QA Investigation Results

Pennsylvania Department of Health
ALYSIA'S HOME CARE SERVICE INC.
Health Inspection Results
ALYSIA'S HOME CARE SERVICE INC.
Health Inspection Results For:


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Initial Comments:

Based on the findings of an onsite unannounced state license survey completed September 12, 2022, Alysia's Home Care Service Inc. was found to be in compliance with the requirements of PA Code, Title 28, Health and Safety, Part IV, Health Facilities, Subpart A, Chapter 51.






Plan of Correction:




Initial Comments:

Based on the findings of an onsite unannounced state license survey completed September 12, 2022, Alysia's Home Care Service Inc. was found not to be in compliance with the following requirements of PA Code, Title 28, Health and Safety, Part IV, Health Facilities, Subpart H, Chapter 611, Home Care Agencies and Home Care Registries.





Plan of Correction:




611.52(d) LICENSURE
Proof of Residency

Name - Component - 00
The home care agency or home care registry may request an individual required to submit or obtain a criminal history record to furnish proof of residency through submission of any one of the following documents:
(1) Motor vehicle records, such as a valid driver ' s license or a State-issued identification.
(2) Housing records, such as mortgage records or rent receipts.
(3) Public utility records and receipts, such as electric bills.
(4) Local tax records.
(5) A completed and signed, Federal, State or local income tax return with the applicant ' s name and address preprinted on it.
(6) Employment records, including records of unemployment compensation

Observations:


Based on review of direct care worker personnel files (PF), and staff (EMP) interview, the agency failed to ensure two (2) of six (6) personnel files contained proof of residency (PF2, & PF3).

Findings included:

Review of personnel files was conducted on September 12, 2022, at 9:30 a.m.

PF2 was hired on 6/25/2021. PF2 contained a PA driver's license but the license was issued on 01/07/2020 (not 2 years preceding the date of hire), and an expired United States of America passport issued 8/3/2011 (did not show PA address or PA residency). PF2 contained no other documentation to show the requirement was met.

PF3 was hired on 6/30/2022. PF3 contained a PA driver's license but the license was issued on 4/30/2022, and a signed self-attestation of PA residency "AFFIDAVIT OF PENNSYLVANIA 2-YEAR RSIDENCY" signed by PF3 on 6/29/2022. The affidavit was not notarized or confirmed in any other way. PF3 contained no other documentation to show the requirement was met.

Interview with EMP1 (administrator) and EMP2 on September 12, 2022, at 11:30 a.m. confirmed above findings.





Plan of Correction:

Immediately from 9/12/2022, The administrator of Alysia's Home Care has implemented policies to ensure FBI finger print is requested for all new hires who do not have the required prove of two years residency. The agency does not take passport or Affidavit for two years prove of residency. The corrective action will be concluded on 10/14/2022. All new hire packets will be thoroughly reviewed by the staffing coordinator to ensure continuous implementation for the corrective action.

Please see Direct Care Worker Hiring Requirement Policy document which has been created and included in all new hire packets since 9/12/2022 below:

Direct Care Worker Hiring Requirement

Enclosed is the employment packet for a Direct Care Worker (DCW). All pages must be signed be and dated by the DCW.
The Direct Care Worker is responsible to provide the following for employment:
Results of a clear 2 -step TB Test
Copy of Current State ID Card (Driver's License)
Copy of Social Security Card
Two years proof of residency in Pennsylvania:
(1) Motor vehicle records, such as a valid driver's license or a State-issued identification.
(2) Housing records, such as mortgage records or rent receipts.
(3) Public utility records and receipts, such as electric bills.
(4) Local tax records.
(5) A completed and signed, Federal, State or local income tax return with the applicant's name and address preprinted on it.
(6) Employment records, including records of unemployment compensation.
FBI finger print will be required from all new hires without the required prove of two years residency

Return all document to Alysia's Home Care Services for processing.






611.56(a) LICENSURE
Health Screening

Name - Component - 00
The screening shall be conducted in accordance with CDC guidelines for preventing the transmission of mycobacterium tuberculosis in health care settings. The documentation must indicate the date of the screening which may not be more than 1 year prior to the individual's start date.

Observations:


Based on a review of CDC (Center for Disease Control and Prevention) guidelines, active direct care worker personnel files, and staff (EMP) interview, the agency failed to ensure each direct care worker was screened for free from active mycobacterium tuberculosis (TB) in accordance with CDC guidelines for two (2) of two (2) employees hired greater than a year (PF2, & PF6).

Findings included:

According to CDC guidelines "Baseline (preplacement) screening and testing, in addition to the IGRA (interferon-gamma release assay) or TST, shall include a symptom screen questionnaire and an individual TB risk assessment. Serial screening and testing not routinely recommended. Annual TB education is recommended." Retrieved from https://www.cdc.gov/mmwr/volumes/68/wr/pdfs/mm6819-H.pdf

Review of personnel files was conducted on September 12, 2022, at 9 a.m.

PF2 was hired on 6/25/2021 and screened for TB on 6/17/2021. PF2 contained no annual TB education.

PF6 was hired on 3/1/2021 and screened for TB at that time. PF6 contained no annual TB education.

Interview with EMP1 (administrator) and EMP2 on September 12, 2022, at 11 a.m. confirmed above findings, and that staff are not receiving annual TB education.






Plan of Correction:

Immediately from 9/12/2022 the Administrator of Alysia's Home Care Service has implemented policies to require new hires to complete the 2 step TB test, TB risk assessment, and TB education. All employees have been mailed the new TB Education material, TB risk assessment questionnaire, and asks to sign and acknowledge the TB education. All employees will have their TB education acknowledgement placed in their files.

All employees will continuously receive yearly TB education and risk assessment.
Any employee that answers yes to a TB concern will be withdrawn from the job immediately and required to see a doctor for care and must return with a negative doctor's results before resuming work.

The administrator will work to monitor and maintain annual compliance of the TB requirement of the CDC. There will be annual review of policies and procedures by the administrator to ensure Alysia's Home Care Service remains in compliance with all federal nd state mandated regulations.

Also, the Staffing Coordinator will make sure all staff meet the yearly TB compliance to ensure continuous implementation of corrective action. The corrective action will be concluded on 10/14/2022.







611.57(c) LICENSURE
Information to be Provided

Name - Component - 00
(c) Prior to the commencement of services, the home care agency or home care registry shall provide to the consumer, the consumer's legal representative or responsible family member an information packet containing the following information in a form that is easily read and understood: (1) A listing of the available home care services that will be provided to the consumer by the direct care worker and the identity of the direct care worker who will provide the services. (2) The hours when those services will be provided. (3) Fees and total costs for those services on an hourly or weekly basis. (4) Who to contact at the Department for information about licensure requirements for a home care agency or home care registry and for compliance information about a particular home care agency or home care registry. (5) The Department's complaint Hot Line (1-800-254-5164) and the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA). (6) The hiring and competency requirements applicable to direct care workers employed by the home care agency or referred by the home care registry. (7) A disclosure, in a format to be published by the Department in the Pennsylvania Bulletin by February 10, 2010, addressing the employee or independent contractor status of the direct care worker providing services to the consumer, and the resultant respective tax and insurance obligations and other responsibilities of the consumer and the home care agency or home care registry.

Observations:


Based on review of consumer files (CF), and staff (EMP) interview, the agency failed to provide the consumer with required information in a format that was easily read and understood prior to commencement of services for three (3) of six (6) consumer files reviewed (CF1, CF4, & CF6).

Findings included:

Review of consumer files was conducted on September 12, 2022, at 9 a.m.

CF1 signed their service agreement on 7/6/2022 and services commenced on 7/8/2022. CF1's service agreement did not show agency provided the consumer, prior to commencement of services, a listing of the available home care services that would be provided or the hours when those services would be provided.

CF4 signed their service agreement on 4/11/2022 and services commenced on 4/23/2022. CF4's service agreement did not show agency provided the consumer, prior to the commencement of services, a listing of the available home care services that would be provided.

CF6 signed their service agreement on 3/1/2022 and services commenced the same day. CF6's service agreement did not show agency provided the consumer, prior to commencement of services, a listing of the available home care services that would be provided or the hours when those services would be provided.

Interview with EMP1 (administrator) and EMP2 on September 12, 2022, at 11 a.m. confirmed above findings.






Plan of Correction:

Immediately from 9-12-2022 the Administrator of Alysia's Home Care has implemented policies to ensure all consumers are provided with listed available services and hours of service prior to commencement of service.

All current consumers have been mailed a list of available services and hours that Alysia's Home Care provides. The Staffing Coordinator will review all consumers individual files yearly to ensure consumers are updated yearly on services provided and hours of service. The corrective action will be concluded on 10/14/2022.

The Administrator will call all consumers every quarter to check on them and update them of the services and hours the agency provided.

All consumers will sign all updates notification on the agency's services and hours, and they will be kept in their files. A yearly review of policies and procedures will be conducted by the Administrator to verify that Alysia's Home Care services remains in compliance with all federal and state mandated regulations.


Initial Comments:

Based on the findings of an onsite unannounced state license survey completed September 12, 2022, Alysia's Home Care Service Inc. was found to be in compliance with the requirement of 35 P.S. 448.809 (b).







Plan of Correction: