Example #1: Plan of Correction

This is an acceptable sample PoC for Deficiency Example #1. Read it carefully, and then click on each of the blue criterion tab buttons below to see how it meets the five criteria for evaluating acceptable PoCs. It is the responsibility of the participant taking this training to read this information in its entirety.

Facility's Plan of Correction

The facility's manager has completed an in-service on 01/10/21 for all of the staff members regarding conducting monthly fire drills. The fire drills have been conducted on all three shifts. The manager also has made up a schedule for the next year to ensure that at least one fire drill is conducted on each shift because all residents have the potential to be affected. The facility manager will ensure that follow-up in-services will be provided and put the monthly fire drills on his calendar. The manager will check the documentation monthly. The manager will provide in-services quarterly to all staff members and will monitor the fire drill schedule monthly to ensure the fire drills are conducted as required on each shift. A copy of the in-services with staff signatures and dates as well as the fire drill documentation log have been included with this PoC. This was completed on 01/15/21.


According to Criterion 1, "the PoC must address how corrective action will be accomplished for those residents affected by the violation(s)."

In this sample PoC, the facility's manager has completed an in-service on 01/10/21 for all of the staff members regarding conducting monthly fire drills. Also, fire drills have been completed for all three shifts.

According to Criterion 2, "The PoC must address how the facility will identify other residents with the potential to be affected by the same violation(s)."

In this sample PoC, the manager has also made up a schedule for the next year, to ensure that at least one fire drill is conducted on each shift because all residents have the potential to be affected.

According to Criterion 3, "The PoC must address the measures or systematic changes the facility will put into place to ensure the violation(s) will not recur."

In this sample PoC, the facility manager will ensure that follow-up in-services will be provided and has put the monthly fire drills on his calendar.

According to Criterion 4, "the PoC must address how the facility will monitor its corrective actions to ensure that the violation(s) are being corrected and will not recur."

According to this sample PoC, the manager will check the documentation monthly. The manager will provide in-services quarterly to all staff members and will monitor the fire drill schedule monthly to ensure the fire drills are conducted as required on each shift.

According to Criterion 5, "the PoC must provide dates when corrective action will be completed."

In this sample PoC, a copy of the in-services with staff signatures and dates as well as the fire drills documentation log have been included with this PoC. This was completed on 01/15/21.