Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00230977 Renewal 08/23/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.141(c)(14)On the annual physical exam for individual #2 the section of Information pertinent to diagnosis in case of emergency was incomplete.The physical examination shall include: Medical information pertinent to diagnosis and treatment in case of an emergency. Physical form header highlighted in green (attachment #1) to bring attention to" Please complete all information to avoid return visits". Both program managers and medical coordinator were trained that any blank spaces on the physical would not be fully completed (attachment #2) 09/26/2023 Implemented
SIN-00209959 Renewal 08/04/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(a)The bathroom connected to individual #1's bedroom had a layer of a white substance consistent with powder dust throughout the entire bathroom.Clean and sanitary conditions shall be maintained in the home. Individual has agreed to have her bedroom and bathroom cleaned while she is at work Mondays and Tuesdays. Household Responsibilities updated, posted and team notified. Individual #1 Bathroom cleaned surfaces day of licensing (attachments #5-11 photos) 08/19/2022 Implemented
6400.73(a)The rails on the ramp out front of the home were bowing, creating a space where someone could be injured. Each ramp, and interior stairway and outside steps exceeding two steps shall have a well-secured handrail. Sanded surfaces and caulked all gaps on railing (attachment #12, video) 09/15/2022 Implemented
6400.101There were drapes on the back sliding doors making it very difficult to use the egress quickly and easily.Stairways, halls, doorways, passageways and exits from rooms and from the building shall be unobstructed. Drapes were moved to the left of rod support, no longer in the way of door knob or blocking egress (attachment #12) 09/08/2022 Implemented
SIN-00179650 Renewal 01/14/2020 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.181(e)(14)Individual #2 assessment did not fully describe whether the individual can swim and avoid water.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 assessment was immediately updated to be more clear on the individual's water safety skills. She is unable to recognize the danger of water, and is unable to swim. This is reflected in her current assessment, and has not changed in the past year. This issue was resolved on 1/15/20. A copy of the amended assessment has been emailed as supporting documentation. Individual #2 moved to another Provider Agency on 10-15-20. 01/15/2020 Implemented
6400.165(c)Individual #2 medication polyeth Glyc Pow 3350 NF mix 17gm with 8oz water/juice drink daily at 8am, was on the medication record as a PRN rather than given daily as on the medication label.A prescription medication shall be administered as prescribed.The label was incorrect. Glyc Pow 3350 NF mix 17gm with (8) ounces of water is an as needed medication. The pharmacy confirmed this with the PCP, and fixed the label. Medication labels, and logs will be checked daily by staff, weekly by the program supervisor, and by the medication practicum observer during every Medication practicum. All MAR's were reviewed for all the individuals supported in SBR's Residential Program; no discrepancies were found. Staffing MAR reviews and a copy of the corrected label has been submitted as supporting documentation, via email. Implemented
SIN-00093261 Renewal 06/27/2016 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.181(e)(14)Individual #1¿s assessment dated 4/7/16 does not indicate ability to swim. 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 Assessment was immediately corrected. Additionally, a check box has been added to the Assessment template that specifically includes a check box that clearly indicates whether or not an individual has the ability to swim; the progress and growth comments section of the assessment contains the supervision levels needed for the individual when she is around bodies of water.{Within 30 days receipt of this plan of correction quality assurance or program designee will complete an audit of individuals served will be conducted to ensure all required areas of the assessment are completed DD 11.21.16] 07/11/2016 Implemented
SIN-00062880 Renewal 03/06/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.110(a)The home did not have a smoke detector in the attic.(a) A home shall have a minimum of one operable automatic smoke detector on each floor, including the basement and attic. Smoke detector was installed in the attic at 504 Larkspur on 3/6/14. In the future, both the supervisor and the property manager will ensure that smoke detectors are properly installed on every floor of the dwelling. 03/06/2014 Implemented
SIN-00063595 Renewal 03/06/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.110(a)The home did not have a smoke detector in the attic A home shall have a minimum of one operable automatic smoke detector on each floor, including the basement and attic. The smoke detector was installed on 3/6/14. In the future, both the supervisor and property manager will ensure that operable smoke detectors are on each floor of the home and that they are functioning correctly by performing monthly fire drills. Property manager will perform quarterly checks on all smoke detectors to ensure they are all installed and fully operational. Pertinent documentation was submitted via email. 03/06/2014 Implemented
SIN-00255677 Renewal 08/20/2024 Compliant - Finalized
SIN-00192758 Renewal 08/18/2021 Compliant - Finalized
SIN-00074898 Renewal 03/31/2015 Compliant - Finalized