Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00202182 Renewal 03/22/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.166(a)(11)Individual #1's March 2022 medication administration record did not include the diagnosis or purpose for each medication.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Diagnosis or purpose for the medication, including pro re nata.A review of 55PA Code Chapter 6400.166(a)(11)took place with TTSR Administrator and Residential Coordinator Traci Phillips who met with TTSR Assistant Director and TTSR Compliance Officer. This meeting took place on 3/31/2022 and the review consisted of the following: ¿ Violation found during licensing inspection in which the MARS for identified individuals did not contain the diagnosis or purpose of medications prescribed by a physician on the MAR for staff knowledge. ¿ Need for all MARS agency-wide to include the diagnosis and purpose for all medications prescribed by a physician to include pro re nata medications Compliance will be measured during routine monthly reviews and checks of all MARS received from the pharmacy to ensure that all MARS have all required information including the diagnosis and purpose for all medications prescribed by a physician to include pro re nata medications. TTSR Residential Coordinator states that the pharmacy responsible for the creation of all MARS was informed of the need to reflect diagnosis and purpose of all prescribed medications on the MARS on 3/29/2022. On 3/30/2022, TTSR also received the MARS for April 2022 but Residential Coordinator has hand written all diagnosis and purposes on the MARS (hand written) and this will ensure that all staff are aware of the purpose of each medication for the month until the pharmacy makes the needed additions starting in May of 2022. Attached is a copy of the MAR for individual #1 which shows that the MAR which will be used to track medications administered shows the diagnosis or purpose of each medication for the individual for the month of April 2022. Also attached is the sign off sheet that shows that the Residential Coordinator was retrained on 55PA Code Chapter 6400.166(a)(11) and that the pharmacy who creates the MARS for individuals at TTSR will show diagnosis and purpose of all medications for every TTSR individual. 03/29/2022 Implemented
SIN-00106765 Renewal 01/05/2017 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.81(k)(6)Individual #1's bedroom does not have a mirror. In bedrooms, each individual shall have the following: A mirror. On 1/6/2017, a mirror was placed on Individual #1¿s wall. House supervisor will be tasked with making sure that a mirror remains on the walls of the individuals who reside at this site to remain in compliance with regulation 6400.81(k)(6). During a meeting with house supervisor held on 1/6/2017, a review of regulation 6400.81(k)(6) took place and she acknowledges (by signing the attached meeting signature page) that she will ensure that there are mirrors in all bedrooms at all times through routine bedroom inspections. TTSR Administrative staff will conduct random and routine house inspections throughout the year to see that all 6400 regulations are met in the home. In the event that an individual wishes to not have a mirror in their bedroom, TTSR will apply for a waiver to request that a mirror not be placed in the bedroom. Until such time as a waiver is obtained, the mirror will remain in the individual¿s bedroom.[Immediately and at least quarterly, a designated staff person shall check all individuals' bedrooms to ensure each individual has a mirror as required. House supervisor shall educate all staff persons working in community homes that each individual shall have a mirror in their bedroom and to monitor throughout the course of their duties. (AS 2/7/17)] 01/06/2017 Implemented
SIN-00054351 Renewal 01/07/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)The home's license expired on January 6, 2014. The self- inspection was completed on 4/30/13 which is more than 6 months prior to the license expiration date. Repeat Violation 10/16/12, et al.(a) 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. On 1/30/2014, Training Toward Self Reliance, Inc. CEO as well as the Assistant Director for TTSR met at approx. 10:00AM to discuss the findings of the Licensing Inspection that was held on January 7th, 2014 through January 9th, 2014. One of the areas of non-compliance for all TTSR sites reads, ¿The home's license expired on January 6, 2014. The self- inspection was completed on 4/30/13 which is more than 6 months prior to the license expiration date.¿ During this meeting between the CEO and Assistant Director, it was agreed upon that after review of the regulations associated with this area of non-compliance that the Assistant Director as well as the CEO will be solely responsible for not only the inspection of all TTSR sites agency-wide, but also will ensure that the Licensing Score sheets are completed in the time frame designated by PA Code Chapter 6400.15 (a) (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.) To ensure that the assessments are completed in the time allotted, TTSR CEO as well as Assistant Director will complete the above mentioned tasks during the months of September and October 2014 (which is within the 3 to 6 month timeframe allotted for completion of this task as our License will be set to expire in January of 2015). TTSR CEO will maintain these Score sheets for submission during the next State Licensing Inspection in 2015. Attached in binder is a signed document which shows that the meeting took place on 1/30/2014. 01/30/2014 Implemented
6400.44(b)(2)44 b) (1-19) The Program Specialist shall be responsible for the following: The job description for the program specialist did not include the following functions and duties: Coordinating and completing the assessments, providing the assessment as required under 6400.181(f) (relating to the assessment), participating in the development of the ISP, ISP annual update and ISP revision, and reviewing the ISP, annual updates and revisions under 6400.186 for content accuracy. (b) The program specialist shall be responsible for the following: (2) Providing the assessment as required under § 6400.181(f) (relating to assessment). Changes were made to the Job Description for all program Specialists on 1/10/2014. Attached is a copy of the revised job description (in binder). Also attached is a sign off sheet for a meeting with all program specialists who were trained on the additions made to this policy on 1/10/2014. The attached training verification sheet was signed by all program specialists acknowledging that they understand that they are responsible for additions made to their job description to include; coordinating and completing the assessments, providing the assessments as required under 6400.181 (f)(relating to assessment), participating in the development of the ISP, ISP annual update, and ISP revision, and reviewing the ISP, annual updates, and revisions under 6400.186 for content accuracy. The Assistant Director for TTSR was responsible for the update to this policy. The Assistant Director also coordinated the meeting to review above mentioned changes. 01/10/2014 Implemented
SIN-00043541 Renewal 10/16/2012 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)On 10/16/12, the agency self-assessment did not include the date the assessment was completed. None of the agency's self-assessments included a date. (Partially implemented-adequate progress 4/11/2013 CEM)(a) 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. Since Tammy Nelson, CEO, is the person responsible for the completion of each house assessment, she and the Program Manager as well as Compliance Officer for TTSR met on 3/20/2013 to discuss the protocol for completion of assessments. Attached is a copy of the signature sheet as well as the curriculum of topics discussed during this training meeting. In summary, the training involved the completion of the self-inspections as well as a review of the timelines and expectations of the CEO for TTSR in ensuring that the self-assessments for each home are completed thoroughly (INCLUDING ACTUAL DATES WRITTEN ON SCORESHEETS WHICH SHOW THE DATE OF INSPECTION)and in a timely manner (3 to 6 months prior to the expiration date of the agency¿s certificate of compliance). 03/11/2013 Implemented
SIN-00259122 Renewal 01/22/2025 Compliant - Finalized
SIN-00166529 Renewal 11/13/2019 Compliant - Finalized