Based on the concerns arising from COVID-19, The Department of Drug and Alcohol Programs, Bureau of Quality Assurance for Prevention and Treatment, has implemented temporary procedures for conducting an annual renewal inspection. The inspection will be divided into two parts. 1, an abbreviated off-site inspection, will be conducted off site, and will require the submission of administrative information via email to a Licensing Specialist. 2, an abbreviated on-site inspection, will be conducted on-site, at a later date and will include a review of client/patient records, and a physical plant inspection.This report is a result of Part 1, an abbreviated off-site inspection, conducted on July 23, 2020 by staff from the Department of Drug and Alcohol Programs, Bureau of Quality Assurance for Prevention and Treatment. Not all regulations were reviewed, the remainder of the regulations, not reviewed during Part 1, will be reviewed at a later date.Based on the findings of Part 1, an abbreviated off-site inspection, Self Help Movement, Inc., was found not to 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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Observations
Based on an administrative review, the facility failed to demonstrate sufficient coverage of staff certified in CPR or First Aid on the following dates and shifts: June 5, 2020 - 11:00 P.M. to 7:00 A.M.June 8, 2020 - 3:00 P.M. to 11:00 P.M.June 12, 2020 - 11:00 P.M. to 7:00 A.M.June 15, 2020 - 3:00 P.M. to 11:00 P.MJune 19, 2020 - 11:00 P.M. to 7:00 A.M.These findings were reviewed with project and facility staff during the licensing process.
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Plan of Correction
Due to COVID19 we were unable to update our First Aid/CPR training which expired in April for some of our staff. We did not file for an exception so we were out of compliance.
Those requiring First Aid/CPR certification or needing an update attended training on the following dates; 6/23/20 - 6/26/20.
All shifts now have sufficient coverage with staff certified in CPR/First Aid training.
The Human Resources Manager will review certification cards to ensure that those staff members who have to be re-certified receive their re-certification before it expires. He/she will also check to make sure that all shifts will have coverage with staff members that are First Aid/CPR certified at all times.
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