainer has been contracted to complete practicum observations on med certified staff to ensure compliance in med administration practices 10/12/2022. Shared Values will hire a nurse to monitor and reconcile medication errors and documentation errors related to med administration 11/7/2022. The community managers have been retrained in medication documentation practices for strengthened operational oversight 9/19/2022. The community managers will be required to review medication and MARS during each site visit. The community mangers are required to have a minimum of three site visits a week. The program specialist will be required to review medication at all homes at least once a week. The program director will be required to conduct random reviews of MARs at all homes. The program director has reviewed job descriptions and completed internal training with the community managers with medication oversight of all the residential homes. Shared Values will hire a nurse by 11/7/2022.The nurse will be responsible for reviewing the MARs, blood sugar logs and additional medical documentation. Upon notification of any medication errors, progressive disciplinary action will be implemented and retraining of staff will be considered as necessary. All Shared Values DSP are expected to be trained and observed in medication administration by Friday, October 21, 2022 10/10/2022 Implemented
SIN-00193964 Renewal 09/15/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.22(e)(1)A completed financial review did not identify written record of two $300 withdrawals on 7/28/21 and 7/29/21 from individual's #1 account (PNC bank). If the home assumes the responsibility of maintaining an individual's financial resources, the following shall be maintained for each individual: A separate record of financial resources, including the dates and amounts of deposits and withdrawals. Shared Values will keep a written account of residents¿ financial transactions to ensure accurate monitoring and oversight of residents¿ monies. The program specialist updated a written financial record sheet to track all residents¿ financial transactions on 9/23. See attachment #: 1 09/23/2021 Implemented
6400.67(a)The first floor bathroom wall should be repaired. There are several markings on the wall where the sink was replaced.Floors, walls, ceilings and other surfaces shall be in good repair. Shared Values will ensure that all sites are properly maintained and is presentable. Maintenance addressed the wall behind the vanity in the first-floor bathroom on 10/28/2021. See attachment #: 2 10/28/2021 Implemented
6400.70The telephone in the home is not easily accessible to the individual. The phone is located on the second floor of the home and the individual is unable to use the stairs.A home shall have an operable, noncoin-operated telephone with an outside line that is easily accessible to individuals and staff persons. Shared values will ensure that all sites have phones that are easily accessible to residents and staff. Shared Values purchased a phone set and replaced the assisting phone with a two-phone set on 9/17/21. See attachment #: 3 09/17/2021 Implemented
6400.71There is no emergency contact list by the phone.Telephone numbers of the nearest hospital, police department, fire department, ambulance and poison control center shall be on or by each telephone in the home with an outside line. Updated contact list was placed in the home on 9/20/21. See attachment #:4 09/20/2021 Implemented
6400.72(a)There is no screen in the 2nd floor bathroom window.Windows, including windows in doors, shall be securely screened when windows or doors are open. 5. No screen in 2nd flr bathroom window: Maintenance replaced the screen. Corrected on 10/29/21. See attachment #: 5 10/29/2021 Implemented
6400.73(a)There is no railing for ramps on the outside of the home. Each ramp, and interior stairway and outside steps exceeding two steps shall have a well-secured handrail. No railing for ramp on outside of house:, railing was installed. Completed 10/31/21. See attachment #: 6 10/31/2021 Implemented
6400.77(b)There is no antiseptic or thermometer in the first aid kit. 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. No antiseptic or thermometer in first aid kit: Shared Values purchased and replenished missing items from the first aid kit. Corrected on 9/20. See attachment #: 7 09/20/2021 Implemented
6400.80(a)There are major cracks in the cement in the backyard landing of the home which poses as a tripping hazard and should be repaired. Outside walkways shall be free from ice, snow, obstructions and other hazards. 6400.80 (a) Major Cracks in cement landing in back of home, cracks were repaired. Corrected on 10/30/21. See attachment #: 8 10/30/2021 Implemented
6400.82(f)There is no trash can in the 2nd floor bathroom of the home.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. 6400.82 (f): No trash can in 2nd flr bathroom: The Community manager purchased a trash can and placed it in the second-floor bathroom. Corrected on 9/17/21. See attachment #: 9 09/17/2021 Implemented
6400.111(a)There is no fire extinguisher on the 2nd floor of the home. (During unannounced on 9/16 there was one on 2nd floor).There shall be at least one operable fire extinguisher with a minimum 2-A rating for each floor, including the basement and attic. 6400.111 (a): No fire extinguisher on 2nd flr: Shared Values contracted with Shapiro Fire Company to install replacement fire extinguishers. Corrected on 10/1/21. See attachment #: 10 10/01/2021 Implemented
6400.112(d)The fire drill completed on 8/18/21 took 3 minutes for evacuation. 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 employe 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. Staff informed management that they were waiting to get to the meeting place before ending the drill. Corrected on 10/7/21. See attachment #: 11 10/07/2021 Implemented
6400.141(c)(6)Individual #1 last TB test was read on 3/25/19, which is six months outside of the regulatory two-year timeline.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. 6400.141 (c) (6): Individual #1 TB was read on 3/25/19 which is six months outside of the regulatory two-year timeline: Follow up appointment made to correct citation. Corrected on 11/1. See attachment #:12 11/01/2021 Implemented
6400.141(c)(10)Individual's #1 12/21/20 physical form stated that individual is not free of communicable disease with no further explanation as to precautions that should be taken.The physical examination shall include: Specific precautions that must be taken if the individual has a communicable disease, to prevent spread of the disease to other individuals. 13. 6400.141 (c) 10: Individual #1 12/20/20 physical stated individual wasn't free from communicable diseases: Share Values LPN followed up with PCP and got documentation stating that the individual was free from communicable diseases. Corrected on 11/1/2021. See attachment #: 13. 11/01/2021 Implemented
6400.144PRN medication "Phenazopyridine 200 MG tab" for individual #1 is listed on the MAR, but not present at the time of inspection.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. 6400.144: Individual #1 PRN Phenazopyridine on MAR but not on site: The LPN contacted the PCP office and got documentation stating that the above med was discontinued. Corrected on 10/1/21. See attachment #: 14. 10/01/2021 Implemented
6400.217Individual's #1 record did not contain a signed consent for info release form.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. 6400.217: Individual #1 record did not contain a signed consent for release of information form: The program specialist reviewed consent paperwork with individual prior to individual signing it. Corrected on 9/28/21. See attachment #: 15 09/28/2021 Implemented
6400.167(a)(4)Individual #1 Blood glucose test strips and Easy Touch were signed off on MAR as given at 12 PM during time of inspection which was 10 AM. Medication cannot be administered more than 1 hour before or after the prescribed time. (This was also the case during unannounced inspection on 9/16).Medication 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.6400.167 (a) (4): Test strip and easy touch signed for 12pm. Inspection was conducted at 10am: Corrected on 10/1/21. See attachment #: 14 10/01/2021 Implemented
SIN-00253028 Unannounced Monitoring 10/03/2024 Compliant - Finalized
SIN-00176160 Renewal 09/14/2020 Compliant - Finalized