| Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
| 2380.53(a) | On 9/18/2025 at 2:35PM, an aerosol spray bottle of Claire Disinfectant Spray was unlocked and accessible on a shelf in the bathroom in the hallway near the entrance of the facility. At 3:04PM, a bottle of Acetone Nail Polish Remover was unlocked and accessible in a cabinet in program area four. | Poisonous materials shall be kept locked or made inaccessible to individuals, when not in use. | The can of Claim Disinfectant Spray was removed from the staff bathroom and locked in the Janitor's closet. The bottle of Acetone was removed from cabinet and locked in the janitor's closet. Both were removed and locked on 9/18/2025. |
09/18/2025
| Implemented |
| 2380.55(a) | At approximately 3:00PM, in Program Areas Two, Three and Four, the microwaves contained splatters of food particles on the inside and areas of delamination on the inside and outside. | Clean and sanitary conditions shall be maintained in the facility. | The microwaves in Program Areas Two, Three and Four were removed on 09/19/2025, prior to any further use of these microwaves. Three new microwaves were purchased on 9/23/2025 and placed in Program Areas two, three and four. |
09/19/2025
| Implemented |
| 2380.111(c)(1) | Individual #1's annual physical examination, completed 8/27/2025, did not include a review of previous medical history. Individual #4's annual physical examination, completed 7/17/2025, did not include a review of previous medical history. | The physical examination shall include: A review of previous medical history. | Unfortunately, The physical cannot be corrected as it is too far passed the date of the physical.
Individual # 1 lives in a group home with another agency. The physical was completed on 8/27/2025, but we do not know the day it way received. NAME REMOVED Program Specialist requested more information regarding the lines that indicate see MAR. On 9/17/25, NAME REMOVED received a copy of the September 2025 Therap Mar via e-mail. This provided us with a current list of diagnosis's , medications, allergies and dietary guidelines. Individual #4 lives with his family and they did not provide any additional information with the physical form. See below for future corrective action. |
10/01/2025
| Implemented |
| 2380.21(u) | Individual #1 was informed and explained individual rights on 2/5/2024 and then again on 2/6/2025. Individual #2 was informed and explained individual rights on 6/12/2025. Individual #3 was informed and explained individual rights on 2/6/2025. Individual #4 was most recently informed and explained individual rights on 9/1/2024. Individual #5 was informed and explained individual rights on 7/23/2024 and then again on 7/30/2025. The provider agency's current individual rights document did not include: 2380.21c, an individual may not be reprimanded, punished or retaliated against for exercising the individual's rights; 2380.21g, an individual has the right to designate persons to assist in decision-making and exercising rights on behalf of the individual. | The facility shall inform and explain individual rights and the process to report a rights violation to the individual, and persons designated by the individual, upon admission to the facility and annually thereafter. | 2380.21U- For this regulation we will now explain and have the individual or guardian sign the 2 times per year to keep us in compliance. Our past practice was to have these signed at the Individual's ISP Meeting.
2380.21g- The Individual rights form was updated on 9/22/2025. A statement was added to the top, AN INDIVIDUAL MAY NOT BE DEPRIVED OF HIS RIGHTS. Also added was a new #1 stating: AN INDIVIDUAL MAY NOT BE REPRIMANDED, PUNISHED, OF RETALIATED AGAINST FOR EXERCISING INDIVIDUAL'S RIGHTS. And a new #2: AN INDIVIDUAL HAS THE RIGHT TO DESIGNATE PERSONS TO ASSIST IN DECISION-MAKING AND EXERCISING RIGHTS ON BEHALF OF THE INDIVIDUAL. The policy and procedure was also updated by the compliance officer, NAME REMOVED. |
09/22/2025
| Implemented |
| 2380.36(a) | Direct Service Worker #1, date of hire 6/23/2025, was trained in general fire safety on 6/23/2025. This training did not include site specific evacuation procedures, responsibilities during fire drills, the designated meeting place outside the building or within the fire safe area in the event of an actual fire, smoking safety procedures if individuals or staff persons smoke at the facility, the use of fire extinguishers, smoke detectors and fire alarms, and notification of the local fire department as soon as possible after a fire is discovered. | Program specialists and direct service workers shall be trained before working with individuals in general fire safety, evacuation procedures, responsibilities during fire drills, the designated meeting place outside the building or within the fire safe area in the event of an actual fire, smoking safety procedures if individuals or staff persons smoke at the facility, the use of fire extinguishers, smoke detectors and fire alarms, and notification o the local fire department as soon as possible after a fire is discovered. | On 9/19/2025 we received additional documentation from our HR department on DSP #1. This document shows that she had training in the following areas: evacuation procedures; responsibilities during fire drills; designated meeting place; smoking safety procedures; use of fire extinguishers; use of smoke detectors; use of fire alarms. The documentation contains a summary of general fire safety. It also lists the following copies of policy and procedures she received; Evacuation policy and procedure; smoking safety policy and procedure and policy for monitoring when the alarm is inoperable. DSP#1 will be attending the Annual fire safety training for staff on 10/3/2025. |
10/03/2025
| Implemented |
| 2380.123(h) | Individual #2's prescribed medication, Acetaminophen, had an expiration date of 5/2025. | Prescription medications that are discontinued or expired shall be destroyed in a safe manner according to applicable Federal and State statutes and regulation. | Individual #2 mother was contacted on Friday 9/19/2025 regarding expired bottle. The bottle and medication was sent home with Individual #2 on Friday 9/19/2025. On Monday 9/22/2025 a new bottle of acetaminophen was received with an expiration date of 12/2026. |
09/22/2025
| Implemented |
| 2380.126(a)(11) | Individual #1's September 2025 Medication Administration Record did not include the diagnosis or purpose for Bethanechol 10MG. Individual #5's September 2025 Medication Administration Record did not include the diagnosis or purpose for Tylenol 500MG and Clonazepam. | 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. | Individual #1 September 2025 MAR had the diagnosis of urinary retention added on the left hand side under the name and instructions for Bethanechol 10mg on 9/19/2025 before the time of administration. Individual #5 September 2025 MAR had the diagnosis of tone/spasticity added on the left hand side under the clonazepam dosage and instructions on 9/19/2025 before the time of administration. The purpose for the Tylenol, pain, was added to the September MAR under the dosage and instructions on 9/19/2025 before the time of administration. |
09/19/2025
| Implemented |