Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00238357 Renewal 03/12/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.32(r)An individual has the right to lock the individual's bedroom door. Individual #2 and Individual #3 did not have a lock on his bedroom doors.An individual has the right to lock the individual's bedroom door.Numeric keypad locks will be installed on bedroom doors. Individuals and staff will be trained on how the locks function. 04/30/2024 Implemented
6400.213(1)(i)Individual #1's record did not include their hair color, eye color or identifying marks. These sections of Individual #1's record were left blank.Each individual's record must include the following information: Personal information, including: (i) The name, sex, admission date, birthdate and Social Security number hair color, eye color or identifying marks.Individual #1¿s hair color, eye color, and identifying marks were added to her Fact Sheet, which is contained in her record and attached to all medical forms. 03/13/2024 Implemented
SIN-00217276 Renewal 02/23/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.112(d)Individuals in the home did not evacuate the home in the allotted 2 ½ minutes. On November 25, 2022, a fire drill was conducted at 11:10PM. This is documented as an asleep fire drill. The evacuation time from the home was 3 minutes and 40 seconds, exceeding the allotted 2 ½ minutes. 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. Director of Residential Services contacted the Chief of the Forest City Fire Department, who provides the annual fire safety training for the CLA, and discussed the approved evacuation time for the CLA. The Chief verified that a 4-minute evacuation time, which had been documented on previous year¿s annual fire safety trainings, remains appropriate for the CLA due to the sprinkler system within the home. A written statement from the Chief indicating the 4-minute evacuation time was obtained from the Chief on 2/24/2023. 02/24/2023 Implemented
SIN-00178829 Renewal 10/27/2020 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.163(h)Individual #1's medication PRN for Diazepam 5mg was dispensed on 6/7/2019 and expires a year from that date. There was no new blister pack for that PRN. The old PRN was not disposed of.Prescription medications that are discontinued or expired shall be destroyed in a safe manner according to Federal and State statutes and regulations.All resident medications will be monitored for expiration date by each Program Manager on a weekly basis. Any medication found to be expired will be disposed of properly and replaced. Documentation of monitoring will occur on a monthly basis on the current Program Manager Monthly Monitoring Checklist. This monitoring was added to the current monthly checklist on 10/28/2020 11/28/2020 Implemented
SIN-00158476 Renewal 07/30/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)The license for this chapter expired on 7/1/2019. A Self-Assessment was not completed until 7/10/2019.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. 55 PA Code Chapter 6400.15(a) - Program Specialist will complete a self-assessment of each home during the month of October, January and April. All self-assessment will be dated to insure compliance. 07/30/2019 Implemented
SIN-00134443 Renewal 06/12/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.71There were no numbers listed for the ambulance or fire department in the home.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. 55 PA Code Chapter 6400.71 - Telephone numbers of the closest hospital, police department, fire department, ambulance and poison control center will be on or near each telephone in the home with an outside line. Program Specialist will monitor each home for compliance. 06/15/2018 Implemented
SIN-00120328 Renewal 08/29/2017 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.181(e)(4)This area was not evaluated in Individual #1's assessment. The assessment must include the following information: The individual's need for supervision. 55 PA Code Chapter 6400.181(e)(4) - Need for supervision is currently identified throughout assessment; however, a specific section will be added to identify need for supervision. Program Specialist will add this section to all assessments. 10/02/2017 Implemented
6400.181(e)(13)(viii)This area was not evaluated in Individual #1's assessment.The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Managing personal property. 55 PA Code Chapter 6400.181(13(viii) Managing personal property section will be added to all assessments. Program Specialist will be responsible to add this section to all assessments. 10/02/2017 Implemented
SIN-00099857 Renewal 08/16/2016 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.33(e)Individual #1 has a video camera in his bedroom which sends a live feed to a monitor in the kitchen area. Staff report that the video camera is used to monitor Individual #1 while he is in his bedroom due to Individual #1 being a fall risk. An individual has the right to privacy in bedrooms, bathrooms and during personal care. 55 PA Chapter 6400.33(e) - Monitor has been removed from individual #1's bedroom and awake staff will monitor individual while in bedroom until waiver approved. Waiver requested on 9/2/2016. 12/31/2016 Implemented
6400.62(a)There was a large bottle of Great Value Dishwasher Gel under the kitchen sink. The label reads that poison control should be called if ingested. The kitchen cabinet was locked with a baby-proof lock, but the doors could be pulled open allowing enough room to reach into the cabinet and remove the large bottle. The poisons were accessible.Poisonous materials shall be kept locked or made inaccessible to individuals.55 PA Code Chapter 6400.62(a) - Residential Program Specialist immediately removed dishwasher gel - baby proof locks have been replaced with keyed locks. Residential Program Specialist instructed all staff to keep all materials containing a label stating poison control to be contacted if ingested within key locked cabinets. 08/16/2016 Implemented
6400.181(e)(8)The assessment for Individual #2 dated 2/18/16 does not assess the individual's ability to evacuate during a fire.The assessment must include the following information: The individual's ability to evacuate in the event of a fire. 55 PA Code Chapter 6400.181(8) - Residential Program Specialist has updated assessment for individual #2 to include the individuals ability to evacuate in the event of a fire. 08/16/2016 Implemented
6400.181(e)(14)The assessment for Individual #2 dated 2/18/16 does not assess the individual's ability to swim or temper 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. 55 PA Code Chapter 6400.181(14) - Residential Program Specialist has updated assessment to show individual #2 progress over the last 365 days regarding the individuals knowledge of water safety and ability to swim. 08/16/2016 Implemented
6400.213(11)The Individual Support Plan for Individual #2 states that Individual #2 requires 1:1 supervision between 8AM and 4PM. The assessment does not include this information. Each individual's record must include the following information: Content discrepancy in the ISP, The annual update or revision under § 6400.186. 55 PA Code Chapter 6400.13(11) Residential Program Specialist has updated Assessment to include individual #1 requires 1:1 supervision between 8am and 4pm 08/16/2016 Implemented
SIN-00080020 Renewal 07/22/2015 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.112(a)A fire drill was not completed in January 2015. An unannounced fire drill shall be held at least once a month. Director of Residential Services, Residential Program Specialist and House Manager will coordinate and conduct an unannounced fire drill at least once a month. Documentation of date and time of drill will be recorded and maintained on site. Unannounced drill held on 7/22/15 - documentation forwarded to Licensing. 07/22/2015 Implemented
SIN-00061735 Renewal 05/07/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.22(d)(1)The financial record for Individual #1 stated that he only had $64.27 when in essence he had $164.72.The home shall keep an up-to-date financial and property record for each individual that includes the following: Personal possessions and funds received by or deposited with the home. No changes will be made to current system; however, staff will be retrained on the Agency Policy & Procedure for Auditing Consumer Finances. This training will occur on Wednesday 5/21/14 and attendance sheet will be forwarded as documentation. 05/21/2014 Implemented
SIN-00259837 Renewal 02/05/2025 Compliant - Finalized
SIN-00200561 Renewal 03/22/2022 Compliant - Finalized
SIN-00050014 Renewal 04/17/2013 Compliant - Finalized