Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00257272 Renewal 12/12/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.141(c)(10)The most recent physical for Individual One did not answer the communicable disease questionThe physical examination shall include: Specific precautions that must be taken if the individual has a communicable disease, to prevent spread of the disease to other individuals. Physical scheduled 1/15/25. Completed physical examination documentation will be obtained. 01/15/2025 Implemented
6400.144Individual One is prescribed Insulin Lispro Kwikpen U-100 100 units/ML. The sliding scale for this medication is unclear and inconsistent, and needs more thorough documentation as to what amount of insulin was administered and for what reasons. The amount of insulin is administered based on a combination of how much of a meal was eaten in conjunction with the blood sugar level at that time. Corresponding documentation needs to reference the specific name of the insulin that is being administered as well as what the dose is. The reasoning for the dose needs to be clearly documented as well given that it is judged based on more than one determining factor. Additionally, the sliding scale only references how much of the insulin is to administer for blood sugar readings between 200 and 350. What to do for readings outside of those parameters needs to be clearly documented and should not be assumed.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. An updated clarified script was obtained and will be submitted for review. 12/18/2024 Implemented
6400.151(a)Staff physical for Staff One is past due, with the last completed on 12/8/22. A staff person who comes into direct contact with the individuals or who prepares or serves food, for more than 5 days in a 6-month period, including temporary, substitute and volunteer staff, shall have a physical examination within 12 months prior to employment and every 2 years thereafter. staff was contacted on 12/13/24 with instructions to schedule her physical and she said she would - staff was contacted again on 1/13/25 asking for an update 01/31/2025 Implemented
6400.181(f)The assessment mailing letter was not found in Individual One's record.The program specialist shall provide the assessment to the individual plan team members at least 30 calendar days prior to an individual plan meeting.Program Director reviewed this requirement with the program manager/specialist. 12/13/2024 Implemented
SIN-00235042 Unannounced Monitoring 11/21/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.163(h)Medications Bacitracin and Mupirocin Ointment prescriptions were in medication box but not on Medication Administration Log (MAR). Medications were reported to have been discontinued and should not have been in individual's #3 medication box.Prescription medications that are discontinued or expired shall be destroyed in a safe manner according to Federal and State statutes and regulations.Bacitracin has been removed from the medication box. Upon of November 2023 MAR Mupirocin Ointment is on the MAR and should be in the mediation box. Additionally, this prescription is not expired. 12/31/2023 Implemented
6400.165(b)Sunscreen Kids AER SPF 50 was on the medication administration log (MAR), but not in the medication box.A prescription order shall be kept current.Sunscreen was added to medication box. 12/31/2023 Implemented
SIN-00216824 Renewal 12/15/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.111(f)The attic fire extinguisher tag shows its last inspection was in 2016 A fire extinguisher shall be inspected and approved annually by a fire safety expert. The date of the inspection shall be on the extinguisher. Program manager reviewed this finding with the staff team. A request to replace or inspect/recharge the fire extinguisher was made in December 2022. 03/31/2023 Implemented
6400.165(g)Quarterly psychotropic review is not in the record for individual #5If a medication is prescribed to treat symptoms of a psychiatric illness, there shall be a review by a licensed physician at least every 3 months that includes to document the reason for prescribing the medication, the need to continue the medication and the necessary dosage.Appointments have been completed; however, documentation has not been received from the provider. Program will continue to follow up with the provider to obtain appointment documentation. 01/31/2023 Implemented
6400.166(b)The medication review for Individual #5 found that the newly prescribed PRN medication Loperamide was in her medication box, but wasn't listed on the MAR.The information in subsection (a)(12) and (13) shall be recorded in the medication record at the time the medication is administered.Medication had just arrived to the home 24hrs prior to this inspection. Medication was added to the MAR on 12/16/22. 01/19/2023 Implemented