Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00269240 Renewal 07/08/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.144Individual # 1 is prescribed Pedialyte PRN. The medication was not at the home during the physical site walk through.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. Pedialyte was brought to the home from another site on 7/9/25. 07/28/2025 Implemented
6400.46(d)Staff # 4 was hired in 01/08/2023 but did not receive training in First Aid and CPR until 08/07/24Program specialists, direct service workers and drivers of and aides in vehicles shall be trained within 6 months after the day of initial employment and annually thereafter, by an individual certified as a training by a hospital or other recognized health care organization, in first aid, Heimlich techniques and cardio-pulmonary resuscitation.Staff #4 is scheduled to attend CPR and First Aid on 7/23/25. 07/28/2025 Implemented
SIN-00225235 Renewal 06/21/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.142(f)Individual #1 does not have a written dental hygiene plan.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. Provider completed individual #1 dental hygiene plan on 7/6/2023 (see attachment #12). 07/06/2023 Implemented
6400.144Individual #1's supervision care needs state there are to be breath of life checks completed overnight every 30 minutes as well as checked/changed/repositioned a minimum of every 2 hours. There is no documentation that these checks are being completed.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. The provider has created a medication administration treatment record to ensure that overnight supervision needs are met. (see attachment #13). Staff will document on the treatment record every 30 minutes for the breath of life checks and document on the treatment record for every 2 hours checked/changes/repositioned. The medical department, director, and team supervisors were trained on this regulation on 7/11/23 (see attachment #2-this will be sent to licensing as the plan of correction was due 7/10/23). 07/11/2023 Implemented
6400.145(1)Emergency medical plan identified for this home is not person specific. The Emergency Medical Plan states that staff will utilize the closest hospital to the home unless emergency personnel or a licensed physician indicates otherwise. This hospital or source of health care must be based on the preference of the individual or their substitute decision maker unless honoring the request puts the individual at risk of harm.The home shall have a written emergency medical plan listing the following: The hospital or source of health care that will be used in an emergency. Individual number 1s Emergency Medical Plan was completed (see attachment #14) 07/06/2023 Implemented
6400.181(a)Individual #1's date of admission was 11/16/2022. The individual's initial assessment was not completed until 1/18/2023, which exceeds the 60 calendar days after admission. 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. The provider realizes this citation cannot be corrected. The program specialist and director were trained on this regulation on 7/6/23 (see attachment #5) 07/06/2023 Implemented
6400.181(d)Initial assessment completed on 1/18/23 upon Individual #1's admission was not signed by the program specialist. Additional assessment updates that have been completed on 2/16/23 and 3/21/23 are also not signed by the program specialist.The program specialist shall sign and date the assessment. Individual #1 annual assessment was signed and dated by program specialist and individual on 6/23/23 (see attachment #15) 07/06/2023 Implemented
6400.50(a)Staff #1 was trained on Individual #1's ISP on 6/9/23, however there is no length of training included.Records of orientation and training, including the training source, content, dates, length of training, copies of certificates received and staff persons attending, shall be kept.The provider realizes this citation cannot be corrected. A new form was given to the program with length of training to start utilizing asap (see attachment #16). All team supervisors, program specialist, medical, and director were trained on this regulation on 7/6/23 and 7/11/23. (see attachments #5 and #2 will be sent as plan of correction was due 7/10/23) 07/11/2023 Implemented
6400.182(c)Individual #1's diet plan changed on 3/9/2023, however the ISP was not updated at the time of the change.The individual plan shall be initially developed, revised annually and revised when an individual's needs change based upon a current assessment.The program specialist completed an email to the supports coordinator on 6/21/2023 with the correct diet to include in the ISP. (see attachment #17) 07/06/2023 Implemented
6400.183(c)There is no list of persons who attended Individual #1's ISP meeting held on 1/3/2023.The list of persons who participated in the individual plan meeting shall be kept.The provider realizes this citation cannot be corrected. A sign in sheet was given to the program to start utilizing asap (see attachment #16). All team supervisors, program specialist, and director were trained on this regulation on 7/6/23 and 7/11/23. (see attachments #5 and #2 will be sent as plan of correction was due 7/10/23) 07/11/2023 Implemented
6400.196(c)Individual #1's diet order was changed on 3/9/2023 however there is no documentation that staff were trained on the changed order.Documentation of the training provided, including the staff persons trained, dates of training, description of training and training source, shall be kept.The staff were trained on 6/28/23. (see attachment #22) 07/06/2023 Implemented
SIN-00208740 Renewal 07/11/2022 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.112(a)Repeat 08/03/21-A fire drill was held on 05/15/22 which took 04 (minutes) :06 (seconds) to evacuate, on 04/14/22 which took 4:28 to evacuate, on 02/09/22 which took 04:27 to evacuate, on 11/25/21 which took 04:39 to evacuate and 08/23/21 which took 4:35 to evacuate. The Extended evacuation time for the home is 3 (min) :30 seconds. An unannounced fire drill shall be held at least once a month. Merakey Allegheny Valley School recognizes that this citation cannot be corrected for this specific documentation. 07/28/2022 Implemented
6400.112(e)An asleep fire drill was held on 05/15/22 which took 04 (min) :06 (sec) to evacuate, on 04/14/22 which took 04:28 to evacuate, 11/25/21 which took 04:39 to evacuate. There was no additional fire drill held in these months where individuals would have evacuated within the 3 minute 30 second extended evacuation time.A fire drill shall be held during sleeping hours at least every 6 months. Merakey Allegheny Valley School recognizes that this citation cannot be corrected for this specific documentation. 07/28/2022 Implemented
SIN-00161509 Renewal 10/01/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.112(c)The smoke detector in the attic has never been checked for operability, during or shortly after, every monthly fire drill.A written fire drill record shall be kept of the date, time, the amount of time it took for evacuation, the exit route used, problems encountered and whether the fire alarm or smoke detector was operative. Merakey Allegheny Valley School acknowledges that the smoke detector in the attic at was not checked for operability, during or shortly after, every monthly fire drill. A training was conducted on 10/9/2019 (Attachment 5 and 6) with the House Manager to review proper listing of pull stations, smoke detectors, and flashlights, and the correct required fire checks. A check that all smoke detectors and pull stations were accounted for was conducted by the House Manager and Administrator (Attachment 7)on 1/31/2020. On 2/1/1020 all smoke detectors were checked by the House Manager (Attachment 8). The Administrator will monitor the fire checks for proper compliance during monthly house checks. Guardian Protection Systems will also continue their checks twice a year (Attachments 9 16). 02/01/2020 Implemented
SIN-00141584 Renewal 10/04/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.106A furnace inspection occurred on 05/02/17 and not again until 05/24/18Furnaces shall be inspected and cleaned at least annually by a professional furnace cleaning company. Written documentation of the inspection and cleaning shall be kept. Merakey Allegheny Valley School acknowledges that the furnace at 24 Grandview Road Hummelstown should have been cleaned within 365 days. To prevent a reoccurrence of this event, a certified letter (Attachment #1, #2, #3) was sent to Hummelstown Fuel Oil Service who cleans the furnace for Merakey Allegheny Valley School. The letter clearly states the time frame needed between furnace cleanings. In addition, the Administrator conducted a training session with the Maintenance Supervisor on the proper scheduling for furnace cleanings (Attachment #4). The Maintenance Supervisor will follow up with the company to confirm all furnace cleanings fall in the correct time frame. The Maintenance Supervisor will validate with that the furnace cleanings are scheduled within the correct time frame with the Administrator. Documentation of the furnace cleaning will be kept in the House Fire Book when completed. 11/13/2018 Implemented
6400.163(c)8/29/18 Psych medication review doesn't include/identify psych meds. 6/6/18 review doesn't include/identify psych meds 3/20/18 review doesn't include/identify psych meds 12/13/17 review doesn't include need to continue meds. If a medication is prescribed to treat symptoms of a diagnosed psychiatric illness, there shall be a review with documentation by a licensed physician at least every 3 months that includes the reason for prescribing the medication, the need to continue the medication and the necessary dosage.Merakey Allegheny Valley School acknowledges the Psychotropic Medication Consultation Form did not identify current medications. To prevent a reoccurrence of this event, the current psychotropic medications will be typed directly on the Psychotropic Medication Consultation Form (Attachment #9). The Social Services Supervisor conducted a training with the Behavior Specialist on the proper completion of the Psychotropic Medication Consultation Form (Attachment #10). The Behavior Specialist will verify all current psychotropic medications are on the Psychotropic Medication Consultation Form prior to the Psychiatric appointment. Copies of the Psychotropic Medication Consultation Form will be submitted to the Social Services Supervisor to review for proper completion. This will be verified with the Social Services Supervisor¿s signature/initials for 3 months. The signed copies will be maintained by the Social Services Supervisor. The original Psychotropic Medication Consultation Form will be maintained in the individual¿s medical chart. 10/19/2018 Implemented
SIN-00121500 Renewal 10/17/2017 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.144Individual #1 had a 60 oz. fluid restriction prescribed on 4/17/17. Not documentation was present in the record which tracks the total amount of fluid intake this individual receives. 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. 6400.144 Allegheny Valley School/NHS acknowledges there was no documentation for the amount of fluids the individual on the 60 ounce fluid restriction was receiving. To immediately correct the issue, an intake form was put in place (see attachment #4). The staff was trained on the correct procedure to follow to record the fluid intake (see attachments #5). This will allow the individual¿s total amount of fluid intake to be properly monitored. The waiver nursing department reviewed the physician orders for another individual with a fluid requirement. A fluid intake form was put in place and the staff trained on the proper procedure. To prevent a reoccurrence of this event, the staff will continue to monitor the fluid intake as long as the physician¿s order stays in place. The House Manager will monitor the daily documentation during the regular documentation checks. The monthly intake form will be turned in to the waiver nursing department for review and to be filed. 10/23/2017 Implemented
6400.162(a)Individual #1's medication label for Earwax Treatment Drops 6.5% reads instill 4 drops in each ear twice, once monthly. Physican order states instill 4 drops each ear twice monthly. The original container for prescription medications shall be labeled with a pharmaceutical label that includes the individual's name, the name of the medication, the date the prescription was issued, the prescribed dose and the name of the prescribing physician. 6400.162(a) Allegheny Valley School/NHS acknowledges that the label on the Earwax treatment drops 6.5% did not match the physician¿s order. The pharmacy was immediately notified by the Waiver Health Coordinator to send a corrected label (see attachment #1). The House Manager immediately applied a sticker to the earwax treatment drops label that states ¿Directions changed Refer to MAR¿ (see attachment #2) until a correct label was received on 10/25/17 (see attachment #3). The correct label contained the same directions for use as the prescribing physician¿s order, as well as the individual¿s name, medication name, the date prescribed, the prescribed dose, and the name of the prescribing physician. All medication records, including medication labels and physician orders with the Earwax treatment drops were reviewed by the Waiver Nursing Department. No discrepancies were found. To prevent a reoccurrence of this event, the Waiver Nurses will compare the labels of medications received from the pharmacy with the physician¿s order when the medications are received. In addition, the House Manager will compare the label to the physician¿s order prior to placing the medication in the medication closet. Any discrepancies discovered will be reported immediately to the pharmacy and corrections requested. 10/25/2017 Implemented
SIN-00085325 Renewal 10/14/2015 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(a)Repeat Violation: The following poisons where found to be unlocked at this site: Hand sanitizer, hand soap, and pro health mouth wash. All of these items are listed as poisons. The individual in this home is not poison aware. Poisonous materials shall be kept locked or made inaccessible to individuals. NHS acknowledges that the mentioned products should have been in a locked area of the home. There are locked closets for the storage of poisonous materials in each of the homes, and the products are now locked in those areas. To assure there is no recurrence of this event the House Managers were retrained on their responsibility to monitor storage of poisonous material (Staff Attendance Sheet with memo Attachment #1). Additionally, the direct care teams for all homes were reminded to properly handle and store poisonous materials (Staff Attendance Sheet with memo Attachment #14). The compliance to this requirement will be validated during monthly supervision with the Administrator. The House Manager will bring a completed site checklist, which includes review of toxic products for discussion and review to the monthly House Manager meetings (Safety Audit Attachment # 15). 12/21/2015 Implemented
SIN-00068692 Renewal 10/14/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.164(b)On 9/23/14 Individual #1 was administered the medication Lorazepam 2mg before a medical procedure. It was indicated on the medical hold/sedation form, but was not signed off as to who administered the medication on the MAR. The information specified in subsection (a) shall be logged immediately after each individual's dose of medication.   11/11/2014 Implemented
SIN-00175331 Renewal 08/25/2020 Compliant - Finalized
SIN-00102580 Renewal 10/24/2016 Compliant - Finalized
SIN-00054870 Renewal 11/12/2013 Compliant - Finalized
SIN-00041069 Renewal 11/19/2012 Compliant - Finalized