Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00274117 Renewal 09/19/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.110(e)The smoke detectors in the home were not interconnecting smoke detectors.If the home serves four or more individuals or if the home has three or more stories including the basement and attic, there shall be at least one smoke detector on each floor interconnected and audible throughout the home or an automatic fire alarm system that is audible throughout the home. The requirement for homes with three or more stories does not apply to homes licensed in accordance with this chapter prior to November 8, 1991. All wireless smoke detectors were reprogrammed and tested by maintenance contractor to ensure full interconnection throughout the home on 09/25/25. To be safe, the entire set of smoke detectors were replaced to avoid a situation where they disconnect. 09/30/2025 Implemented
6400.144Medication Triamcinolon 0.1% Oint listed on the medical record for individual 1 was not observed in the home during the visit on 9/19/25.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. The medication was ordered from the Pharmacy and placed in the home for i to be administered to the individual 09/30/2025 Implemented
6400.165(c)A review and count of medication (a 30 day supply of Culturelle Probiotic pills dispensed on 9/2/25) for individual 1 revealed that the individual was not administered their medication timely. The blister pack showed 13 pills missing on the 19th day of the month.A prescription medication shall be administered as prescribed.A retraining has been done with the House Supervisor and the staff in the home to comply with the guidance from the electronic MAR which does a complete count of medications administered. 09/30/2025 Implemented
6400.166(a)(11)The medical record log for Individual 1 did not state the diagnosis or purpose for any of the medications prescribed.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 pharmacy was notified and asked to update the MAR to show the diagnosis for all medications on the MAR 09/24/2025 Implemented
6400.167(c)Facility failed to report a medication error to the department timely.A medication error shall be reported as an incident as specified in § 6400.18(b) (relating to incident report and investigation).The incident was entered into HCSIS by the Agency's Asset and Property Manager who is a Certified Investigator. 09/30/2025 Implemented
6400.181(f)There was no correspondence showing that the annual assessment was sent to the ISP team at least 30 days prior to the 06/17/25 ISP meeting for individual 1.The program specialist shall provide the assessment to the individual plan team members at least 30 calendar days prior to an individual plan meeting.The Program Specialist has updated the annual monitoring compliance sheet to show a communication due date to all SCs between 60 and 30 days to the one year anniversary of the last annual ISP meeting. 09/26/2025 Implemented
6400.182(a)Individual 1's ISP does not state that poisons should be locked per the 05/16/25 assessment.The program specialist shall coordinate the development of the individual plan, including revisions with the individual and the individual plan team.Communication was sent to the SC by the Program Specialist to revise the ISP to state that poisons should be locked per the 05/16/25 assessment. The SC has revised the ISP to state as such and it was confirmed on the updated ISP 09/30/2025 Implemented
SIN-00243987 Unannounced Monitoring 04/19/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.64(b)There is what appears to be rodent droppings in the bottom kitchen cabinet to the left of the sink.There may not be evidence of infestation of insects or rodents in the home. The home was inspected and there was no sign of an infestation. The kitchen cabinet was sanitized and cleaned out. 05/18/2024 Implemented
6400.163(f)Individual #3 is prescribed insulin. The insulin is stored in a medication box in a refrigerator; however, the box was not locked.Prescription medications stored in a refrigerator shall be kept in an area or container that is locked.Staff was coached to always lock the insulin box even though it is is in the fridge as that is a requirement. A mandatory attestation was also sent via secure communication for all staff to acknowledge the training. A copy of the attestation will be sent as proof of the training. All staff will be forced to read and acknowledge the training when they log into Therap to complete their progress notes. 04/29/2024 Implemented
SIN-00265451 Unannounced Monitoring 04/30/2025 Compliant - Finalized