Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00274270 Renewal 09/24/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.111(f)A fire extinguisher shall be inspected and approved annually by a fire safety expert. The date of the inspection shall be on the extinguisher. The fire extinguisher in the attic was outdated. The tag reflects that the extinguisher was last inspected in Oct 2023. This exceeds the time frame. A fire extinguisher shall be inspected and approved annually by a fire safety expert. The date of the inspection shall be on the extinguisher. The fire extinguisher in the attic was replaced the day after our inspection (9/25/25). 09/25/2025 Implemented
6400.112(g)The agency completed a sleep fire drill on 4.29.25 and 10.30.24, both occurring at 11:15pm. Fire drills shall be at different times of the day and night. Fire drills shall be held on different days of the week and at different times of the day and night. The current Fire Drill Log includes broad timeframes for when drills should happen. To avoid drills being done at the same time each year, we will narrow these timeframes to 3-hour windows or less. For example, the current form lists Sleep Drills between 11pm and 5am twice a year. The updated form will require one drill between 11pm and 1:30am, and the second between 2am and 5am. 11/01/2025 Implemented
6400.144Individual #6 had his annual physical on 1.20.25. At this appointment his Primary Care Physician (PCP) made a referral for a colonoscopy. The PCP reported his last colonoscopy that was conducted in 2019, revealed a single polyp, grade 1 internal hemorrhoids, and mild diverticulosis. Given these findings, a follow-up colonoscopy was recommended after 5 years. There was no documentation that a colonoscopy has occurred since the referral was made. The agency will provide services for the medicalHealth 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. Our Nursing Healthcare Coordinator contacted the Digestive Health Specialist, which performed the colonoscopy in 2019 and noted that no follow-up colonoscopy was needed until 2029 to request that they provide confirmation that a colonoscopy is not needed until 12/2029 as was noted following the colonoscopy and as noted on the response to the PCP's referral that was missing a checkmark on why the colonoscopy referral was denied. A copy of a fax sent by the specialist to the PCP on 9/30/25 noting that this individual is not due for a colonoscopy will be provided as confirmation of the follow-up plan established by the specialist, noting that the next colonoscopy should be scheduled in 12/2029. This fax was retrieved from the individual's hospital electronic patient portal, and includes the note specifically addressed to the PCP. 09/30/2025 Implemented
6400.181(a)Each individual shall have an initial assessment upon admission to the residential home and an updated assessment annually thereafter. Individual #6 had assessments dated 8.8.24 and 8.8.25, however the assessments lacked meaningful information. The assessments provided did not reflect the same level of skills within the assessment and Individual Support Plan (ISP) in several areas, including motor development skills and personal needs. The assessment reflects the individual is independent in many of the areas, whereas the ISP reflects that the individual requires verbal prompts in the same area. Assessments are essential to maximizing growth and development and protect the individual's health and safety. Assessments that lack quality or not individualized and relevant to the person's specific needs can lead to services that lack quality and potentially lead to harm. 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. Training will be held on 10/23/25 for all Program Specialists and Site Supervisors to reinforce the expectation that each Residential Skills Assessment must include thorough and meaningful information on the individuals' current skill levels as well as establishing relevant recommendations for what services and activities will help individuals both maintain and increase their skills across different domains. All Program Specialists have also been asked to update every Residential Skills Assessment by 11/30/25 to include this information for all individuals receiving services. 10/23/2025 Implemented
6400.181(e)(12)The annual assessment shall include recommendations for specific areas of training and services. The annual assessments for Individual #6 dated 8.8.24 and 8.8.25 do not include recommendations. The area of the annual assessment reflects to "continue with last years plan" however when reviewing the previous year's assessment, that area of the 2024 assessment also reflects to "continue with last years plan".The assessment must include the following information: Recommendations for specific areas of training, programming and services. Training will be held on 10/23/25 for all Program Specialists and Site Supervisors to reinforce the expectation that each Residential Skills Assessment must include clear recommendations for training, programming, and services. This helps provide a framework to support individuals based on their needs and build skills in different areas of their lives. All Program Specialists have also been asked to update every Residential Skills Assessment by 11/30/25 to include this information for all individuals receiving services. 10/23/2025 Implemented
6400.181(e)(13)(viii)The annual assessment for Individual #6 dated 8.8.25 did not document the progress and growth of managing personal property.The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Managing personal property. -The Residential Services Skills Assessment was updated on 9/25/25 to include a section that looks at everyone's ability to manage personal property, such as electronics, clothing, and furniture. A screenshot of this section will be provided. -All the other residents' assessments will be updated by 11/30/2025 to ensure this information is completed for all individuals receiving services. 09/25/2025 Implemented
6400.32(h)The individual has a right to privacy. Individual #6 had a camera located in his bedroom that faced the exit door. Cameras are not allowed in individual bedrooms or bathrooms to maintain their privacy.An individual has the right to privacy of person and possessions.It was confirmed with our IT Department on the day of the inspection (9/25/25) that this camera was not active. A screenshot of the video monitoring system was shared with licensing inspectors and management. This screenshot will also be included as confirmation that the cameras were not active. Additionally, as recommended, we removed the camera from the bedroom the day after licensing (9/26/25). Pictures will also be provided as proof of this being done. 09/26/2025 Implemented
SIN-00231163 Renewal 09/26/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(c)Poisonous materials shall be stored in their original, labeled containers. At the time of the inspection, located at the kitchen sink was a white unlabeled soap dispenser filled approximately 1/8 of the way with a clear liquid. Located at the sink in the laundry room was a small clear unlabeled push top bottle that was filled approximately ¼ of the way with a cream-colored liquid. Located in the basement bathroom sink was a gold and clear decorative soap dispenser that was filled approximately 1/8 of the way with a clear liquid.Poisonous materials shall be stored in their original, labeled containers. On the date of inspection, the soap container was discarded immediately. 10/26/2023 Implemented
6400.67(a)Floors, walls, ceilings, and other surfaces shall be in good repair. At the time of the inspection, the wall toilet paper holder was broken as the one mount was unattached from the wall and laying on the heating element on the floor. The toilet paper holder itself was also laying on the heating element on the floor as well.Floors, walls, ceilings and other surfaces shall be in good repair. The toilet paper holder was repaired within 24 hours of the licensing date. 10/26/2023 Implemented
6400.111(a)There shall be at least one operable fire extinguisher with a minimum 2-A rating for each floor, including the basement and attic. At the time of the inspection, there was no fire extinguisher in the attic.There shall be at least one operable fire extinguisher with a minimum 2-A rating for each floor, including the basement and attic. An operable, inspected and tagged fire extinguisher was immediately placed in the attic. 10/19/2023 Implemented
6400.113(a)There was no documentation or record that Individual #1 received fire safety training in 2022. Individual #1 received fire safety training on 3/1/23 and again on 9/17/23. 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. Individual #1 had received Fire Safety training on 9/17/2023. Training will be provided in March and every 6 months following. 10/26/2023 Implemented
6400.142(a)Individual #1 had a dental examination completed on 5/4/21, and their next one was completed on 3/16/23. This exceeds the requirement.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. Individual #1 will have a follow-up appointment scheduled no later than 3/16/2024. Individual #1's dentist will be contacted to receive recommendation on new upper and lower dentures for ideal fit & bite to restore chewing surface. 10/26/2023 Implemented
6400.142(f)The dental hygiene plan in individual #1's record dated 3/16/23 was left blank, and there was no record of one being completed prior for Individual #1.An individual shall have a written plan for dental hygiene, unless the interdisciplinary team has documented in writing that the individual has achieved dental hygiene independence. Individual #1 will have a follow-up appointment scheduled no later than 3/16/2024. Individual #1's dentist will be contacted to receive recommendation on new upper and lower dentures for ideal fit & bite to restore chewing surface. Individual #1 will have a dental hygiene plan completed at her upcoming appointment. 10/26/2023 Implemented
SIN-00163415 Renewal 10/02/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)The license for this chapter expired on 10/1/2019. The self-assessment for this residence was not completed until 9/12/2019.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 Residential Services Administrator reviewed with all Program Specialist the completion of self assessment no later than July prior to the license expiration and completion no earlier than April prior to the expiration of the license. 10/08/2019 Implemented
6400.72(b)The screen was torn on the door to the back patio. Screens, windows and doors shall be in good repair. Screen will be repaired and monthly inspection of the screens will be performed. Facility repair request will be completed for any screens that are not in good repair. 10/14/2019 Implemented
6400.112(d)There were 2 failed fire drills this year. On 2/6/2019 at 9am, the evacuation time was 4 minutes and 6 seconds. On 4/30/2019 at 11:10pm, the evacuation time was 5 minutes and 20 seconds. Individuals shall be able to evacuate the entire building, or to a fire safe area designated in writing within the past year by a fire safety expert, within 2 1/2 minutes or within the period of time specified in writing within the past year by a fire safety expert. The fire safety expert may not be an employe of the home or agency. Staff assistance shall be provided to an individual only if staff persons are always present at the home while the individual is at the home. An evaluation of these fire drill times was completed and a fire expert was contacted to review the evacuation routes and times. the time has since be extended and ramps and additional staffing has been provided in order to evacuate the program participants within the designated time. In addition, the agency is reviewing the need to install sprinklers in this facility in order to better meet the safety needs. 10/08/2019 Implemented
SIN-00105519 Renewal 12/12/2016 Compliant - Finalized
SIN-00066532 Renewal 09/18/2014 Compliant - Finalized
SIN-00054679 Renewal 07/02/2013 Compliant - Finalized