Observations
Based on a review of client records, the facility failed to complete treatment plan updates at least every 60 days in two of five client records.
Client #3 admitted December 23, 2025 and still a current client. A treatment plan was completed on January 20, 2026 and an update was due by March 21, 2026 but not completed prior to inspection.
Client #5 admitted January 29, 2026 and still a current client. A treatment plan was completed on February 10, 2026 and an update was due by April 11, 2026 but not completed prior to inspection.
This finding was reviewed with facility staff during the licensing process.
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Plan of Correction
Admin Asst will keep a log of Client due dates for treatment plan updates which will be reviewed by the Clinical Director on a monthly basis to ensure client updates are completed on time. Will be in compliance 5/16/26. |