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September 9, 2022 Nuh Ahmed Jama, Authorized Agent Sheltering Arms LLC Bloomington, Minnesota 55425 License Number: 1107812 (245D - HCBS) CORRECTION ORDER Dear Nuh Ahmed Jama: On August 19, 2022, a licensing review of Sheltering Arms LLC, located at 7900 International Drive Suite 300, Bloomington, Minnesota, was conducted to determine compliance with state and federal laws and rules governing the provision of home and community-based services to persons with disabilities and age 65 and older under Minnesota Statutes, Chapter 245D. As a result of this licensing review a Correction Order is being issued. A. Reason for Correction Order Pursuant to Minnesota Statutes, section 245A.06, if the Commissioner of the Department of Human Services (DHS) finds that the license holder has failed to comply with an applicable law or rule and this failure does not imminently endanger the health, safety, or rights of the persons served by the program, the Commissioner may issue a Correction Order to the license holder. The following violation(s) of state or federal laws and rules were determined as a result of the licensing review. Corrective action for each violation is required by Minnesota Statutes, section 245A.06 and is hereby ordered by the Commissioner of Human Services. 1. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (b). Violation: For two of two persons whose records were reviewed (P1 and P2), the license holder did not develop and review the individual abuse prevention plan as required. a. The license holder failed to review P1’s individual abuse prevention plan annually in 2022. b. The license holder reviewed P2’s individual abuse prevention plan on November 18, 2021; however, the license holder failed to include a statement of measures that will be taken to minimize the risk of abuse to the vulnerable adult when the individual assessment indicated the need for measures within the scope of each licensed service the person is receiving. Corrective Action Ordered: Within 30 days of receiving this order, you must develop and review an individual abuse prevention plan for P1 and P2 including the above mentioned information. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.071, subdivision 3, paragraph (b). Violation: For one person whose record was reviewed (P2), the license holder did not, within the scope of services, complete assessments as required. The license holder failed to complete assessments for P2 that included information about the person that described the person's overall strengths, functional skills and abilities, and behaviors or symptoms. Corrective Action Ordered: Within 30 days of receiving this order, you must complete assessments for P2 that describe the person’s overall strengths, functional skills and abilities, and behaviors or symptoms. On an ongoing basis, you must maintain compliance throughout your program as required in this subdivision. 3. Citation: Minnesota Statutes, section 245D.071, subdivision 4, paragraph (b). Violation: For one person whose record was reviewed (P2), the license holder did not develop a service plan that documents the service outcomes and supports based on the assessments as required. The license holder failed to document the following information in P2’s current supports and methods for current outcomes: · the methods or actions that will be used to support the person and to accomplish the service outcomes, including information about: o any changes or modifications to the physical and social environments necessary when the service supports are provided; o any equipment and materials required; and o techniques that are consistent with the person’s communication mode and learning style; · the measurable and observable criteria for identifying when the desired outcome has been achieved and how data will be collected; · the projected starting date for implementing the supports and methods and the date by which progress towards accomplishing the outcomes will be reviewed and evaluated; and · the names of the staff or position responsible for implementing the supports and methods. Corrective Action Ordered: Within 30 days of receiving this order, you must develop a service plan that documents the service outcomes and supports listed above for P2. On an ongoing basis, you must maintain compliance as required in this subdivision. B. Right to Request Reconsideration If you believe any of the citations are in error, you have the right to request that the Commissioner of Human Services reconsider the parts of the Correction Order that you believe to be in error. The request for reconsideration must be in writing and received by the Commissioner within 20 calendar days after receipt of this report. Your request for reconsideration must be sent to: Commissioner, Department of Human Services ATTN: Legal Unit Licensing Division PO Box 64242 St. Paul, MN 55164-0242 Please note that a request for reconsideration does not stay any provisions or requirements of the Correction Order. The Commissioner’s disposition of a request for reconsideration is final and not subject to appeal under Minnesota Statutes, chapter 14. If you have any questions regarding this Correction Order, please contact Lindsay Norris at 651-431-5752 as soon as possible. Lindsay Norris, Senior Licensor-Home and Community Based Services Licensing Division Office of Inspector General
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