Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00243024 Renewal 04/18/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(a)There was a one dose packet of Acetaminophen in the first aid kit left from the first aid kit manufacturer. This was removed and corrected at the time of inspection.Poisonous materials shall be kept locked or made inaccessible to individuals. Acetaminophen was removed during the licensing inspection. 04/19/2024 Implemented
6400.113(c)The fire safety training did not include a list of individuals that attended the training. A written record of fire safety training, including the content of the training and a list of the individuals attending, shall be kept.Upon admission and annually thereafter, all individuals will be trained in fire safety. A written record will include date, content of the training, names of those who attended and the name of the trainer. 06/03/2024 Implemented
6400.163(h)A PRN blister pack of Acetaminophen 325mg tablets that expired on 4/14/24 remained in individual#1's medication box. The new blister pack that was dispensed on 4/15/24 was present in the box but the expired blister pack had not been removed. The expired blister pack was removed at the time of inspection.Prescription medications that are discontinued or expired shall be destroyed in a safe manner according to Federal and State statutes and regulations.The blister pack of Acetaminophen was removed during the licensing inspection. 04/29/2024 Implemented
SIN-00224034 Renewal 04/19/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.106Documentation that a furnace inspections was completed annually was not provided.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. To ensure health and safety these inspections need to be completed annually. This inspection had been completed annually; however, we did not have the report available upon inspection. 05/01/2023 Implemented
6400.141(c)(3)Individual 1's medical record had no documentation of a Diphtheria and Tetanus immunization. Provider completed the appointment during the inspection.The physical examination shall include: Immunizations for individuals 18 years of age or older as recommended by the United States Public Health Service, Centers for Disease Control, Atlanta, Georgia 30333. During the inspection when this was noted, we immediately took the individual to the pharmacy to have the immunization completed. The individual is now up to date on this immunization. It is essential for the health and safety of our residents that we ensure all immunizations are up to date. 05/01/2023 Implemented
SIN-00203985 Renewal 04/21/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.68(a)The water temperature in the home was tested and would not go above 67 degrees. Staff was doing wash at the time.A home shall have hot and cold running water under pressure. A workorder is attached and a plumber for the hot water issue is scheduled for 5/13/22. The water temperature in this home drops when the washing machine or dishwasher are used, or if multiple people take showers. 05/04/2022 Implemented
6400.76(a)The lint trap on the outside of the house by the back door was clogged with lint and unable to allow lint to exit the vent. Furniture and equipment shall be nonhazardous, clean and sturdy. Workorder was submitted and the blockage was removed. 05/04/2022 Implemented
6400.216(a)There were medical books with individual information unlocked in the living room. There was private medical information including appointment dates with the names of the individuals posted on the wall in the kitchen. An individual's records shall be kept locked when unattended. Medical records were immediately placed in a locked closet. 05/04/2022 Implemented
SIN-00142667 Renewal 06/18/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.67(a)The home's 2nd bathroom shower faucet was found detached and corroded. Exit #2 had door molding that was missing. The exit from the back bedroom had molding stripped down to the bare wood and the door hinges were found rusted.Floors, walls, ceilings and other surfaces shall be in good repair. On 6/21/18, House Manager, Nathan Walusimbi, entered a work order in our system to have the shower faucet in the second bathroom shower repaired, the molding on the Exit #2 door repaired, 3 long exposed nails on the back bedroom exit repaired, and the rusted door hinges on the back bedroom exit repaired, by 7/1/18. The importance of these requirements was reviewed with staff and the need for all floors, walls, ceilings, and other surfaces to be in good repair is understood. Nathan will monitor the home and continue to strive to meet this necessary requirement to assure the Individuals are receiving the highest quality of care. Implemented
6400.67(b)Exit #2 had missing door molding and had 3 long exposed nails. Floors, walls, ceilings and other surfaces shall be free of hazards.On 6/21/18, House Manager, Nathan Walusimbi, entered a work order in our system to have the shower faucet in the second bathroom shower repaired, the molding on the Exit #2 door repaired, 3 long exposed nails on the back bedroom exit repaired, and the rusted door hinges on the back bedroom exit repaired, by 7/1/18. The importance of these requirements was reviewed with staff and the need for all floors, walls, ceilings, and other surfaces to be in good repair is understood. Nathan will monitor the home and continue to strive to meet this necessary requirement to assure the Individuals are receiving the highest quality of care. Implemented
6400.76(a)The dining area chairs have missing top and bottom stops. Furniture and equipment shall be nonhazardous, clean and sturdy. On 6/21/18, House Manager, Nathan Walusimbi, entered a work order in our system to have the Dining area chairs repaired/replaced and bottom stops attached to all legs of the chairs, by 7/1/18. The importance of this requirement was reviewed with staff and the need for furniture and equipment to be non-hazardous, clean and sturdy is understood. Nathan will monitor the home and continue to strive to meet this necessary requirement to assure the Individuals are receiving the highest quality of care. Implemented
SIN-00115292 Renewal 05/26/2017 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)The self-assessment was completed on 3/01/2017 and the license expired on 2/01/2017.The agency shall complete a self-assessment of each home the agency operates serving eight or fewer individuals, within 3 to 6 months prior to the expiration date of the agency¿s certificate of compliance, to measure and record compliance with this chapter. The agency should complete a self assessment of each home within 3-6 months prior to the expiration date of the agency's certificate of compliance. The assessment was completed on 3/1/17, 1 month after the license expired on 2/1/17. The provider will continue to strive to meet this necessary requirement.[Going forward, a Program Designee will monitor to ensure compliance with meeting the required deadline. JG 11/28/17]. 03/01/2017 Implemented
6400.62(a)Lysol disinfecting spray, ODO Ban Disinfectant, EZ Off oven clean and clorox wipes were found unlocked in a closet located in the hall.Poisonous materials shall be kept locked or made inaccessible to individuals.Lysol Disinfecting spray, ODO Ban disinfectant, EZ Off oven cleaner, and Clorox Wipes were found unlocked in a closet located in the hall. Poisonous materials need to be locked away or made inaccessible to individuals. Poisonous chemicals will be kept locked away or stored in an area inaccessible for the individuals immediately. The manager of this home unlocked this closet the day of licensing. Because the reviewer did not observe it being unlocked, it gave the impression that it is unlocked at all times. The provider will continue to ensure that poisonous materials remained locked and safe. [Going forward, a Program Designee will monitor to ensure compliance. JG 11/28/17]. 09/05/2017 Implemented
6400.71The Emergency Numbers posted in the home did not include the local police, fire and ambulance.Telephone numbers of the nearest hospital, police department, fire department, ambulance and poison control center shall be on or by each telephone in the home with an outside line. There were no emergency telephone numbers for Local Police, Fire, and Ambulance, posted in the home. Telephone numbers for the nearest hospital, police department, fire department, ambulance, and poison control center were posted on or near the house phone with an outside line. 09/05/2017 Implemented
6400.164(b)Individual #1's Medication Administration Record (MAR) was not initialled by staff when the Ensure Vanilla Liquid Drink was given. The information specified in subsection (a) shall be logged immediately after each individual's dose of medication. The medical book review showed missing staff initials when Ensure Vanilla Liquid Drink was given. Initials should be logged immediately after each individuals dose of medication. All medication administration protocols must be followed to ensure the safety of the individuals in our care. 09/05/2017 Implemented
6400.181(e)(12)The annual assessment dated 12/15/2016 for Individual #1 did not contain recommendations in the areas of training and programming. The assessment must include the following information: Recommendations for specific areas of training, programming and services. The annual assessment completed on 12/15/2016 did not contain recommendations in the areas of training and programming. While the program specialist did write detailed information regarding needed trainings for the individual reviewed, the review team felt more detail could be added to the programming piece. This is being revised in the individual's assessment. Going forward, the program specialist will ensure that this is followed in all assessments. [Going forward, a Program Designee will review assessments for content and to ensure compliance with applicable regulations . JG 11/28/17]. 09/05/2017 Implemented
SIN-00069717 Renewal 10/06/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.67(a)The first floor bathroom tub knob was broken.Floors, walls, ceilings and other surfaces shall be in good repair. Repairs were made to the bathroom tub to ensure all items in the home are in good repair. A monthly check of the physical site needs of the home to ensure that all equipment is in good repair. A work order will be issued immediately to facilitate any repairs. 11/01/2014 Implemented
6400.76(a)Individual # 2's bedroom had missing knobs off the dresser. Furniture and equipment shall be nonhazardous, clean and sturdy. Individual 2 had the dresser repaired in his bedroom. All furniture is in good condition. A monthly check of all furniture and equipment will be conducted by the Program Specialist. A work order will be issued immediately to facilitate the repairs. 10/15/2014 Implemented
SIN-00187189 Renewal 04/22/2021 Compliant - Finalized
SIN-00161357 Renewal 08/13/2019 Compliant - Finalized
SIN-00095007 Renewal 02/02/2016 Compliant - Finalized
SIN-00042167 Renewal 10/10/2012 Compliant - Finalized
SIN-00043263 Renewal 10/10/2012 Compliant - Finalized