Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
6400.66 | (Repeat 09/17/24, 01/10/25)The floodlights outside of the side egress did not turn on during the walkthrough. Staff confirmed that the floodlights did not have motion sensors nor dusk til dawn sensors | Rooms, hallways, interior stairways, outside steps, outside doorways, porches, ramps and fire escapes shall be lighted to assure safety and to avoid accidents.
| 1.Field Managers and License Compliance Managers have Conducted a thorough inspection of all light fixtures in and outside of all homes. All fixtures were tested and found to have been in compliance
2.All staff will be trained on maintenance report policy and how to properly complete a maintenance form and sign off by 9-1-25 |
09/01/2025
| Implemented |
6400.72(b) | The front entryway, bedroom and hallway sliding closet doors do not have bottom tracks to keep the doors secure. | Screens, windows and doors shall be in good repair. | 1.Owners of the home are to be spoken to and notified of repairs or replacements of tracks on all closet doors, and alternate options given by 9-1-25. If the home owners do not correct the problem, Next Step Care maintenance will ensure compliance by 9-30-25.
2.Field Managers and License Compliance Managers have Conducted a thorough inspection of all doors in all other homes, all were found to have been in compliance |
09/30/2025
| Implemented |
6400.112(c) | The Fire Drill conducted on 04/23/25 does not include problems encountered. The space is left 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. | 1.License Compliance Manager has reviewed all previous fire drill reports from the past 12 months to ensure compliance. All other homes were found to be in compliance
2.All staff will be trained and Emphasize the importance of complete and accurate documentation, especially the Problems Encountered section and review how to properly complete fire drill form. Staff will be trained by License Compliance Manager and sign off by 9-1-25. |
09/01/2025
| Implemented |
6400.216(a) | Records (i.e. body charting) for Individual # 1 was found in a cardboard box and plastic tote bin in the basement unlocked. | An individual's records shall be kept locked when unattended.
| 1.All records were collected and moved into the home office locked
2.Next Step Care has created a policy on Individual Record Storage, staff will be trained on this policy and sign off by 9-1-25 |
09/01/2025
| Implemented |