INITIAL COMMENTS
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This report is a result of an on-site licensure renewal inspection conducted by staff from the Department of Drug and Alcohol Programs, Bureau of Quality Assurance Prevention and Treatment on October 29-30, 2019. Based on the findings of the on-site inspection, Community Care & Addiction Recovery Services was found to not be in compliance with the applicable chapters of 28 PA Code which pertain to the facility.
The following deficiencies were identified during this inspection:
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Plan of Correction
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709.94(b) LICENSURE Project management services
709.94. Project management services.
(b) The hours of project operation shall be displayed conspicuously to the general public.
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Observations
During a physical site inspection on October 30, 2019, the project failed to display conspicuously the hours of operation to the general public.
These findings were reviewed with the project staff during the licensing process.
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Plan of Correction
Community Care & Addiction Recovery Services (CCARS) has created the following POC in response to a deficiency found during an on-site licensing renewal inspection conducted on 10/29/19 -10/30/19.
The Project Director spoke with the office manager on 11/1/19 to review this deficiency regarding signage missing for hours of operation to the general public. Office Manager will post business hours of operation and verbally retrain staff and ensure they understand the importance of this signage and that it needs to be posted at the entrance to our facility at all times.
To ensure this deficiency does not reoccur, the Project Manager will monthly inspect building signage for compliance per DDAP regulations. Facility signage has been posted and is in compliance, effective 11/1/2019. |
709.94(c) LICENSURE Project management services
709.94. Project management services.
(c) A telephone number shall be displayed conspicuously to the general public for emergency purposes.
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Observations
During a physical site inspection on October 30, 2019, the project failed to display a telephone number conspicuously to the general public for emergency purposes.
These findings were reviewed with project staff during the licensing process.
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Plan of Correction
Community Care & Addiction Recovery Services (CCARS) has created the following POC in response to a deficiency found during an on-site licensing renewal inspection conducted on 10/29/19 -10/30/19.
The Project Director spoke with the office manager on 11/1/19 to review this deficiency regarding signage missing to display a telephone number conspicuously to the general public for emergency purposes. Office Manager will retrain staff and insure they understand the importance of this signage and that it always needs to be posted at the entrance to our facility at all times.
To ensure this deficiency does not reoccur, the Project Manager will monthly inspect building signage for compliance per DDAP regulations. Facility signage has been posted and is in compliance, effective 11/1/2019. |