Inspection IDReason for InspectionInspection DateInspection Status 
SIN-00138747 Renewal 07/24/2018 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
2380.111(c)(6)Individual #1's physical examination, completed 10/2/17, did not address communicable disease; this section was left blank.The physical examination shall include: Specific precautions that shall be taken if the individual has a serious communicable disease as defined in 28 Pa. Code §  27.2 (relating to specific identified reportable diseases, infections and conditions) to the extent that confidentiality laws permit reporting, to prevent the spread of the disease to other individuals.The annual physicals and new admissions physicals will be compared and reviewed to assure that all the boxes or lines are filed in. The assigned counselor as well as the Program Specialist will review for completion and thoroughness. On a quarterly basis the Supervisor will review a 25% random sample of the annual physicals for completion, current and any changes that may have occurred. [Individual #1's medical information was updated 7/24/18 to state individual is free of communicable disease. On 8/717, the Site supervisor educated all staff persons responsible for auditing Individuals' physical examinations of the required information as per 2380.111(c)(1)-(11). Documentation of the training was be kept. (Additions by AES,HSLS on 8/20/18)] 08/07/2018 Implemented
2380.181(f)The program specialist provided Individual #2's assessment, completed 5/4/18, to the plan team members on 6/1/18 for an ISP meeting on 6/4/18.The program specialist shall provide the assessment to the SC or plan lead, as applicable, and plan team members at least 30 calendar days prior to an ISP meeting for the development, annual update and revision of the ISP under § §  2380.182, 2390.152, 6400.182 and 6500.152 (relating to development, annual update and revision of the ISP).The Program Specialist and the Supervisor will have the annual dates for the individual¿s assessments on outlook as well as a spreadsheet this way we can double check that it is being done in a timely manner. A critical revision form will be submitted once the assessment is sent to all team members. At least quarterly the Program Specialist or Supervisor shall review 25% sample of the assessments and aforementioned tracking system to ensure timely competition by the Program Specialist. Documentation shall be kept, As of 8/14/2018. 08/07/2018 Implemented
2380.186(a)The program specialist completed ISP reviews for Individual #2 for review periods from 6/1/17 to 8/24/17, from 9/1/17 to 11/22/17, from 12/1/17 to 2/23/18 and from 3/1/18 to 5/25/18. The ISP reviews did not include from 8/25 to 8/31/17, from 11/23/17 to 11/30/17 and from 2/24/18 to 2/28/18.The program specialist shall complete an ISP review of the services and expected outcomes in the ISP specific to the facility licensed under this chapter with the individual every 3 months or more frequently if the individual¿s needs change which impact the services as specified in the current ISP.To correct the deficiency indicated we will implement Microsoft Outlook as a working tool to prevent errors. Outlook is a personal information manager from Microsoft that includes a calendar and pop-up task manager. Once we accurately input review dates in outlook a reminder will automatically inform us when reviews are due. We will also add a reminder a week prior to due date as an extra measure to enhance efficiency. At least quarterly a designated management staff person shall review 25% sample ISP review and aforementioned tracking system to ensure timely competition by the Program Specialist. Documentation shall be kept. As of 8/14/2018. [The site supervisor and program specialist will be responsible for the aforementioned plan to ensure ISP reviews are completed timely and cover review periods. (DPOC by AES,HSLS on 8/20/18)] 08/07/2018 Implemented
SIN-00099843 Renewal 08/10/2016 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
2380.53(a)There was an bottle of a blue liquid later identified by the program specialist as windshield washer fluid in the hallway closet near the laundry area that was not locked. Poisonous materials shall be kept locked or made inaccessible to individuals, when not in use.All poisonous materials are locked in a supply cabinet with no access to individuals. We are not keeping any automotive supplies on site. See photo of locked supply cabinet. [The bottle of a blue liquid was removed at 10:30 AM on 8/10/16 by the program specialist. Within 30 days of receipt of the plan of correction, the Director and/or site supervisor shall develop and implement policies and procedures to ensure all poisonous materials are locked or made inaccessible to individual when not in use. Within 60 days of receipt of plan of correction and upon hire all staff person shall be trained in aforementioned policies and procedures. Documentation of policies and procedures and trainings shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.53(b)The bottle of a blue liquid later identified by the program specialist as windshield washer fluid in the hallway closet near the laundry area was unlabeled. Poisonous materials shall be stored in their original, labeled containers.All poisonous materials shall be stored in their original labeled containers under lock and key supply cabinet. See photo of our supply cabinet.[Within 30 days of receipt of the plan of correction, the Director and/or site supervisor shall develop and implement policies and procedures to ensure all poisonous materials are locked or made inaccessible to individual when not in use. Within 60 days of receipt of plan of correction and upon hire all staff person shall be trained in aforementioned policies and procedures. Documentation of policies and procedures and trainings shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.113(a)A physical examination for Direct Staff Worker #1 hired on 11/4/1989 could not be located.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 persons, shall have a physical examination within 12 months prior to employment and every 2 years thereafter.Summation letter of Direct Staff Worker #1 was obtained from Concentra, our employee health provider and letter is submitted. The summation letter verifies the physical was obtained within the specified parameters. [Immediately and upon completion, the Director or designated management staff person shall review all staff person's current physical examination to ensure completion and entered into the staff person record. Within 30 days of receipt of the plan of correction the Director shall develop and implement policies and procedures to ensure all staff persons have physical examination completed and documentation is maintained in the employee's record to include a tracking system and record/file review. Within 60 days of receipt of the plan of correction, all staff person responsible for implementing the aforementioned policies and procedures to ensure staff persons have physical examinations completed as required shall be trained in the aforementioned policies and procedures by the Director. Documentation of trainings, reviews, policies and procedures including the tracking system shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(1)The assessment completed on 2/29/16 for Individual #1 did not include functional strengths, needs and preferences.The assessment must include the following information: Functional strengths, needs and preferences of the individual.New assessment for approval and signatures to address this issue was completed in My Avatar our new electronic record. New assessment sent and Critical Review form completed and sent to team. [Individual #1 had an assessment completed on 10/11/6 to include functional strengths, needs and preferences of the individual. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessment to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(2)The assessment completed on 2/29/16 for Individual #1 did not include interests of the individual.The assessment must include the following information: The likes, dislikes and interests of the individual, including vocational and employment interests.New assessment for approval and signatures to address this issue was completed in My Avatar our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include interests of the individual. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(3)(i)The assessment completed on 2/29/16 for Individual #1 did not assess the individual's current level of performance and program in the acquisition of functional skills.The assessment must include the following information: The individual¿s current level of performance and progress in the following areas:  Acquisition of functional skills.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team..[Individual #1 had an assessment completed on 10/11/6 to include individual's current level of performance and program in the acquisition of functional skills. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(3)(ii)The assessment completed on 2/29/16 for Individual #1 did not include the individual's current level of performance and progress in communication.The assessment must include the following information: The individual¿s current level of performance and progress in the following areas: Communication.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team..[Individual #1 had an assessment completed on 10/11/6 to include the individual's current level of performance and progress in communication. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(3)(iii)The assessment completed on 2/29/16 for Individual #1 did not include the individual's current level of performance and progress in personal adjustment.The assessment must include the following information: The individual¿s current level of performance and progress in the following areas:  Personal adjustment.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include the individual's current level of performance and progress in personal adjustment. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(3)(iv)The assessment completed on 2/29/16 for Individual #1 did not include the individual's current level of performance and progress in personal needs with or without assistance from others.The assessment must include the following information: The individual's current level of performance and progress in the following areas: Personal needs with or without assistance from others.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team..[Individual #1 had an assessment completed on 10/11/6 to include the individual's current level of performance and progress in personal needs with or without assistance from others. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(5)The assessment completed on 2/29/16 for Individual #1 did not include the individual's ability to self-administer medications.The assessment must include the following information: The individual¿s ability to self-administer medications.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include the individual's ability to self-administer medications. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(6)The assessment completed on 2/29/16 for Individual #1 did not include the individual's ability to safely use or avoid poisonous materials.The assessment must include the following information: The individual¿s ability to safely use or avoid poisonous materials, when in the presence of poisonous materials.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include the individual's ability to safely use or avoid poisonous materials. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(7)The assessment completed on 2/29/16 for Individual #1 did not include the individual's knowledge of the danger of heat sources and the ability to sense and move away quickly from heat sources.The assessment must include the following information: The individual¿s knowledge of the danger of heat sources and ability to sense and move away quickly from heat sources which exceed 120° F and are not insulated.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include the individual's knowledge of the danger of heat sources and the ability to sense and move away quickly from heat sources. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(8)The assessment completed on 2/29/16 for Individual #1 did not include the individual's ability to evacuate in the event of a fire.The assessment must include the following information: The individual¿s ability to evacuate in the event of a fire.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include the individual's ability to evacuate in the event of a fire. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(12)The assessment completed on 2/29/16 for Individual #1 did not include recommendations for specific areas of training, vocational programs and competitive community integrated employment.The assessment must include the following information: Recommendations for specific areas of training, vocational programming and competitive community-integrated employment.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include recommendations for specific areas of training, vocational programming and competitive community-integrated employment. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(13)(i)The assessment completed on 2/29/16 for Individual #1 did not include the individual's current level in health.The assessment must include the following information: The individual¿s progress over the last 365 calendar days and current level in the following areas: Health.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include the individual's current level in health. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(13)(ii)The assessment completed on 2/29/16 for Individual #1 did not include the individual's progress and current level in motor and communication skills.The assessment must include the following information: The individual¿s progress over the last 365 calendar days and current level in the following areas:  Motor and communication skills.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include individual's progress and current level in motor and communication skills. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(13)(iii)The assessment completed on 2/29/16 for Individual #1 did not include the individual's current level in personal adjustment.The assessment must include the following information: The individual¿s progress over the last 365 calendar days and current level in the following areas: Personal adjustment.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include the individual's current level in personal adjustment. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
2380.181(e)(14)The assessment completed on 2/29/16 for Individual #1 did not include the individual's knowledge of water safety and the ability to swim.The assessment must include the following information: The individual¿s knowledge of water safety and ability to swim.New assessment for approval and signatures to address this issue was completed in My Avatar ,our new electronic record. New assessment sent and Critical Review form completed and sent to team.[Individual #1 had an assessment completed on 10/11/6 to include the individual's knowledge of water safety and the ability to swim. Within the 60 days of receipt of the plan of correction, the program specialist(s) shall review all individuals' current assessments to ensure all required information is included and will update as needed with the missing information and provide to plan team members as required and maintain documentation of correspondence. At least quarterly for 1 year, the Director shall review assessments completed within that quarter to ensure the program specialist completed assessments with all required information. Documentation updates to assessments and of reviews shall be kept. (AS 10/20/16)] 09/27/2016 Implemented
SIN-00063650 Renewal 08/14/2014 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
2380.89(e)Alternate exits routes were not used during the monthly fire drills conducted from 12/4/13 to 8/5/14. The fire drill records listed "exits A & E" on each drill.Alternate exit routes shall be used during fire drills.All individuals served at the ATF and senior center at Braunlich Ross program will be required to use both exits successfully. Every individual will exit successfully past the threshhold within two and a half minutes. Documentation will evidence the success of exiting in two and half minutes and fire drill record will indicate the exit used. Future drill documentation will indicate one exit and all individuals having partisipated and with success. 08/28/2014 Implemented
SIN-00051696 Renewal 07/08/2013 Compliant - Finalized
RegulationLIS Non-Compliance AreaCorrection RequiredPlans of CorrectionCorrection DatePOC Status
2380.70(d)The first aid kit did not contain tweezers.(d)  First aid kits shall contain antiseptic, an assortment of adhesive bandages, sterile gauze pads, a thermometer or other temperature gauging equipment, tweezers, tape and scissors.First Aid Kit: 1. At inspection new sealed tweezers were placed in the first aid kit and in nmerous places in the site and a spare tweezers was taped to the kit. 2. First aid inventory list was created to inspect the kit each month for exact items and expiration dates. A counselor three will inspect and date and sign off monthly. 3. Staff will sign off on the July in-service sheet reviewed at a staff meeting. 07/29/2013 Implemented
2380.88(f)The fire extinguishers in the kitchen and file room did not have the annual inspection date on the extinguishers.(f)  Fire extinguishers shall be inspected and approved annually by a firesafety expert. The date of the inspection shall be on the extinguisher.Extinguishers: 1. At inspection the PFE fire extinguisher company visited Ross and Apologized for the omission of a date stamp on two extinguishers. PFE supplied a copy of the June 10th, 2013 service to eight extinguishers at Ross. He stamped the lables on the two needed. 2. Extinguisher inventory and inspection list was created for the counselor three to inspect each 07/31/2013 Implemented
2380.173(4)The record of Individual #2 did not contain a copy of the annual assessment that was completed on March 4, 2013.Each individual's record must include the following information:(4)  Assessments as required under §  2380.181 (relating to assessment).Assessments: Annual assessment dated March 4th, 2013 was not filed in teh individuals chart. 1. At inspection, a copy of the signed Ross assessment from March 4th was faxed from the CLA to inspectors at the inspection. A copy was entered in the chart. 2. At the July staff meeting, the staff reviewed the assessment requirements 2280.173 3. ID unit will review assessment at the August 2013 unit meeting. [The program specialist will audit all individuals records by 9/1/13 to ensure that each record contains a copy of the annual assessment (CHG 8/8/13).] 07/31/2013 Implemented
2380.186(b)1. The three month Individual Support Plan review for Individual #1, dated June 14, 2012, was not signed by the Program Specialist. 2. The three month Individual Support Plan reviews for Individual #2, dated January 10, 2013 and April 4, 2013, were not signed by the Program Specialist.(b)  The program specialist and individual shall sign and date the ISP review signature sheet upon review of the ISP.Three month review of the ISP signed by the Program Specialist Program specialist did not sign the June 14th 2012 review for PM. Prgram specialist did not sign the January or April for SA. 1. Reviews were signed by program specialist. 2. At the July staff meeting, the staff reviewed the three month review yellow form and signature areas reviewed. 3. New color coded monthly spreadsheet for review dates was created and each month the list of the reviews due will be published and signatures obtained when the form is completed before being filed. Forms will not be filed without all required signatures. 07/31/2013 Implemented
2380.186(d)Three month Individual Support Plan reviews for Individual #2, dated January 10, 2013 and April 4, 2013, were not provided to the SC and plan team members within thirty calendar days of completion of the reviews.(d)  The program specialist shall provide the ISP review documentation, including recommendations, if applicable, to the SC or plan lead, as applicable, and plan team members within 30 calendar days after the ISP review meetingDistribute three month reviews to IDT within 30 calendar days. No proof of reviews were sent on Jan. 10th 2013 and April 4th, 2013 for SA. Both were re-mailed with documentation. 1. The gold critical communication forms complted for both reviews in Jan. and April for SA. 2. At July staff meeting, the staff reviewed using the gold form or email to document sending all required forms to the IDT. 3. Chart will be audited after the AURD meeting by counselors for compliance. 07/31/2013 Implemented
SIN-00158634 Renewal 07/10/2019 Compliant - Finalized
SIN-00118318 Renewal 08/03/2017 Compliant - Finalized
SIN-00079600 Renewal 08/19/2015 Compliant - Finalized
SIN-00083035 Unannounced Monitoring 04/10/2015 Compliant - Finalized