Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00216720 Renewal 12/20/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.82(e)The bathtub in the bathroom to the right of Individual #1's bedroom did not have a nonslip surface or mat. Bathtubs and showers shall have a nonslip surface or mat. On 12/21/2022 the bathtub in the bathroom to the right of Individual #1's bedroom had a nonslip surface placed in the bathroom. 01/30/2023 Implemented
6400.110(a)The home did not have a smoke detector in the attic. A home shall have a minimum of one operable automatic smoke detector on each floor, including the basement and attic. A smoke detector will be placed in the attic of site 0042 by UCIP's contracted security company. This will be placed in by them to ensure that the in smoke detector is linked into the current system. 01/30/2023 Implemented
SIN-00148628 Renewal 01/16/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.112(c)The written fire drill record for the fire drills held from 12-19-17 to 12-16-18 documented the front door as the exit route used. The home as two doors in the front of the home.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 fire alarm or smoke detector was operative. Manager has done an monthly chart alternating the dates, times, days and routes of fire drills. Also an January 2019 drill was done using an different door.[At least quarterly for 1 year, the CEO or designee shall audit at least a 10% sample of fire drill records to ensure fire drills are held and documented as required. Documentation of audits shall be kept. Within 60 days of receipt of the plan of correction, the CEO or designee shall train all staff persons who are responsible for conducting and reviewing fire drill records of the requirements of fire drills as per 6400.112(a)-(I). In addition, all fire drills shall be unannounced and those aware of the aforementioned chart shall not participate in fire drills. (DPOC by AES,HSLS on 3/5/19)] 01/28/2019 Implemented
SIN-00088531 Renewal 01/12/2016 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.142(a)The two most recent dental examination for Individual #1's were 8/27/15 and 5/7/14.An individual 17 years of age or younger shall have a dental examination performed by a licensed dentist semiannually. An individual 18 years of age or older shall have a dental examination performed by a licensed dentist annually. The Program Specialist will add all medical appointments to a 3 year tracking form. To track last, current and next years appointment to make sure they are all in compliance and all information is included on the forms. The Program Specialist will update each month and turn into the Director of Residential Services for his review monthly. [The Program Specialist or designated staff person will schedule medical appointments to ensure all individuals' physical examinations with all required information are completed within required timeframes. Documentation of individual record reviews and tracking form reviews shall be kept. (AS 5/3/16)] 04/21/2016 Implemented
6400.181(a)The two most recent assessments for Individual #1 were completed on 12/16/15 and 11/7/14. Each individual shall have an initial assessment within 1 year prior to or 60 calendar days after admission to the residential home and an updated assessment annually thereafter. The initial assessment must include an assessment of adaptive behavior and level of skills completed within 6 months prior to admission to the residential home. Program Specialist will add Assessments to a 3 year tracking form that will track last, current and next years dates to make sure they will be in compliance. They will update this form monthly and send it to their manager for review. [The Program Specialist or designated staff person will schedule medical appointments to ensure all individuals' physical examinations with all required information are completed within required timeframes. Documentation of individual record reviews and tracking form reviews shall be kept. (AS 5/3/16)] 04/21/2016 Implemented
SIN-00096987 Renewal 01/12/2016 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.142(a)The two most recent dental examination for Individual #1's were 8/27/15 and 5/7/14.An individual 17 years of age or younger shall have a dental examination performed by a licensed dentist semiannually. An individual 18 years of age or older shall have a dental examination performed by a licensed dentist annually. 4.21.16 The Program Specialist will add all medical appointments to a 3 year tracking form. To track last, current and next years appointment to make sure they are all in compliance and all information is included on the forms. The Program Specialist will update each month and turn into the Director of Residential Services for his review monthly. [The Program Specialist or designated staff person will schedule medical appointments to ensure all individuals' physical examinations with all required information are completed within required timeframes. Documentation of individual record reviews and tracking form reviews shall be kept. (AS 5/4/16)] 04/21/2016 Implemented
6400.181(a)The assessment for Individual # 1 was completed on 12/15/16 and 11/7/14 Each individual shall have an initial assessment within 1 year prior to or 60 calendar days after admission to the residential home and an updated assessment annually thereafter. The initial assessment must include an assessment of adaptive behavior and level of skills completed within 6 months prior to admission to the residential home. 4.21.16 Program Specialist will add Assessments to a 3 year tracking form that will track last, current and next years dates to make sure they will be in compliance. They will update this form monthly and send it to their manager for review. [The Program Specialist or designated staff person will schedule medical appointments to ensure all individuals' physical examinations with all required information are completed within required timeframes. Documentation of individual record reviews and tracking form reviews shall be kept. (AS 5/3/16)] 04/21/2016 Implemented
SIN-00073701 Renewal 01/22/2015 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(c)An clear, unmarked pump bottle containing a blue liquid was in the locked cabinet in the kitchen of the home. Poisonous materials shall be stored in their original, labeled containers. Program Specialist immediately discarded the bottle. Program Specialist will check while doing their monthly monitoring to ensure all bottles have labels. [All homes will be monitored monthly by the program specialist to ensure all poisonous materials are stored in their original, labeled containers. (AS 2/24/15)] 02/11/2015 Implemented
6400.106The home's furnace has not been inspected and cleaned by a professional furnace cleaning company.Furnaces shall be inspected and cleaned at least annually by a professional furnace cleaning company. Written documentation of the inspection and cleaning shall be kept. UCIP maintenance staff have been trained by a master plumber on the maintenance of furnaces. UCIP will make sure all new maintenance staff are trained in this area. 02/11/2015 Implemented
SIN-00041235 Renewal 08/22/2012 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(a)The second floor bath tub had hair and scum residue covering the bottom and sides. (Partially Implemented-Adequate Progress-2/20/13-CEM)(a) Clean and sanitary conditions shall be maintained in the home. Shower was cleaned at time of inspection. DSP's will check to make sure tub is cleaned after every shower. A monitoring summary form will be completed by the DSP on a daily basis that outlines whether or not cleanliness standards in the home are upheld. Staff were trained on 8/24/12 regarding the expectation of cleanliness within the home. The Program Manager will be responsible for ensuring cleanliness standards are adhered to on a daily basis and for reviewing the monitoring summary. 08/24/2012 Implemented
6400.72(b)The door knob on the first floor powder room was extremely loose. (Fully implemented-2/20/2013-CEM)(b) Screens, windows and doors shall be in good repair. Door knob was tightened on site by the landlord. DSP's will check daily and report any maintenance requests to their Program Specialist. A monitoring summary form will be completed by the DSP on a daily basis that outlines whether or not all surfaces are in good repair. Training was provided to staff on 8/24/2012 regarding appropriate maintenance criteria of the home. The Program Manager will be responsible for ensuring all surfaces are kept in good repair at all times and for ensuring completion of the monitoring summary. 08/24/2012 Implemented
6400.111(a)The fire extinguisher in the basement was undercharged. (Partially implemented-adequate progress-2/20/2013-CEM)(a) There shall be at least one operable fire extinguisher with a minimum 2-A rating for each floor, including the basement and attic. Fire extinguisher was replaced by one that was charged. When Program Specialists do their monthly monitoring they will check for fire safety items. Training was provided to staff on 8/24/2012 regarding fire safety guidelines specific to fire extinguishers. The program manager will be responsible for ensuring fire safety guidelines outlined in the 6400 regaulations are adhered to on a daily basis. 08/24/2012 Implemented
6400.144A doctor's order for daily weigh-ins for Individual #1 was not followed by agency staff on the following dates: July 7, 8, 15, 16, 21, 22, 28, and, 29, 2012 and August 4 and 5, 2012. (Partially implemented-adequate progress-2/20/2013-CEM)Health services, such as medical, nursing, pharmaceutical, dental, dietary and psychological services that are planned or prescribed for the individual shall be arranged for or provided. It was corrected by the house purchasing a scale to be accessible at that house at all times. Program Specialist will make sure all doctor's orders are followed as written. Documentation indicating daily weight was measured for two consecutive months was provided by the agency. Training was provided to staff on 8/24/2012 in regards to health services being planned or prescribed for the individuals within the home specific to daily weight of this individual. The program manager will be responsible for ensuring that all health services and doctor's orders are adhered to on a daily basis. 08/24/2012 Implemented
SIN-00168226 Renewal 12/18/2019 Compliant - Finalized