OSHA Inspection: ASPIRE, INC.

Issued

Jul 12, 2017

Abate by

Nov 3, 2017

Penalty

Initial $11,408 · Current $5,704 Reduced

General-duty citation text

Section 5(a)(1): The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees were exposed to acts of workplace violence:    (a) The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that Direct Support Personnel (DSP) are exposed to assaults by a resident with a history of violent behavior during routine interactions with the resident. These assaults have resulted in bodily injury from being struck by the resident     Abatement Note: Among other methods, feasible and acceptable means to abate the workplace violence hazard at Aspire, Inc. include development of engineering and administrative controls, as well as training to materially reduce workplace violence hazards.  These controls include:        Engineering and Work Practice Controls:        1) Install security cameras in hallways and common areas that are monitored in real-time.        2) Ensure staffing supports the utilization of the Code One System to reliably assist in responding to violent events on all shifts and to monitor units to ensure employees' safety during the crisis.      3) Install a half-door on the room of the resident with a history of violence, so staff can communicate with the resident without being in the same room.      4) Ensure that a reliable means of summoning emergency assistance is available to employees, including contact information for emergency support staff at other facilities.      5) Supplement the house phones with panic alarms, radios or cell phones (with pre-programmed emergency numbers) for every employee working on the unit who may be in close proximity to an agitated/escalating client, in order to rapidly and reliably summon assistance.  These employees include but are not limited to resident support staff and group home managers.  In addition, provide training on use and limitations of this equipment.      6) Ensure that all staff members who may come into contact with residents with a history of violent behavior in the course of their work are trained both initially and at regular intervals in methods to protect themselves from resident aggression when non-violent de-escalation techniques are not effective.      7) Conduct site specific training at the beginning of employment, when significant changes are made to the policies, and/or procedures and annually thereafter.       Administrative Controls:      1) Ensure the client to staff ratio on all shifts is in accordance with state regulations and adequate to handle incidents of violent behavior by clients.      2) Establish a system such as chart tags or log books to identify clients with a history of violence.  Update clients? behavioral histories as needed.  Review WPV incidents from the previous shift during change-in-shift meetings.            3) Institute procedures that would communicate to staff any WPV incident so that employees who might not have access to client charts will be aware of a client?s previous acts of violence.      Post Incident:      1) Conduct an investigation and debriefing after each act of workplace violence, including modifications to the GER as appropriate to include documented supervisor input and follow-up with the affected employee(s).  Conduct a root cause or similar analysis of each workplace violence incident, including lessons learned, corrective actions to prevent reoccurrence, and review and evaluation of all GERs related incident addressing each specific hazard identified in the workplace evaluation.  Solicit feedback from impacted employees regarding root cause analysis, including recommendations for improving core safety program components.      2) Establish a liaison with local law enforcement representatives.      3) Establish and disseminate a written anti-retaliation policy that makes clear that such reporting is encouraged and that employees who report such workplace violence incidents or safety concerns will not be retaliated against in any manner