Adelphoi Middle Creek I

Citation, renewal inspection : 55 Pa. Code § 3800.55.g Child Care Worker

During review of the personnel files, the Department was unable to locate documentation to verify Staff person A possessed a high school diploma or General Education Development certificate.

Citation, complaint inspection

Child 1 was subject to a restrictive procedure utilized for reasons other than to prevent the child from injuring himself or others. Per video review, Staff 1 was observed quickly approaching Child 1 and grabbing him by his shirt collar, due to the child leaving his chair, walking toward the bathroom, and kicking a trashcan lid. Based on the Departments review of the video surveillance, child 1 was not demonstrating aggression toward other residents or staff

Citation : 55 Pa. Code § 3800.32.e

All restdent Incoming and outgoing calls are monltored and logged without written permission by the contracling agency or court,

Citation

According to multiple resident interviews on 3-7-16, staff aro reading residents Incoming and outgoing mall.

Citation : 55 Pa. Code § 3800.32.g.3

According {o mulllpte resident interviews on 3-7-16, slaff are reading residents’ incoming and outgoing mail,

Citation : 55 Pa. Code § 3800.103.8

During the physical site Inspection on 3-7-46, it was observed thal a 2.25' x 3.376' window in the corddgr feading to the antrance of the unit on the right hand side allows for an unobstructed view of the men's shower area by anyone walking lhrough {he adjolning enlrance to the unit, 9, PLAN OF GORRECTION (POG} (Attach pages ns necessary, Remember thal you nntst sign and date any attached pages.) Inctudo stops to correct tha violation described above and steps to provent a similer violation from occuring again, Hf steps cannot be coniplotod Inimediately, lactudo datos by which {ha stops will bo completed, On March 16, 2016, a work request (atlached) was submitted fo the Facilities Department to have the window feaaing into the shower area frosted to eliminate line of sight, On March 21, 2016, the facilities department temporarily frosted the window. Please see attached work order, On April 6, 2046, the Advantage Window Company professionally installed permanent zero visibility frosting on the window. Please see picture Repeat Violation: No Date(s) of Provious Violation(s): es ee Signature of Legal Entity Representative {Required on EVERY Page} Date May 25, 2016

Citation : 55 Pa. Code § 3800.143.d

Resident #'{'s health examination record dated 6/20/14 did nol include the address of the examining practitioner.

Citation : 55 Pa. Code § 3800.145.9

Resident #'1’s vision screening record dated 5/20/14 did not include the address of the trealing practitioner.

Citation : 55 Pa. Code § 3800.146.a

Rosldent #'1's haaring screening record dated 5/20/14 did not include the address of the treating practitioner.

Citation, renewal inspection : 55 Pa. Code § 3800.132.c

Fire drill racords for 7/12/13, 7/17/13, and 9/03/13 did not indicate AM or PM for time of drill.

Citation, renewal inspection : 55 Pa. Code § 3800.132.e

The facility's fire drill records indicate no sleeping drills have been conducted from March 2013 through February 2014.

Citation, renewal inspection : 55 Pa. Code § 3800.143.a

Resident #1, admitted 05/22/12, had an Initial health examination on 06/14/12.