| Regulation | LIS Non-Compliance Area | Correction Required | Plans of Correction | Correction Date | POC Status |
| 2380.58(b) | At the time of the inspection, there was a trash can in bathroom #1 that has a pointed metal arm sticking out from the can. A pedal was originally covering it which lifts the lid, but it was pulled off by a participant and now needs to be replaced because without the pedal to cover the metal piece, it becomes a safety hazard. | Floors, walls, ceilings and other surfaces shall be free of hazards. | 1. Upon discovery during the inspection, the metal pedal was reattached immediately to eliminate the hazard.
2. It was also confirmed at the time of the inspection that no individual was harmed due to the hazard. |
05/22/2025
| Implemented |
| 2380.173(1)(ii) | The identifying marks section of Individual #2's personal information form is blank. | Each individual's record must include the following information: Personal information including: The race, height, weight, color of hair, color of eyes and identifying marks. | The personal information form was reviewed with Individual #2's parents who entered "None" on the form for identifying marks. |
05/22/2025
| Implemented |
| 2380.181(a) | Individual #1's annual assessment was completed on 10/19/2023 and not again until 11/8/2024, which exveeds the one year and 15-day grace period allowed by this regulation.
The initial assessment for Induvial #2 was late by 1 day. Individual #2's start date was 3/12/2025. The assessment was completed 5/12/2025 but should have been done by 5/11/2025. | Each individual shall have an initial assessment within 1 year prior to or 60 calendar days after admission to the facility and an updated assessment annually thereafter. | 1. The initial assessment due within 60 days and then annually thereafter were completed after the required due date. Provider was able to show other assessments that were completed on time. |
05/22/2025
| Implemented |
| 2380.183(b) | At the time of the inspection, the provider did not have a copy of Individual #1's ISP meeting sign in sheet, which documents that at least 3 members of the Individual's plan team were present at the meeting where the Individual's plan was developed and/or revised. | At least three members of the individual plan team, in addition to the individual and persons designated by the individual, shall be present at a meeting at which the individual plan is developed or revised. | 1. The day of the inspection, the CPS Program Specialist sent an email to the Supports Coordinator to request a copy of the ISP Signature Sheet. |
05/22/2025
| Implemented |
| 2380.183(c) | At the time of the inspection, the provider did not have a copy of Individual #1's ISP meeting sign in sheet, which documents the list of individuals who participated in the ISP plan meeting, in Individual #1's file as required by this regulation. | The list of persons who participated in the individual plan meeting shall be kept. | 1. The CPS Program Specialist emailed the Supports Coordinator at the time of the licensing inspection to request a copy of the ISP Signature Sheet for the meeting being reviewed. |
05/22/2025
| Implemented |