Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00266677 Unannounced Monitoring 05/22/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(a)Inside The windowsill in the living room has a build-up of dirt and the outside of the sill has mold and mildew. The basement floor has a puddle of water by the front window area, the kitchen cabinets are sticky with food.Clean and sanitary conditions shall be maintained in the home. The windowsill as well as it's outside, and the kitchen cabinets were cleaned 05/22/25. Please see attachments #1 and #2. The puddle of water in the basement floor was mopped on 05/22/25. Please see attachment #3. In addition, a new front door awning was installed as well as some bricks repointed on 06/03/25 to stop water from going into the basement. Please see attachments #4&#5. 06/05/2025 Implemented
6400.64(e)One of the two outdoor trash cans did not have a lid.Trash receptacles over 18 inches high shall have lids. The outdoor trash receptacle without a lid was replaced on 05/24/25. Please see attachment #6. 05/24/2025 Implemented
6400.64(f)One of the two outdoor trash cans was overloaded with trash.Trash outside the home shall be kept in closed receptacles that prevent the penetration of insects and rodents.The overloaded trash can was emptied on 05/24/25. Please see attachment #6. Staff has also been addressed about ensuring equal distribution of trash amongst the outside closed receptacles. 05/24/2025 Implemented
6400.67(b)The lint trap in the dryer has excessive lint Floors, walls, ceilings and other surfaces shall be free of hazards.The excessive lint in the dryer was removed on 05/22/25. Please see attachment #7. 05/22/2025 Implemented
6400.72(b)The window in the dining room does not stay open, it slams shut. Screens, windows and doors shall be in good repair. The window was fixed on 06/02/25. Please see attachment #8. 06/02/2025 Implemented
6400.76(a)The dining room table is wobbly and need to be repaired or replaced. Furniture and equipment shall be nonhazardous, clean and sturdy. A new dining room table set was purchased and delivered on 06/05/25. Please see attachment #9. 06/05/2025 Implemented
6400.76(b)The chairs for the dining room table appear to be for children and are not appropriate for the age and size of the individuals residing in the home.Furniture and equipment shall be appropriate for the age and size of the individuals. A new dining room table set was purchased and delivered on 06/05/25. Please see attachment #9. 06/05/2025 Implemented
6400.76(c)The cushions on the leather couch have cracks and splits that need to be replaced or covered.Furniture shall be comfortable and home-like. A new couch cover was installed on 06/02/25. Please see attachment #10. 06/02/2025 Implemented
6400.80(b)The front lawn was overgrown and full of weeds. The exterior bricks of the home underneath the second and first floor windows were dirty and grimy. The outside of the building and the yard or grounds shall be well maintained, in good repair and free from unsafe conditions.The front lawn was cut and maintained on 05/28/25. The entire front of the home was power washed on 05/29/25. Please see attachments # 11 &12. 05/29/2025 Implemented
6400.216(a)The individuals' records with the ISP and Medication logs were sitting on a shelf in the dining room unlocked. An individual's records shall be kept locked when unattended. The individuals records including the ISP and Medication Logs were locked up on 05/24/25. Please see attachment #13 05/24/2025 Implemented
6400.24The staff was unable to open Individual #2 bedroom and did not have a key to access the area in the event of an emergency.The home shall comply with applicable Federal and State statutes and regulations and local ordinances.A copy of the key to individual #2's bedroom was made on 05/23/25 and kept in the home, and access to that area exists effective the same date. Please see attachment #14. 05/23/2025 Implemented
6400.32(d)Individual # 1 was wearing both a pull up and a diaper, staff stated that it was the normal thing to do. The diaper was removed at time of inspection. There is a 1-hour toileting schedule available in the home. There was no documentation available to validate the reason for double diapering the individualAn individual shall be treated with dignity and respect.A meeting with the staff and this issue was addressed effectively during this meeting. Please see attachment #15. The same communication has gone out to all Residential staff. 05/27/2025 Implemented
6400.32(h)There are cameras in the dining room and at the top of the 2nd floor stairs. There was no documentation to validate the reason for cameras at time of inspection.An individual has the right to privacy of person and possessions.The reason for the cameras is to monitor only the common places for the health and safety of the individuals. Both individuals residing at the site have signed consents for the video monitoring of the site. Please see attachment # 16. Due to the inspection being unannounced, this documentation was not readily available for review at the time of inspection. 05/24/2025 Implemented
6400.163(h)There were two vials of Lorazepam 2mg with one tablet each for individual 1 where the label stated to be taken prior to mammogram appointment; however, Lorazepam 2 mg was not on the MAR. Denta 5000 Plus Paste was in with individual 1's medications but was not on the MAR.Prescription medications that are discontinued or expired shall be destroyed in a safe manner according to Federal and State statutes and regulations.The prescribed Lorazepam 2mg and Denta 5000 plus has been added into the MAR. Please see attachment # 17. 05/23/2025 Implemented
6400.166(a)(11)The medications on individual 1's MAR did not have the diagnosis or purpose for each of the medications.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.The diagnosis/ purpose for each medication was listed on the lower part of Individual¿s MAR. However, the Individual #1¿s MAR has been updated to include the diagnosis /purpose for each medication along the same line that the medication is listed. Please see attachment #17. In addition, communication was made with the agency¿s pharmacy for the diagnosis to be prepopulated in this before delivery with the medications each month. 06/01/2025 Implemented
SIN-00201809 Renewal 03/14/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.65The bathroom located on the second floor did not have window or an operable mechanical ventilation. The existing skylight could not be opened at the time of inspection.Living areas, recreation areas, dining areas, individual bedrooms, kitchens and bathrooms shall be ventilated by at least one operable window or by mechanical ventilation. An opening was made in the skylight screen to enable access to the operating chain, which is used to control the mechanical ventilation on 03/14/2022. Please see attachment #5. 03/14/2022 Implemented
6400.67(a)Individual #1's dresser was missing a knob rendering it difficult to open the drawer.Floors, walls, ceilings and other surfaces shall be in good repair. The knob on this dresser has been replaced as of 03/14/2022. Please see attachment # 6. 03/14/2022 Implemented
SIN-00109541 Renewal 03/13/2017 Compliant - Finalized
SIN-00088319 Renewal 01/15/2016 Compliant - Finalized
SIN-00065663 Renewal 08/07/2014 Compliant - Finalized
SIN-00051878 Renewal 07/18/2013 Compliant - Finalized