Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00242304 Renewal 04/15/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.24(d)(1)At the time of the inspection, Individual #1 did not have a current and up to date property record. An up-to-date financial and property record shall be kept for each indivudal that includes the personal possessions and funds received by or deposited with the family or agency.Life Sharing Specialist and Life Sharing Provider were trained on Regulation 6500.24(d)(1) on 4/24/2024 in regard to the Annual property inventory by Director of Quality Assurance. See Attachment #1. A current copy of Individual #1's Property Inventory List was updated and sent as Attachment #2. 04/24/2024 Implemented
SIN-00185829 Unannounced Monitoring 04/05/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.109(h)On 12/8/20 and 3/3/21 Individual #1 and Individual #2 did not meet at the designated meeting place for the fire drill.Individuals shall evacuate to a designated meeting place outside the home during each fire drill.The LSP had a fire drill on 4/9/2021, showing where Individuals 1 & 2 arrived safely at the designated meeting place, being sent as Attachment # 15. The LSP also has slip on shoes now kept by the door to assist in safety concerns as to why the individuals were not going completely to the meeting place during overnight fire drills. A picture of the slip on shoes kept by the door is being sent as Attachment # 16. LSS received training for regulation 6500.109 (h) on 4/14/2021, signature sheet is being sent as Attachment # 17. LSP received training for regulation 6500.109 (h) on 4/16/2021, signature sheet is being sent as Attachment # 18. 04/30/2021 Implemented
SIN-00153644 Renewal 05/14/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.45(b)Family Living Provider#1 (FLP)received first aid training by a CPR/first aid trainer on 2/26/19. There is no documentation that the FLP received first aid training by an individual certified as a trainer by a hospital or other recognized health care organization, for the prior 1/16/18 training.The primary caregiver shall be trained by an individual certified as a trainer by a hospital or other recognized health care organization, in first aid and Heimlich techniques prior to an individual living in the home and annually thereafter.Prior years training had been removed from training book. Director of Residential and Community Living trained Lifesharing Specialists on the importance of not purging First Aid cards from the training books as it is a one-time only training unless the trainer selects otherwise, see attachment #2. FLPs will start getting their 24 hours of annual training by in-person trainings with content, College of Direct Support, ODP, and packets of information with a written synopsis or test. Example of packets is attachment #4. Residential Director or Designee will complete 6 site (sampling) visits per quarter and 3 file audits per quarter. 06/10/2019 Implemented
6500.46(a)Family Living Provider ( FLP) is employed at a day program owned and operated by another agency. The CCCC's did not provide any trainings to FLP or confirm that she had 24 hours of training, provided by a trainer, for the required 24 hours of training in human services field.The adult family member who will have primary responsibility for caring for and providing services to the individual shall have at least 24 hours of training in the human services field annually.FLP #1 will start completing 24 hours of annual training for CCCC as well as for her employer as CCCC can¿t get needed information to count the hours. FLP #1 will start the 24 hours needed for CCCC 2018-2019 training year now and have all 24 done by 8/31/19. She started on 6/2/19, attachment # 3. Residential Director or Designee will complete 6 site (sampling) visits per quarter and 3 file audits per quarter. 06/10/2019 Implemented
6500.47Family Living Provider (FLP) received first aid training from a previous employer on 1/16/18. Information regarding the trainer, trainer qualifications, and content of the training was not obtained by the provider. Training documentation for all staff members reviewed, did not include the training source. Records of preservice and annual training, including the training source, content, dates, length of training, copies of certificates received and persons attending shall be kept.Prior years training had been removed from training book. FLP #1¿s 2/17/16 First Aid training was retrieved, attachment #1. Director of Residential and Community Living trained Lifesharing Specialists on the importance of not purging First Aid cards from the training books as it is a one-time only training unless the trainer selects otherwise, see attachment #2. Residential Director or Designee will complete 6 site (sampling) visits per quarter and 3 file audits per quarter. 06/10/2019 Implemented
SIN-00105034 Renewal 01/31/2017 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.67REAPEAT Viollation - The front porch floor had a board that was higher then the rest at the top of the steps, causing a tripping hazard Floors, walls, ceilings and other surfaces shall be free of hazards.6500.67 Front porch board was repaired. A picture showing the board on the porch was repaired will be submitted. Lifesharing Program Specialist EK reviewed regulation with Lifesharing Provider RT a training signature sheet was completed and sent. 03/13/2017 Implemented
6500.74REPEAT Violation- The outside front porch steps were not equiped with a nonskid surface. Interior stairs and outside steps that are accessible to individuals shall have a nonskid surface.6500.74-antiskid strips have been placed on outside front porch. a picture of this correction will be submitted. Lifesharing Program Specialist reviewed regulation with Lifesharing Provider RT and signed a training sheet in regards to this citation. 03/13/2017 Implemented
SIN-00082122 Renewal 07/21/2015 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.45(b)Staff #1 was a provider since 7/25/13. There was no record of her completing training in first aid and Heimlich for the current and previous year. The primary caregiver shall be trained by an individual certified as a trainer by a hospital or other recognized health care organization, in first aid and Heimlich techniques prior to an individual living in the home and annually thereafter.Regulation 6500.45b-Staff # 1 completed recertification of 1st Aid and CPR on 04/02/2014. A copy of the 1st Aid and CPR card will be scanned and emailed by Natasha Caruso Lifesharing Coordinator. 08/27/2015 Implemented
6500.46(a)REPEAT: There were no training records for Staff #1. Licensing asked for training records for Staff #1 at least 5 times throughout the 3 day long inspection. No records were brought to licensers. Last year there was no documentation that any training was completed for Staff #1. The adult family member who will have primary responsibility for caring for and providing services to the individual shall have at least 24 hours of training in the human services field annually.Regulation 6500.46a-Staff # 1 received 34 hours of training. Training records and certificates will be scanned and emailed by Natasha Caruso Lifesharing Coordinator. 08/27/2015 Implemented
6500.103The home had an oil furnace which required a cleaning. There was no cleaning noted on the receipt for 2014. Furnaces shall be cleaned at least annually. Written documentation of the cleaning shall be kept.Regulation 6500.103-Invoice was reviewed with Ingams Fuels and they checked off the services performed they did note under parts and materials a new screen was replaced as well as a nozzle. A copy of the invoice will be scanned and emailed by Natasha Caruso Lifesharing Specialist. 08/05/2015 Implemented
6500.107(d)REPEAT: Smoke detectors were not check in June 2015.A smoke detector shall be tested each month to determine if the detector is operative.Regulation 6500.107d-Smoke detectors were checked every month by Staff # 1. A copy of the smoke detector checklist will be scanned and emailed by Natasha Caruso Lifesharing Coordinator. 07/29/2015 Implemented
6500.109(d)The evacuation time was missing from the fire drill log for the fire drill conducted on 2/7/15.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 smoke detector was operative.Regulation 6500.109-Fire drill for 2/7/15 stated evacuation time of 1 minute and 20 seconds. Fire drill form will be scanned and emailed by Natasha Caruso Lifesharing Coordinator. 08/27/2015 Implemented
6500.110(c)Staff #2 did not receive fire safety training for the current year or previous year.Family members and individuals, including children, shall be trained within 31 calendar days of an individual living in the home and retrained annually, in accordance with the training plan specified in subsection (a).Regulation 6500.110c- Staff # 2 received fire safety training by Christeen Turner Lifesharing Specialist. A copy of the training record will be scanned and emailed. A new fire manual and a fire safety checklist for the Lifesharing Specialists to complete during home visits was created for each home to better organize and track content a copy of the appendix of the fire manual and checklistwill be scanned and emailed by Natasha Caruso Lifesharing . 09/04/2015 Implemented
6500.125(c)(1)Staff #1 and #2 have been family living providers since 2013 and they just received their tuberculin skin test on 6/4/15.The physical examination shall include: (1) A general physical examination.(2.) Tuberculin skin testing by Mantoux method with negative results every 2 years for family members 1 year of age or older; or, if a tuberculin skin test is positive, an initial chest X-ray with results noted. Tuberculin skin testing may be completed and certified in writing by a registered nurse or licensed practical nurse instead of a licensed physician. (3.)A signed statement that the person is free of communicable diseases or specific precautions to be taken if the person has a communicable disease. (4.)Information of medical problems which might interfere with the health of the individuals.Regulation 6500.125c1-Staff #1 and Staff #2 received their initial tuberculin test on 08/06/2013 and these were read 08/08/2013 both were negative. These forms will be scanned and sent by Natasha Caruso Lifesharing Specialist. 08/27/2015 Implemented
SIN-00204084 Renewal 04/25/2022 Compliant - Finalized