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September 23, 2022 CERTIFIED MAIL
Jeffery Feltz, Authorized Agent Community Living Options 26022 Main St Zimmerman MN 55398
License Number 1070470 (Home and Community-Based Services) License Number 1070488 (Home and Community-Based Services-Community Residential Setting) Report Number 202206011
ORDER TO PAY A FINE
Dear Jeffery Feltz: The Department of Human Services (DHS) is ordering you to pay a fine of $200 for the failure to report maltreatment at Community Living Options Hilltop located at 15734 240th Street N, Scandia, MN, 55073. Details of our findings are provided below. Our next steps and your options are also detailed. REASON FOR FINE
Failure to Report Maltreatment
It was reported that a staff person (SP) pushed a vulnerable adult (VA) onto the floor then dragged him/her across the floor causing the VA to sustain a rug burn. DHS investigated the report as alleged maltreatment by physical abuse. Based on the maltreatment investigation, DHS determined that mandated reporters, including a supervisory staff person and an adminitrative staff person had knowledge of the incident of maltreatment, but did not make a report as required. Fine: $200 Statute Violated: Minnesota Statutes, section 626.557, subdivision 3 and Minnesota Statutes 245A.65, subdivision 1. Billing and Payment of the Fine
DHS will send you an invoice for the $200 fine. Payment must be made as directed on the invoice. If you request a contested case hearing, as described below, do not pay the fine at this time. Following the contested case hearing, the Commissioner of DHS will issue a final order on this matter. Please note, you may not avoid payment of this fine by closing, selling, or otherwise transferring the license to a third party. If this occurs, you are personally responsible for payment. If you do not pay the fine on or before the date specified on the invoice and you did not request a contested case hearing, as described below, the Commissioner may issue a second fine, may not issue or reissue a license, or may suspend the license until the license holder pays the fine. YOUR RIGHT TO APPEAL
You have the right to appeal the fine. Your request must be in writing and clearly state that you are requesting a contested case hearing for this matter. Your request must be made before the deadlines provided below. If you do not meet this deadline, you lose your right to an administrative appeal. The timeline to appeal began when you received this order. If you are mailing your request, it must be sent by certified mail and postmarked within 10 calendar days from when you receive this order. Please send it to: Commissioner, Department of Human Services Office of Inspector General Licensing Division Attention: Legal Unit PO Box 64242 St. Paul, MN 55164-0242 If your request is being personally delivered, it must be received by DHS within 10 calendar days from when you receive this order. Please bring it to: Commissioner, Department of Human Services Office of Inspector General Licensing Division Attention: Legal Unit 444 Lafayette Road North St. Paul, MN 55155 Upon DHS’ receipt of your timely appeal, your case would be scheduled for a contested case hearing in front of an Administrative Law Judge. Following this hearing, the Commissioner of DHS will issue a final order. Legal representation at the contested case hearing
You do not need a lawyer to appeal. However, a lawyer can help you with your appeal. The state or county will not get you a lawyer and will not pay for a lawyer. If you cannot afford a lawyer, you may be able to get free legal advice or help with your appeal. To find out if free help is available, contact: Volunteer Lawyers Network at 612-752-6677; Central Minnesota Legal Services at 612-332-8151; Southern Minnesota Legal Services at 651-222-4731; or go to www.justice4mn.org to find a local legal services program that may be able to help you. You can also find information on contested cases from the Office of Administrative Hearings website at https://mn.gov/oah/self-help. Click on Administrative Law Overview, then click on Administrative Law Contested Case Hearing Guide for a list of frequently asked questions. Legal authority for this licensing action
· This action is taken under Minnesota Statutes, section 245A.07, subdivision 1, paragraph (a), which describes under which conditions DHS may impose a fine against a license.
· DHS may impose a $200 fine for each health, safety, or supervision licensing violation under Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), clause (4), item (iv).
· Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), clause (5) states that license holders may not avoid payment of a fine by closing, selling, or transferring a license.
· License holders have a right to appeal licensing actions and request a contested case hearing, under Minnesota Statutes, chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612.
· Minnesota Statutes, section 245A.04, subdivision 7, paragraph (d), clause (4), states that DHS shall not issue or reissue a license if the applicant, license holder, or controlling individual has an outstanding debt related to a license fee, licensing fine, or settlement agreement for which payment is delinquent.
· Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), clause (2), states that that the license holder shall pay the fine assessed on or before the payment date specified, and if the license holder does not do so the commissioner may issue a second fine or suspend the license until the license holder complies.
· License holders must have and enforce written policies and procedures related to suspected maltreatment, under 245A.65, subdivision 1.
Questions
If you have any further questions regarding this matter, you may contact Melanie Daniel, Unit Supervisor, at 651-431-6559. Sincerely, 
Alyssa Dotson, Deputy Inspector General Office of Inspector General Licensing Division Enclosure
PO Box 64242 • Saint Paul, Minnesota • 55164-0242 • An Equal Opportunity and Veteran Friendly Employer https://mn.gov/dhs/general-public/licensing/
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