Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00285098 Renewal 01/27/2026 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.105At 11:29 AM on 1/28/26, there was a piece of significantly frayed carpeting, measuring approximately three feet by one and one-half feet, underneath the gas furnace located in the home's basement that posed as combustible material.Flammable and combustible supplies and equipment shall be utilized safely and stored away from heat sources. The carpeting that was frayed was removed by the providers' maintenance technician. Evidence of the removed carpeting is included with this plan of correction as Attachment #1. 04/03/2026 Implemented
6400.106The furnace in the home was inspected and cleaned by a professional furnace cleaning company on 11/12/24, and then again on 12/22/25. This exceeds the annual requirement.Furnaces shall be inspected and cleaned at least annually by a professional furnace cleaning company. Written documentation of the inspection and cleaning shall be kept. Provider reviewed current practices regarding tracking and scheduling of furnace inspection and cleaning and implemented a tracking system to allow for timely inspections and cleanings in accordance with 6400.106. 04/03/2026 Implemented
6400.141(c)(7)Individual #1 had a gynecological examination performed on 06/08/22, with documentation from a licensed physician recommending gynecological examinations every three years, and no additional documentation of an examination completed since was provided to measure compliance. This exceeds the recommendation by the physician. [Repeat violation 03/10/25 et al]The 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. Provider immediately scheduled an updated gynecological exam for Individual #1. That appointment occurred on 2/25/2026. A copy of the visit form is included with this plan of correction as Attachment #3 An audit of all physical exams was conducted to ensure compliance with regulatory requirements for all affected individuals. This was completed by the Nurse, IDD Administrative Coordinator and Group Home Supervisor by 2/28/2026 04/03/2026 Implemented
6400.141(c)(8)Individual #1 is age 69. Individual #1's current physical examination, completed on 5/22/25, included physician recommendations for having a mammogram conducted annually. However, Individual #1 had mammograms completed on 1/10/24, and then again on 3/12/25. This exceeds the annual requirement.The physical examination shall include: A mammogram for women at least every 2 years for women 40 through 49 years of age and at least every year for women 50 years of age or older. Provider immediately scheduled an updated mammogram for Individual #1. That appointment occurred on 2/25/2026. A copy of the visit form is included with this plan of correction as Attachment #3 Provider conducted an audit of all individuals requiring a mammogram to ensure full compliance in accordance with 6400.141(c-8). This audit was completed by 2/28/2026. 04/03/2026 Implemented
6400.181(e)(1)Individual #1's current assessment, completed on 5/2/25, did not include their needs and preferences, as there are neither corresponding fields, nor information addressing this content throughout the entire document. The assessment must include the following information: Functional strengths, needs and preferences of the individual. Individual #1s assessment was reviewed by the team to ensure all areas of required information in accordance with 6400.181(e-1) were referenced. Program Specialist updated the plan to include the needs and preferences of the individual. The Assessment was updated on 3/6/2026. The assessment is included with this plan of correction as Attachment #4. 04/03/2026 Implemented
6400.181(e)(12)Individual #1's current assessment, completed on 5/22/25, did not include recommendations for specific areas of training, programming, and services to promote skill growth.The assessment must include the following information: Recommendations for specific areas of training, programming and services. Individual #1s assessment was reviewed by the team to ensure all areas of required information in accordance with 6400.181(e-12) were referenced. Program Specialist updated the plan to include the needs and preferences of the individual. The Assessment was updated on 3/6/2026. The assessment is included with this plan of correction as Attachment #4 04/03/2026 Implemented
6400.214(b)At 11:19 AM on 1/28/26, neither hard nor electronic copies of the following most current records were being kept at the home for Individual #1: an assessment; and an applicable psychological evaluation The most current copies of record information required in § 6400.213(2)¿(14) shall be kept at the residential home. Both documents were placed in the home on 3/9/2026. These documents have also been provided as a part of this plan of correction as Attachments#4 and #5. A comprehensive assessment and psychological evaluation for the individual will be obtained from a qualified licensed professional. The completed evaluation will be placed in the individual's record in the home to ensure accessibility for staff and regulatory review. A full audit of all individual records within the home will be conducted to verify that each individual has a current assessment and psychological evaluation on file as required. 04/03/2026 Implemented
6400.50(a)Direct Service Worker #1's date-of-hire is 9/29/25. Direct Service Worker #1 completed orientation training on 10/10/25 in the area of job-related knowledge and skills regarding individual-specific reviews of behavior support plans and service plans. However, this in-person training neither documented the trainer who had conducted the session, nor its course length.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 has reviewed the identified training sign-in sheet and updated it to include the trainer's full name and the total length of the training session. The training sign in sheets are included in this plan of correction as Attachment #9 and Attachment #10. 04/02/2026 Implemented
6400.165(g)Individual #1 is prescribed medication to treat symptoms of a psychiatric illness, and there was a review by a licensed physician on 04/09/25, and then again on 09/24/25. This exceeds the every 3-month requirement. Additionally, no other documentation of appointments was provided for review and measuring compliance. This exceeds the every 3-month requirement. [Repeat violation 03/04/25, et. al.]If 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.Provider scheduled a 90 day medication review to occur on 4/22/2026. Provider will ensure all 90 day medication reviews are scheduled and attended within the timeframes specified in 6400.165(g). 04/22/2026 Implemented
6400.213(1)(i)Individual #1's date-of-admission is 4/12/14. However, neither Individual #1's demographics page, nor their content of records included admission date.Each individual's record must include the following information: Personal information, including: (i) The name, sex, admission date, birthdate and Social Security number.Action was taken to add the date of admission to Individual #1's records. Records were updated to include the date of admission. The date of admission was 4/12/2014 and has been added to the face sheet which is included with this plan of correction as Attachment #8. Provider immediately reviewed all other service recipients documentation to ensure the date of admission is noted for each individual person respectively. This was completed by 4/1/2026. 04/01/2026 Implemented
SIN-00240346 Renewal 03/05/2024 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.141(c)(7)Individual #1 had a gynecological examination completed on 08/19/21, and then again on 06/20/23, with no documentation from a licensed physician recommending no or less frequent gynecological examinations. This exceeds the annual requirement.The 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. 1. Annual GYN appointments will be tracked in the Electronic Health Record Appointment Tracking System. A calendar within this system documents appointments coming due. 2. The IDD Group Home Manager will meet with Program Specialists (PS) once a month to review appointments that are due over the next 3 months to ensure they are scheduled in a timely manner. 3. When possible, during the appointment the next appointment will be scheduled at the doctor¿s office prior to leaving the office. The new appointment will be added in the EHR system. 4. The IDD Group Home Program Manager will review the medication consultation form to ensure that the PS added the next appointment in the EHR system and if no appointments were made then this will be added to the monthly meeting to review the appointments that are due in 3 months. 5. Any appointment that is missed, cancelled, rescheduled or refused will be tracked in the EHR and appointment refusal forms will be completed by the Program Specialist and reviewed and signed by the individual to be uploaded and attached to the appointment in the EHR system. 03/15/2024 Implemented
SIN-00222368 Renewal 03/28/2023 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.65On 4/7/23, the air duct vent above the shower in the bedroom hallway bathroom was discovered clogged with dust and debris, obstructing proper ventilation.Living areas, recreation areas, dining areas, individual bedrooms, kitchens and bathrooms shall be ventilated by at least one operable window or by mechanical ventilation. The air duct was cleaned on the day of inspection by staff working at the home and is no longer obstructing proper ventilation. 04/07/2023 Implemented
6400.151(a)The most recent physical examination for Direct Support Professional #1, date-of-hire 2/3/14, was completed 1/15/2020. 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. Human Resources notified the staff person that they must complete or submit a valid bi-annual physical exam in order to continue working their regularly scheduled shifts. 05/05/2023 Implemented
6400.151(c)(2)The most recent tuberculin skin test for Direct Support Professional #1, date-of-hire 2/3/14, was read 1/17/2020. The physical examination shall include: Tuberculin skin testing by Mantoux method with negative results every 2 years; or, if tuberculin skin test is positive, an initial chest x-ray with results noted. Tuberculin skin testing may be completed and certified in writing by a registered nurse or a licensed practical nurse instead of a licensed physician, licensed physician's assistant or certified nurse practitioner. Human Resources notified the staff person that they must complete or submit a valid bi-annual TB test in order to continue working their regularly scheduled shifts. 05/05/2023 Implemented
SIN-00187287 Renewal 05/04/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.15(a)The agency did not complete a self-assessment of the home.The agency shall complete a self-assessment of each home the agency operates serving eight or fewer individuals, within 3 to 6 months prior to the expiration date of the agency¿s certificate of compliance, to measure and record compliance with this chapter. A self-assessment will be completed for each home Between April 1st and July 30th, annually. Prior to the self-assessment being printed for use, the IDD Administrator will check the ODP website for the most current version and supply it to his House Coordinators and Program Specialist to complete the site parts of the assessment. The Program Specialist, Program Director and Program Manager will receive training on how to complete a self-assessment on 6/24/21 from 10am-3pm from the Regional Director. The Program Manager will review and advise House Coordinator and Assistant Program Directors on how to properly fill out the form on 06/29/21 during the weekly managers meeting. The Self Assessments will be completed on 6/30/21. 06/30/2021 Implemented
6400.65The bathroom in the master bedroom does not have a screen in the window which is able to be opened and does not have mechanical ventilation.Living areas, recreation areas, dining areas, individual bedrooms, kitchens and bathrooms shall be ventilated by at least one operable window or by mechanical ventilation. The window screen was found in the garage of the site and placed in the window on 5/11/21 06/23/2021 Implemented
6400.112(c)The written fire drill records for the monthly fire drill held from 12/2020 through 3/2021 did not include the exit routes used.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. The provider has included in manager training that two categories are to be included in fire drills moving forward. 1. The route of escape. 2. The meeting location area. on 5/25/21. The Fire Drills from May and June had the exit route and meeting area, but was not specifically defined. The provider add " exit route used" to the form. On 6/17/21 a fire drill was conducted on this site, on 6/21/21 the site administrator filled out the correct form using the data from the 6/17/21 fire drill and signed off on it. 06/21/2021 Implemented
SIN-00262651 Renewal 03/03/2025 Compliant - Finalized
SIN-00167571 Renewal 12/11/2019 Compliant - Finalized