Excel Supported Living INC

Required medication (Metamucil) was not filled/available, and PRN inhaler was missing from the medication supply for one client.

Client cash funds exceeded the $75.00 limit for three sampled clients.

Water temperature exceeded 120°F in two homes, cleaning chemicals were stored unsecured, no emergency phone was available in one home, and there were exposed electrical wires and unsecured sharps.

Provider failed to ensure equitable sharing of household expenses for Client 3 and Client 5.

Failed to immediately report alleged neglect of Client 1 to the CRU after a fall resulting in injury where the client was not wearing their required protective helmet.

Provider failed to document or initial medication administration on MARs for 4 of 6 sampled clients, resulting in incomplete medication records.

Provider failed to reconcile and verify provider-managed cash, debit, and prepaid accounts for 2 of 6 clients.

No system in place to ensure household supplies and common expenses were shared equitably among clients in shared living arrangements.

Three staff members lacked current annual Bloodborne Pathogens training.

Client 1's Individual Instruction and Support Plan did not contain instructions regarding the use of their prescribed safety helmet.

Failed to treat Clients 5 and 6 with dignity by locking sharp items and household chemicals without legal representative consent or proper assessment.

Failed to obtain necessary signatures for Individual Instruction and Support Plans for Clients 2, 4, and 6.

Failed to ensure Client 6 attended a mandatory three-month psychoactive medication review follow-up appointment.

Provider failed to maintain required property records for 2 of 6 sampled clients.

Provider failed to immediately report alleged verbal abuse of one client (Client 7) to the department (CRU).

Provider failed to ensure requirements for managing client funds were met for 4 of 6 clients, including lacking running balances, failure to document provider-managed cash and debit cards, and failure to have Individual Financial Plans approved by legal representatives.

Provider failed to correctly implement a Community Protection Treatment Plan for 1 of 6 clients, specifically regarding sharps restriction protocols and door/window alarm installation.

Hot water temperatures exceeded the 120 degrees Fahrenheit limit at both Client 3 and Client 5's homes.

Provider failed to obtain current Release of Information consents signed by the client or legal representative for 3 of 6 sampled clients.

Provider failed to ensure accurate medication support; a prescription inhaler in use was not on the Medication Administration Record (MAR).

Provider failed to complete a Functional Assessment for 1 of 6 sampled clients who required extensive support for emotional outbursts.

Two staff members worked alone without documented completion of required Five-Hour training.

Provider failed to reconcile cash/spending accounts for Clients 1, 3, and 5 for several months.

Failed to include use of provider-managed debit cards in Individual Financial Plans for Clients 1 and 3.

Provider failed to remove door/window alarms for Client 5 after the restriction was removed, infringing on rights.

Failed to complete a character, suitability, and competence review for Staff C; missing FBI record of arrests and prosecutions sheet.

Provider failed to implement mandatory safety and treatment restrictions for a client in the Community Protection Program, including missing door/window alarms, unauthorized internet/gaming access, and failure to maintain required supervision.

Provider failed to protect clients from financial exploitation by receiving payment from the department to provide services while also charging rent for provider-owned homes.

Provider failed to ensure support to access health services for two clients, resulting in missed appointments and delayed medical evaluation.

Provider failed to treat clients with dignity and consideration by moving eight clients out of their homes due to staffing shortages without proper notice or consent, causing stress and anxiety.

Provider failed to maintain a safe home environment by failing to repair a charred electrical outlet used with a space heater.

Provider failed to share the Individual Instruction and Support Plan (IISP) with the client's legal guardian and the DSHS Case Resource Manager despite multiple requests.

Provider failed to maintain a safe environment due to a leaking bathroom faucet and constant stream of running hot water that was not repaired, despite ongoing issues.

Provider failed to ensure clients were treated with dignity and consideration by locking sharp items and eating utensils without a valid plan or client consent.

Provider failed to ensure Client 2 was treated with dignity and consideration; personal hygiene products were locked without a plan or consent.

Provider failed to meet residential services contract requirements by owning and renting homes to clients, failing to ensure immediate access to staff, and failing to provide adequate staff, resulting in clients being left without proper supervision or support during illnesses and staffing shortages.