Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00274103 Renewal 09/17/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6400.62(a)Individual #1's Service Plan, last updated 6/10/25, indicates that Individual #1 safely uses personal hygiene products and some household cleaning products. However, for all other types of poisonous substances, Individual #1 requires staff to assist in safely using them. This includes gases, oils, and solvents. In addition, Individual #1 may need some assistance in identifying some warning signs. "[Individual #1] has poor safety skills and needs assistance in this area [of identifying warning labels]." Individual #1's current assessment, completed on 8/5/25, informs that Individual #1 safely uses personal hygiene products and some household cleaning products safely. However, for all other types of poisonous substances, Individual #1 requires staff to assist in safely using them. This includes gases, oils, and solvents. At 10:33 AM on 9/18/25, unlocked and accessible in a cabinet located in the laundry room on the home's main floor were the following poisonous substances: a one-gallon jug of Super Clean Tough Task Cleaner-Degreaser; a 16-ounce Bernzomatic Portable Propane Tank with a warning label that read: "Danger---Extremely Flammable. Explosion Hazard. Contents Under Pressure. Carbon Monoxide Hazard"; five one-gallon bottles of Arocep Ultra Liquid Bleach; and one 32-fluid ounce bottle of Murphy's Concentrated Wood Cleaner. At 10:35 AM, unlocked and accessible underneath the kitchen sink were the following poisonous cleaners: two one-quart spray bottles of Zep Commercial Quick Clean Disinfectant. At 11:02 AM, unlocked and accessible underneath the sink of the full bathroom located on the home's second floor, were the following poisonous cleaners: a one-quart spray bottle of Zep Commercial Quick Clean Disinfectant; a one-gallon bottle of Arocep Ultra Liquid Bleach; and a 24-fluid ounce bottle of Clorox Toilet Bowl Cleaner. [Repeated Violation-10/8/24, et al]Poisonous materials shall be kept locked or made inaccessible to individuals. Individual #1 was reevaluated for poison safety and is able to safely use or avoid poisonous materials. Documentation was updated into the assessment on 10/2/2025. 10/02/5025 Implemented
6400.77(b)At 11:08 AM on 9/18/25, the home's first aid kit did not contain tape. A first aid kit shall contain antiseptic, an assortment of adhesive bandages, sterile gauze pads, a thermometer, tweezers, tape, scissors and syrup of Ipecac, if an individual 4 years of age or younger, or an individual likely to ingest poisons, is served. Tape was replaced in the first aid kit on 9/19/2025. 09/19/2025 Implemented
6400.106The Inspections and cleanings of the home's gas boiler system completed on 10/2/24, and then again on 9/10/25, were not conducted by a professional company. Rather, Agency Maintenance Personnel #1, who possesses a training certificate through American Trainco showing certification obtained on 8/11/14 to 8/12/14 in "Basic Electricity for the Non-Electrician," had completed the aforementioned boiler system inspections and cleanings.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. Landlord previously contacted 3D Facility Services and arranged for an annual furnace cleaning and inspection based on last years furnace installation date of September 2024. 10/30/2025 Implemented
6400.181(e)(13)(vii)Individual #1's date-of-admission is 10/5/24. Their current assessment, completed on 8/5/25, did not address their progress over the last 365 days and current level of functioning in financial independence, as the corresponding field read: "Residential only, N/A."The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Financial independence. Individual's #1's assessment was updated on 10/2/2025 and identifies the individual's progress over the last 365 calendar days and her current level of functioning with financial independence. 10/02/2025 Implemented
6400.181(e)(13)(viii)Individual #1's date-of-admission is 10/5/24. Their current assessment, completed on 8/5/25, did not address their progress over the last 365 days and current level of functioning in managing personal property, as the corresponding field read: "Residential only, N/A."The assessment must include the following information: The individual's progress over the last 365 calendar days and current level in the following areas: Managing personal property. Individual's #1's assessment was updated on 10/2/2025 and identifies the individual's progress over the last 365 calendar days and her current level of functioning with personal property. 10/02/2025 Implemented
6400.181(e)(14)Individual #1's current assessment, completed on 8/5/25, did not address their knowledge of general water safety and ability to swim, as the corresponding field was left blank.The assessment must include the following information:The individual's progress over the last 365 calendar days and current level in the following areas: The individual's knowledge of water safety and ability to swim. Individual's #1's assessment was updated on 10/2/2025 and identifies the individual's progress over the last 365 calendar days and her current level of functioning with water safety and the ability to swim. 10/02/2025 Implemented
6400.216(a)At 11:16 AM on 9/18/25, the door to the staff office located on the home's main level was not equipped with a lock. A purple binder, entitled, "North East: Go-To Book," containing Individual #1's current physical examination, completed medical appointments, Service Plan, Room and Board Contract, and demographic information, was unlocked and accessible in this upper-left cabinet of the desk in the staff office. An individual's records shall be kept locked when unattended. Individual #1's record was placed on locked shelf within desk on 9/19/2025. 09/19/2025 Implemented
6400.51(a)(3)Direct Service Provider #2's date-of-hire is 3/25/25. Direct Service Provider #2 completed orientation training on 5/12/25.Prior to working alone with individuals, and within 30 days after hire, the following shall complete the orientation as described in subsection (b): Direct service workers, including full-time and part-time staff persons.Staff orientation was previously completed on 5/12/2025. 05/12/2025 Implemented
6400.52(a)(1)Direct Service Provider #2's date-of-hire is 3/25/25. Direct Service Provider #2 completed 20.0 hours of orientation training on 4/3/25, Direct Services Provider #2 did not work 20 hours on 4/3/25.The following shall complete 24 hours of training related to job skills and knowledge each year: Direct service workers.New staff will be documenting training hours using "real time." Each training will be documented with a start time and an end time, allowing for accuracy in recording of training hours. 10/10/2025 Implemented
6400.163(d)Individual #1's current assessment, completed on 9/18/25, explains that Individual #1 does not take any medications but would need staff support in administration if Individual #1 did take any medications. At 11:08 AM on 9/18/25, atop a bookshelf next to Individual #1's bed within their bedroom, was an opened 32-count package of Extra Strength Tylenol (500 MG) dissolvable packets.Prescription medications and syringes, with the exception of epinephrine and epinephrine auto-injectors, shall be kept in an area or container that is locked.Extra Strength Tylenol has been placed in a locked cabinet. 10/02/2025 Implemented
SIN-00254528 Renewal 10/08/2024 Compliant - Finalized