INITIAL COMMENTS
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This report is a result of an on-site licensure renewal inspection conducted on January 22, 2018, by staff from the Division of Drug and Alcohol Program Licensure. Based on the findings of the on-site inspection, Caron Counseling Services 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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704.11(c)(2) LICENSURE CPR CERTIFICATION
704.11. Staff development program.
(c) General training requirements.
(2) CPR certification and first aid training shall be provided to a sufficient number of staff persons, so that at least one person trained in these skills is onsite during the project's hours of operation.
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Observations
Based on a review of facility records provided as part of the presubmission process, and based on a review of facility records conducted during the on-site inspection, the facility failed to ensure that there were staff persons with first aid training working all hours of operation for the facility.
The facility did not have documentation that there was a staff person trained in first aid working the following dates and times:
01/02/2018 from 8:00AM to 12:30PM
01/03/2018 from 8:00AM to 12:30PM
01/04/2018 from 8:00AM to 9:00AM and from 6:00PM to 9:30PM
01/08/2018 from 5:00PM to 9:30PM
01/09/2018 from 8:00AM to 12:30PM
01/10/2018 from 8:00AM to 12:30PM
01/11/2018 from 8:00AM to 11:00AM and 7:30PM to 9:30PM
These findings were reviewed with facility staff as part of the inspection process.
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Plan of Correction
Plan of Correction:
All employees who are currently out of compliance with mandatory First aid training will be notified.
First Aid Training will be offered to all necessary staff in order to ensure that a sufficient number of staff are trained ensuring that at least one trained staff person is onsite at all times during the projects hours of observations.
Program Director will ensure that staffing of each shift reflects that someone is present at all times trained in CPR and First Aid.
The Director of Training is responsible for ensuring training adherence.
Estimated completion date is April 18, 2018.
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