Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
2380.89(c) | Exits utilized were not documented on fire drill held on 10/5/16 and 12/6/16. The fire drill form does not indicate if the fire alarm system was operable on 9/23/16, 10/5/16, 11/21/16, 12/6/16, 1/9/17, and 2/21/17. | 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 was operative. | Program Specialist, Team Lead, and Staff, will all complete review Fire Safety Training. Program Specialist will complete a monthly check of the Fire safety records and initial that they were completed accurately. Team lead will also complete a monthly check of the fire safety records and initial they were completed and accurate. |
04/28/2017
| Implemented |
2380.111(c)(1) | This section was not completed on Individual #4's physical. | The physical examination shall include: A review of previous medical history. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.111(c)(5) | Individual #4 was admitted to program on 7/26/2016. She didn't have a TB test until 11/15/2016. | The physical examination shall include: Tuberculin skin testing with negative results every 2 years; or, if the tuberculin skin test is positvie, an initial chest X-ray with results noted. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.111(c)(7) | This section was not included on the physical exams for individual #1 and individual #4. | The physical examination shall include: An assessment of the individual's health maintenance needs, medication regimen and the need for blood work at recommended intervals. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.111(c)(8) | This section was not completed on Individual #4's physical. | The physical examination shall include: Physical limitations of the individual. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.111(c)(9) | This section was not completed on Individual #4's physical. | The physical examination shall include: Allergies or contraindicated medication. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.111(c)(10) | This section was not included on the physical exams for individual #1, individual #3 and individual #4. | The physical examination shall include: Medical information pertinent to diagnosis and treatment in case of an emergency. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.111(c)(11) | This section was not completed on Individual #1's and Individual #3's physical. | The physical examination shall include: Special instructions for an individual's diet. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.113(c)(3) | This section was not completed on staff #1's physical exam dated 9/17/16. | The physical examination shall include: A signed statement that the person is free of serious communicable diseases as defined in 28 Pa. Code § 27.2 (relating to specific identified reportable diseases, infections and conditions) to the extent that confidentiality laws permit reporting, or that the person has a serious communicable disease as defined in § 27.2 to the extent that confidentiality laws permit reporting, but is able to work in the facility if specific precautions are taken that will prevent spread of disease to individuals. | Human Resources Coordinator, Kate Zimmerman, will include a checklist in the front of each staff's file that documents everything required before they are able to begin/continue work at the day program. This would include the physical and note the sections of the physical that need to be completed. KZ will also include a statement at the top of the physical form that notes that all fields must be completed prior to submission. |
04/28/2017
| Implemented |
2380.173(1)(ii) | Race, hair & eye color were not listed in the records for individual #1, individual #2, individual #3, and individual #4. Identifying marks were not listed in the record for individual #4. | Each individual's record must include the following information: Personal information including: The race, height, weight, color of hair, color of eyes and identifying marks. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.173(1)(iii) | Language/means of communication was not listed in the records for individual #1, individual #2, individual #3, and individual #4. | Each individual¿s record must include the following information: Personal information including: The language or means of communication spoken or understood by the individual and the primary language used in the individual¿s natural home, if other than English. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.173(1)(iv) | Religious Affiliation was not listed in Individual #4's record. | Each individual¿s record must include the following information: Personal information including: Religious affiliation. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.181(d) | Individual #4's initial assessment was completed on 8/2/2016. The Program Specialist did not sign & date this assessment. | The program specialist shall sign and date the assessment. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.186(a) | Individual #1 had ISP Reviews on 2/17/16, 5/23/16, 8/23/16, and 11/9/16. The timeframe between 11/9/16-3/20/17 (date of inspection) exceeds the 3 month requirement. Individual #2 had ISP Reviews on 3/26/16, 7/26/16, and 12/15/16. The timeframe between 3/26-7/26/16 and 7/26-12/15/16 exceeds the 3 month requirement. | The program specialist shall complete an ISP review of the services and expected outcomes in the ISP specific to the facility licensed under this chapter with the individual every 3 months or more frequently if the individual¿s needs change which impact the services as specified in the current ISP. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |
2380.186(b) | Individual #1 didn't sign his ISP Reviews dated 2/17/16 and 8/23/2016. | The program specialist and individual shall sign and date the ISP review signature sheet upon review of the ISP. | Program Specialist mentor AD will create a checklist that will be placed in the front of each individuals file. This will be signed by each program specialist during a monthly audit of Assessments, ISP, Quarterly review forms, Facesheet, and Physicals. Program specialists will be verifying forms are completed within the specified timeframes and contain all necessary signatures and information. |
04/28/2017
| Implemented |