| Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
| 6400.62(d) | In the garage, there were cleaning supplies stored with open and unopened food items in a storage bin. | Poisonous materials shall be kept separate from food, food preparation surfaces and dining surfaces. | In the garage, cleaning supplies found stored with open and unopened food items in storage bin were removed, separated, stored, and locked in the closet during the inspection on 12/13/2022. See attachment#4. |
12/13/2022
| Implemented |
| 6400.64(a) | Individual 3'-bedroom closet has a brown substance smeared on the wall and ceilings.
Individual 3'-bathroom wall has a brown substance smeared on it.
Individual 2 free standing fan on their bedroom dresser has a large dust accumulation.
The second-floor hall bathroom has a green residue around the entire surface of the sink faucet. | Clean and sanitary conditions shall be maintained in the home. | A brown substance smeared on the wall and ceilings in individual 3- bedroom closet, brown substance smeared on bathroom wall in individual 3-bedroom, large dust accumulation on standing fan in individual 2-bedroom dresser, and green residue around the entire surface of second floor hall bathroom sink faucet were cleaned/ repaired on 12/13/2022. See attachment #5. |
12/13/2022
| Implemented |
| 6400.67(a) | In the living room bay window seat, there is a rotten area that is brown in color and soft to the touch. | Floors, walls, ceilings and other surfaces shall be in good repair. | Living room bay window seat found with rotten area that was brown in soft color and soft touch was repaired and sealed on 1/03/2023. See attachment #6. |
01/03/2023
| Implemented |
| 6400.67(b) | The second-floor hall bathroom wall mounted wash towel rack is not securely attached to the wall and spins and wobbles at the base.
The first-floor hall utility closet has an inoperable lock on it. This closet needs to be locked as it contains many hazards. These hazards include an open ceiling with missing drywall, the ceiling ducts are slit open in a couple of areas with insulation peeking out, there are pieced of wood and metal hanging from the ceiling. This lock was fixed and made operable by a maintenance person by the end of the inspection.
There is an accumulation of lint in the clothes dryer lint trap.
Individual 1s bedroom door has a broken towel rack on the back of the door, with pointy ends exposed.
Individual 2'-bedroom floor ventilation cover is not securely affixed to the floor and is also covered in dust. | Floors, walls, ceilings and other surfaces shall be free of hazards. | Utility closet on the first-floor closet lock was replaced during licensing on 12/13/2022.
Utility closet ceiling was repaired on 12/15/2022.
Towel rack in the 2nd floor bathroom was removed on 12/13/2022 during inspection.
Lint discovered during inspection was removed at the time of inspection on 12/13/2022.
The broken tower rack in individual 1bedroom was removed on 12/13/2022.
The ventilation cover in individual 2-bedroom was cleaned and secured on 12/13/2022. See attachment#7. |
12/13/2022
| Implemented |
| 6400.81(k)(6) | Individual 1 bedroom does not contain a mirror. | In bedrooms, each individual shall have the following: A mirror. | The mirror was installed in individual 1-bedroom on 12/15/2022. |
12/15/2022
| Implemented |
| 6400.113(a) | Individual 3 was not re-instructed annually in general fire safety, evacuation procedures, responsibilities during fire drills. Last training was completed 02/02/2022. It could not be determined when the individual was trained in fire safety in 2021. | An individual, including an individual 17 years of age or younger, shall be instructed in the individual's primary language or mode of communication, upon initial admission and reinstructed annually in general fire safety, evacuation procedures, responsibilities during fire drills, the designated meeting place outside the building or within the fire safe area in the event of an actual fire and smoking safety procedures if individuals smoke at the home. | The fire safety training document for individual 3 was found after the inspection dated 8/20/2021 within the EHR system where all records are stored on 12/15/2022. See attachment#9. |
12/15/2022
| Implemented |
| 6400.141(a) | Individual 3 did not have a physical examination annually; current exam was completed 09/14/22 and previous exam not provided at time of inspection. | An individual shall have a physical examination within 12 months prior to admission and annually thereafter. | Individual 3 annual physical was completed on 9/14/2022 according to documents collected on 12/21/2022.
The results of the PPD (QuantiFERON TB Gold) were read on 9/17/2022. Previous annual physical was completed on 2/9/2021. See attachment 10; 10a. |
12/21/2022
| Implemented |
| 6400.144 | Individual 3 completed a podiatry appointment October 4, 2022, with a follow update for December 6, 2022. No follow up appointment was provided. | 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.
| Individual 3 podiatry follow up appointment Documentation for 12/6/2022 was found and uploaded to the agency EHR system after the inspection on 12/15/2022.see attachment#11, & 11a-new appointment. |
12/15/2022
| Implemented |