Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00268268 Renewal 06/10/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.68(b)The running water in the master bathroom returned with temperatures of 130.5, exceeding the allowable threshold of 120F. Hot water temperatures in bathtubs and showers may not exceed 120°F. PC supervisor ensured tempered gauge on the hot water tank was set at the level where water temperature would not exceed the 120F. according to regulation. 06/11/2025 Implemented
6400.72(b)The front storm door is missing a door handle. Screens, windows and doors shall be in good repair. PC will purchase door handle and replace the handle on the side of the door that is missing. 06/14/2025 Implemented
6400.82(f)Bathroom#1 (located outside of the occupied bedroom) and Bathroom#3 (located by the back door) do not have a trash receptacle or paper towels.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. PC supervisor will purchase bathroom trash receptacles and paper towels for bathrooms #1 and #3. Trash receptacles and paper towels will be accessible in all bathrooms. 06/11/2025 Implemented
6400.106There was no annual furnace inspection on file for this location.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. PC will reach out to property manager to get a furnace inspection documentation. Documentation will be kept on file at this location. 06/15/2025 Implemented
6400.113(a)There was no documentation that individual #1 received fire safety training upon admission to the program on 10/22/24. An individual, including an individual 17 years of age or younger, shall be instructed in the individual's primary language or mode of communication, upon initial admission and reinstructed annually in general fire safety, evacuation procedures, responsibilities during fire drills, the designated meeting place outside the building or within the fire safe area in the event of an actual fire and smoking safety procedures if individuals smoke at the home. PC will have documentation of fire safety training for individual #1 completed upon admission to program and annually there after. 06/11/2025 Implemented
6400.141(a)Annual Physical Exam dated 5/12/25 for individual #1 was incomplete. It did not include the following sections: - Allergies/Contradicted medication. - Recommendations for health maintenance - Special Diet instructions - Information Pertinent to diagnosis incase of emergency - Physical Limitations of the individual.An individual shall have a physical examination within 12 months prior to admission and annually thereafter. PC supervisor will have information for incomplete sections filled out by doctors or filled out by staff to prior to annual physical appointment. 06/13/2025 Implemented
6400.34(a)The individual Rights statement signed by individual #1 did not include all of the individual rights as outline in the 6400 Regulations.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.PC Director of programs will update individual rights to include all rights in the 6400 regulations 6400.34(a) section 34r through 34v. 06/11/2025 Implemented
6400.165(a)Per her MAR, Individual #1is prescribed a PRN Albuterol Nebulizer, this medication was not present in her medication box.A prescription medication shall be prescribed in writing by an authorized prescriber.PC will obtain written documentation for medication by an authorize prescriber. Prescription will be filled and placed in medication box. 06/16/2025 Implemented
6400.181(f)There was no documentation as to when Individual #1's assessment was sent to her team prior to her ISP meeting on 1/27/25.The program specialist shall provide the assessment to the individual plan team members at least 30 calendar days prior to an individual plan meeting.PC will ensure individual #1 60 day assessment will be sent to the team 30 days prior to the ISP meeting and maintain documentation of assessment being sent to the team. 06/12/2025 Implemented