Observations
Based on a review of personnel records, the facility failed to ensure all staff persons received a minimum of 6 hours of HIV/AIDS training and at least 4 hours of TB/STD and other health-related topics training within the regulatory timeframe in two of two applicable personnel records reviewed. Employee # 4 was hired as a counselor on May 23, 2023 and was due to have the HIV/AIDS training and the TB/STD training completed no later than May 23, 2024. There was documentation, in the record, indicating the HIV/AIDS training was completed; however, there was no documentation showing the TB/STD training was completed as of the date of the inspection.Employee # 5 was hired as a counselor on June 5, 2023 and was due to have the HIV/AIDS training and the TB/STD training completed no later than June 5, 2024. There was documentation, in the record, indicating the HIV/AIDS training was completed; however, there was no documentation showing the TB/STD training was completed as of the date of the inspection.This is a repeat citation from the October 4, 2024 annual licensing renewal inspection.This finding was reviewed with facility staff during the licensing process.
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Plan of Correction
Facility director has scheduled a training for employees # 4 and # 5 for TB/STD to be completed by the end of December 2025. The training certificates will be placed in the employee files upon completion.
Facility director will be responsible for monitoring all new and current employee trainings to remain in compliance with this regulation.
Facility director will check employee charts every quarter to ensure all required trainings are in employee files. Employees who do not follow through with these required trainings will be written up and given 30 days to complete them. If they are not completed within 30 days, termination will be considered. |