Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00272144 Renewal 07/10/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.18(i)Individual 2 - Incident IDs 9652552 and 9652554 have discovery dates of 05/27/25 and 05/31/25 and were still open without requests for extensions on the date of inspection.The home shall finalize the incident report through the Department's information management system or on a form specified by the Department within 30 days of discovery of the incident by a staff person unless the home notifies the Department in writing that an extension is necessary and the reason for the extension.For Incident IDs 9652552 and 9652554, the organization's Incident Management Administrator requested extensions on 7/22/2025 as the agency was directed by the county to file the incidents on 7/2/2025, requiring additional time for completion. Incident ID 9652552 was finalized on 7/26/2025 and has since been closed. For Incident ID 9652554, an additional extension was requested on 7/29/2025 to allow the Administrative Review Committee to obtain further information from the Certified Investigator, with the final section submitted on 8/29/2025. (Attachments 5,6,7,8 & 9) 07/22/2025 Implemented
SIN-00209079 Renewal 07/19/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.68(b)The water temperature in the home was 139.8 degrees Fahrenheit. Hot water temperatures in bathtubs and showers may not exceed 120°F. The Individuals shower was inspected by maintenance and temperature was immediately lowered. An anti-scalding device was purchased for the Individual's shower and maintenance ordered to install device upon delivery. 09/09/2022 Implemented
6400.141(c)(9)There is no prostate exam on file for Individual #2.The physical examination shall include: A prostate examination for men 40 years of age or older. Individual #2 has been scheduled for a prostate exam completion with his PCP. 09/30/2022 Implemented
6400.141(c)(10)The physical for Individual #2, dated 4/14/22, does not indicate whether or not he is free from communicable diseases.The physical examination shall include: Specific precautions that must be taken if the individual has a communicable disease, to prevent spread of the disease to other individuals. Individual #2 has been scheduled with PCP for an updated physical examination. At this appointment, Individual #2 PCP will document appropriately whether or not Individual is free from communicable diseases. The home Supervisor will review and ensure appropriate documentation and will carry out medical orders. The home Supervisor will upload appointment documentation to the Individuals' electronic home page for review and confirmation from the Program Specialist. 09/30/2022 Implemented