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November 4, 2022 Nella Maloylo, Authorized Agent Palladium Adult Day Care Inc 15270 Germanium Street Northwest Ramsey, Minnesota 55303 License Number: 1107624 (Rule 223) CORRECTION ORDER Dear Nella Maloylo: On October 27, 2022, a licensing review of Palladium Adult Day Care Inc, located at 9673 63rd Avenue North, Maple Grove, Minnesota, was conducted to determine compliance with Minnesota Statutes and Rules governing adult day care services under Minnesota Rules, parts 9555.9600 through 9555.9730 (Rule 223). 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 three participants whose records were reviewed (P1 and P3), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP). a. The license holder failed to review P1’s IAPP quarterly as part of the review of the program plan or service plan between February 28, 2022 and August 19, 2022. b. The license holder failed to review P3’s IAPP quarterly as part of the review of the program plan or service plan between March 15, 2021 and September 10, 2021. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Rules, part 9555.9660, subpart 1. Violation: For two participants whose records were reviewed (P1 and P3), the license holder did not include information in the participant’s written record as required. The license holder failed to include an application form in P1 and P3’s records that included P1 and P3's source of referral. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subpart. 3. Citation: Minnesota Rules, part 9555.9700, subpart 2. Violation: For two participants whose records were reviewed (P2 and P3), the license holder did not complete initial service planning as required. a. The license holder failed to conduct needs assessments for P2 and P3 that addressed the participant’s physical status using information from the medical report received from the participant’s physician. · The license holder conducted P2’s needs assessment on April 5, 2021; however, the license holder did not receive the medical report from P2’s physician until May 4, 2021. · The license holder conducted P3’s needs assessment on March 15, 2021; however, the license holder did not receive the medical report from P3’s physician until March 25, 2021. b. The license holder failed to develop a preliminary service plan for P1 that included: · P1’s nutritional needs and, where applicable, dietary restrictions; and · the role of P1’s caregiver or caregivers in carrying out the service plan. c. The license holder failed to develop a preliminary service plan for P2 that included the role of P2’s caregiver or caregivers in carrying out the service plan. Corrective Action Ordered: Within 30 days of receiving this order, you must update P1 and P2’s preliminary service plan to include the information and specifications detailed above. On an ongoing basis, you must maintain compliance as required in this subpart. 4. Citation: Minnesota Rules, part 9555.9700, subpart 3. Violation: For two participants whose records were reviewed (P1 and P3), the license holder did not develop a written plan of care as required. a. The license holder failed to develop a written plan of care for P1 that included: · an update of the preliminary service plan and additional services required by P1; · short and long term objectives for P1 stated in concrete, measurable and time specific outcomes; and · the anticipated duration of the individual plan of care as written. b. The license holder failed to develop a written plan of care for P3 that included§ an update of the preliminary service plan and additional services required by P3. §Corrective Action Ordered: Within 30 days of receiving this order, you must develop written plans of care for P1 and P3 that include the information listed above. On an ongoing basis, you must maintain compliance as required in this subpart. If you fail to correct the violations specified in the Correction Order within the prescribed time lines the Commissioner may issue an Order of Conditional License or may impose a fine and order other licensing sanctions pursuant to Minnesota Statutes, sections 245A.06 and 245A.07. 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: Office of Inspector General Legal Counsel’s Office Attention: Licensing Legal Unit P.O. Box 64953 Saint Paul, MN 55164-0953 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, please contact your licensor, Desiree Tiller, at 651-431-4622. Brittany Raddatz, Human Services Senior Licensor Licensing Division Office of Inspector General
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