Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00188344 Renewal 06/02/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.121(c)(4)No vision or hearing screening indicated on 5/5/21 physical exam for individual #1. The physical examination shall include: Vision and hearing screening for individuals 18 years of age or older, as recommended by the physician.The physician completed a vision and hearing screening on 6/9/21. He noted the results on the physical form. See attachment 12. 06/09/2021 Implemented
6500.182(c)(1)(vi)No current dated photo. There is a photo in the file but no indication of when this photo was taken.Each individual's record must include the following information: Personal information, including: A current, dated photograph.The life sharing provider verified that the photo on file was taken June 2020. That is not noted on the photo. See attachment 13 06/09/2021 Implemented
6500.45(a)The First aid training for staff member#1 was completed -3/6/19, and again on 4/30/21, not within the annual timeframe.The primary caregiver shall be trained by an individual certified as a trainer by a hospital or other recognized health care organization, in first aid and Heimlich techniques prior to an individual living in the home and annually thereafter.Our life sharing staff have worked with this provider to show her how to do training online in the future. The life sharing provider in this instance acknowledged that she had difficulty obtaining training virtually. She usually attends training in person, which was suspended due to the Covid-19 pandemic. 06/14/2021 Implemented
6500.45(b)The CPR training for staff member #1 was conducted on-3/6/19 and again on 4/30/21, not within the annual timeframe.The primary caregiver shall be trained and certified by an individual certified as a trainer by a hospital or other recognized health care organization, in cardiopulmonary resuscitation, if indicated by the medical needs of the individual, prior to the individual living in the home and annually thereafter.Our life sharing staff have worked with this provider to show her how to do training online in the future. The life sharing provider in this instance acknowledged that she had difficulty obtaining training virtually. She usually attends training in person, which was suspended due to the Covid-19 pandemic. 06/14/2021 Implemented
SIN-00165054 Renewal 10/08/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.64(a)The bathroom tub and shower had substances consistent with dirt along the corners of the stall.Clean conditions shall be maintained in all areas of the home.the bathroom was cleaned thoroughly by the life sharing provider and the specialist. Program specialists are reviewing physical site concerns more closely to ensure compliance with all regulations. 11/13/2019 Implemented
6500.110(c)The annual fire safety training for staff 1 was not present in the record.Family members and individuals, including children, shall be trained within 31 calendar days of an individual living in the home and retrained annually, in accordance with the training plan specified in subsection (a).The provider in this home underwent fire safety training on 11/13/19. Moving forward, training for life sharing providers will be offered in the home in addition to the provider office. This will help to ensure that providers receive required training. 11/13/2019 Implemented
SIN-00073380 Renewal 12/16/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.62(a)Individual #1 was assessed that they could not safely handle poisons. The kitchen sink cabinet was unlocked and poisonous materials that included: Pine Sol, Mop and Shine, and Paint Thinner were found. The labels on each of these bottles of poisonous material documented to call Poison Control if accidentially swallowed.Poisonous materials shall be kept locked or made inaccessible to individuals.The Life Sharing Specialist met with the Provider on 12/17/2014 to review with the provider where to store poison items in the home. There was a lock present on one of the closets and that is where all poisonous items will be stored. The Life Sharing Specialist checked the home again during the next monthly monitoring on 1/13/2015, in which the cleaning items were stored in a locked closet. Going forward, the Life Sharing Specialist will monitor where the poisonous materials are stored during Monthly monitoring's. 12/17/2014 Implemented
SIN-00043824 Renewal 12/05/2012 Compliant - Finalized