Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00216823 Renewal 12/15/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(d)There were food items stored in a closet along with cleaning supplies.Poisonous materials shall be kept separate from food, food preparation surfaces and dining surfaces.This was moved immediately. The poisons were placed in another location away from food that is designated to keep poisons locked. 12/31/2022 Implemented
6400.67(a)A handle is missing on a drawer in the kitchen.Floors, walls, ceilings and other surfaces shall be in good repair. Ticket was placed on 12/19/22 and was accessed by facilities. The facilities department is waiting for the part to replace the handle. 02/28/2023 Implemented
6400.68(c)The only coliform water test that was on filed occurred on 11/28/22.A home that is not connected to a public water system shall have a coliform water test by a Department of Environmental Resources¿ certified laboratory stating that the water is safe for drinking purposes at least every 3 months. Written certification of the water test shall be kept.6400.68(c) was reviewed with the agency's facilities department. The facilities department now has a schedule to complete water testing for this home on an every 3 month basis 01/19/2023 Implemented
6400.112(e)Greater than 6 months between sleep drills. The most recent documented drills occurred on December 29, 2021 and October 18, 2022A fire drill shall be held during sleeping hours at least every 6 months. Last overnight drill held October 2022. Next overnight drill to be held by April 2023. Overnight drills will be conducted at least every six months. 01/31/2023 Implemented
6400.141(c)(7)Individual #3's most recent OBGYN was completed on 10/4/2020 One was Scheduled for 12/15/22 but canceledThe physical examination shall include: A gynecological examination including a breast examination and a Pap test for women 18 years of age or older, unless there is documentation from a licensed physician recommending no or less frequent gynecological examinations. The Senior Program Associate (SPA) of home will make all appointments as soon as possible to ensure that the appointments are scheduled to not exceed a year. GYN canceled by provider and rescheduled for 1/25/23. 01/25/2023 Implemented
6400.142(a)The two most recent dental exams on file for individual #3 are dated 10/28/20 and 12/5/22 which is greater than 1 year apart.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. The Senior Program Associate (SPA) of home will make all appointments as soon as possible to ensure that the appointments are scheduled to not exceed a year 01/31/2023 Implemented
6400.144The following PRNs for individual #3 were not present at the time of inspection: Bisacodyl 10 MG Loperamide (Imodium) Metamucil PRN Ketoconazole 2% shampooHealth 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. Medication was reordered on 12/16/22 and was delivered to the home. 01/31/2023 Implemented
6400.163(h)The following medications in the box if individual #3 were expired. PRNs Indomethacin 25 MG capsules expired on 4/12/22 PRNs Meloxicam 7.5 MG tab expired on 4/19/22Prescription medications that are discontinued or expired shall be destroyed in a safe manner according to Federal and State statutes and regulations.These medications were returned to the pharmacy. 01/31/2023 Implemented
6400.165(b)Ammonium Lactate 12% cream was in the medication box of individual #3 but is not on a current MARA prescription order shall be kept current.Medication was added to the MAR on 12/15/22. 01/31/2023 Implemented
SIN-00130387 Renewal 02/20/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(c)There were spray bottles without labels that had written Lysol on them. All purpose cleaner bottles. The bottles contained a yellowish liquid and a purple liquid.Poisonous materials shall be stored in their original, labeled containers. All cleaning products and poisons are now being stored in their original containers. Staff have been retrained on how to properly handle and store poisonous materials. 03/14/2018 Implemented
6400.68(c)The coliform inspection was completed on 3/31/17 and no other documentation.A home that is not connected to a public water system shall have a coliform water test by a Department of Environmental Resources¿ certified laboratory stating that the water is safe for drinking purposes at least every 3 months. Written certification of the water test shall be kept.A sample of water was collected on 3/22/18 and is currently being tested. The well water will continue to be collected and tested on a quarterly basis. 03/22/2018 Implemented
6400.142(a)Individual #1 last dental examination was completed on 6/27/16.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. The Program Nurse will do a continuous monitoring of dates on annual doctors appointments through ongoing communication via email, phone calls and faxes. Individual #1 was sent for bloodwork which was required to be completed prior to scheduling a dental examination. Due to a concern in the results of the bloodwork, Individual #1 is being sent to receive more bloodwork prior to scheduling a dental appointment. 03/23/2018 Implemented
SIN-00109602 Renewal 02/09/2017 Compliant - Finalized