Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00291889 Renewal 07/09/2026 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.121(c)(4)The hearing and vision screening for Individual 2 was not completed and there wasn't a recommendation for further screening. The physical examination shall include: Vision and hearing screening for individuals 18 years of age or older, as recommended by the physician.The provider and the Program specialist will arrange for the required hearing and vision screenings for the two individuals. The result of the screening will be obtained and documented in each individual record. If further evaluation or screening is recommended, the provider will ensure that the recommendation followed through and documented. 08/01/2026 Implemented
6500.121(c)(10)Individual 2's physical that is dated 05/27/26 does not indicate if the individual is free of communicable disease. The physical examination shall include: Specific precautions that must be taken if the individual has a communicable disease, to prevent spread of the disease to other individuals.The Life Sharing provider will contact the individuals healthcare providers to obtain documentation confirming whether each individual was assessed as free form communicable diseases. The documentation will be obtained and maintained in each individuals health record. The Program Specialist will review all physical examination documentation upon receipt to ensure that required health information, including documentation regarding communicable diseases, is clearly indicated. Any incomplete documentation will be returned to that healthcare provider for clarification. 08/01/2026 Implemented
SIN-00268916 Renewal 06/05/2025 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.62(d)A poisonous cleaning material was stored in the same kitchen cabinet as cooking oil.Poisonous materials shall be kept separate from food, food preparation surfaces and dining surfaces.This was corrected the day of the inspection 06/12/2025 Implemented
6500.67The bathroom sink cabinet door was not connected to the bottom hinge. One of the 2nd floor bedroom doors was not connected to its hinges and came off the hinges when it was opened.Floors, walls, ceilings and other surfaces shall be free of hazards.The door on the bathroom cabinet has been repaired 07/30/2025 Implemented
6500.102There was excess lint in the dryer's lint catcher.Flammable and combustible supplies and equipment shall be utilized safely and stored away from heat sources.This was corrected the day of the inspection 06/12/2025 Implemented
6500.109(f)6/21/2024, 9/20/2024, 12/21/2024, 3/21/2025 -- No alternate route indicated, only Front door.Alternate exit routes shall be used during fire drills.JEVS administration met with the life sharing team to discuss how to complete fire drills correctly. The life sharing staff will meet with each provider to ensure they understand the requirements. 06/12/2025 Implemented
6500.32(h)There was a ring camera in the living room pointed towards the kitchen.An individual has the right to privacy of person and possessions.The camera was removed and the provider was instructed on why she could not have it in her home. The camera was removed on June 6, 2025. 06/20/2025 Implemented
6500.136(a)(11)There was no Dx or purpose for the medications on the MAR od individual 10.A medication record shall be kept, including the following for each individual for whom a prescription medication is administered: Diagnosis or purpose for the medication, including pro re nata.JEVS worked with the pharmacy and the diagnosis and purpose for all medications has now been added to the MARS. 07/23/2025 Implemented
6500.136(b)Individual 10 - Depakote 500 mg at 8AM was not signed off on MAR but dose was missing from BP. Haldol 20 mg was signed off as being administered on 06/05/25 at 2 pm, but it is to be administered at the day program. Benadryl 50 mg at 8 PM -- a dose was missing for 06/05/25, but was not signed off on MAR. Seroquel 200 mg at 2 PM was signed off on MAR for 06/02 & 06/03 but Med was administered at the day program. Seroquel 400 mg at 8 PM, the 06/05/25 dose was missing from the blister pack, but was not signed off on MAR.The information in subsection (a)(12) and (13) shall be recorded in the medication record at the time the medication is administered.This issue occurred because the individual went to camp. He took his medication, but the provider did not account for documenting the administration of the medication. Going forward the provider will document that medication was given out of the home and by whom when this situation comes up again. 06/16/2025 Implemented
6500.137(a)(1)Individual 10 - Neurontin 300 mg was last administered on 06/05/25 at 8 AM. The care giver stated that the medication had run out. Haldol 20 mg was not administered on 06/06/25 at 8 AM Zoloft 100 mg at 8 AM was not administered on 06/06/25 at 8 AM Vitamin D3 1,000 units was not administered on 06/06/25.Medication errors include the following: Failure to administer a medication.This issue occurred because the individual went to camp. He took his medication, but the provider did not account for documenting the administration of the medication. Going forward the provider will document that medication was given out of the home and by whom when this situation comes up again. 06/20/2025 Implemented
SIN-00188347 Renewal 06/02/2021 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.121(c)(10)The Physical exam does not indicate if Individual#1 is free from communicable diseases. The physical examination shall include: Specific precautions that must be taken if the individual has a communicable disease, to prevent spread of the disease to other individuals.The physician has scheduled an appointment for KL on July 12th, 21. He will complete the form at that time. JEVS can send the form after July 12th to validate that the appointment was kept and that the form was completed correctly. 06/25/2021 Implemented
6500.45(a)First aid training was completed for staff member#1 on-11/18/17, and again on 5/29/21, 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.The fire safety training for this person was completed on 6/26/19. The record was not available to the licensing review at the time of the inspection see attachment 19 06/07/2021 Implemented
6500.45(b)The CPR training was conducted on- 11/18/17, and again on 5/29/21, 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.CPR training for this person was completed o 6/26/19. The record of training was not in the person's file and was not available to the licensing reviewer at the time of the inspection see attachment 20 06/07/2021 Implemented
SIN-00166950 Renewal 10/08/2019 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.110(c)Caregiver #1 did not have documented annual fire safety training in record. April 2018 was the last fire safety training in 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).fire safety training was completed on 10/29/19. Training will be offered in the life sharing home as well as the JEVS office going forward. This will help to ensure that training is completed as required. 10/29/2019 Implemented
6500.48(a)Caregiver #1 did not have 24 hours of documented training for the 2018 calendar year. 22.08 hours were documented on the training syllabus at the time of review.The primary caregiver and the life sharing specialist shall complete 24 hours of training related to job skills and knowledge each year.While we cannot correct missed training from 2018, we understand that it is something to be corrected for the future. Training will be offered in the life sharing home as well as the JEVS office going forward. This will help to ensure that training is completed as required. 01/01/2020 Implemented
6500.139(d)Caregiver #1 verification of medication training from the individual's health care source was not found in caregiver #1 file.A record of the training shall be kept, including the person trained, the date, source, name of trainer and documentation that the course was successfully completed.Medication training was completed for this person on 12/5/19. Training will be offered in the life sharing home as well as the JEVS office going forward. This will help to ensure that training is completed as required. 12/05/2019 Implemented
SIN-00139428 Renewal 07/25/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
6500.64(a)There was rust around the drain in the bathtub upstairs.Clean conditions shall be maintained in all areas of the home.Provider used a calcium and rust remover to clean the tub on 7/30. Providers were instructed to keep all parts of the home clean and well maintained at all times. Life sharing specialists and management will inspect homes monthly as part of monthly monitoring 07/30/2018 Implemented
6500.67The foot board attached to the bed in Individual#1's bedroom was broken.Floors, walls, ceilings and other surfaces shall be free of hazards.The entire bedframe for the individual was replaced on 8/2/18. Life sharing providers have been instructed to replace broken or unsafe furniture immediately. Life sharing specialists and management will inspect furniture as part of the monthly monitoring 08/02/2018 Implemented
6500.109(d)For fire drills dated 9/9/17, 12/21/17, and 6/25/18 the time the fire drill was conducted was not indicated.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 smoke detector was operative.All management staff was re-trained in how to conduct fire drills per licensing regulations on 8/23/18. Program directors will review fire drill forms as they are completed to make sure they are completed as required. 08/23/2018 Implemented
SIN-00225685 Renewal 06/06/2023 Compliant - Finalized
SIN-00205909 Renewal 06/02/2022 Compliant - Finalized