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February 8, 2023 Husen Robleh, Authorized Agent Sunshine Adult Day Care Inc 10109 Georgia Avenue North Brooklyn Park, Minnesota 55445 License Number: 1096049 (Rule 223) CORRECTION ORDER Dear Husen Robleh: On February 1, 2023, a licensing review of Sunshine Adult Day Care Inc, located at 2612 1st Avenue South, Minneapolis, 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 Rules, part 9555.9660, subpart 1. Violation: For three of five participants whose records were reviewed (P1, P2 and P5), the license holder did not include information in the participant’s written record as required. a. Although the license holder maintained a report on P1’s physical examination dated April 12, 2022, the license holder failed to maintain a report on P2’s physical examination updated annually in 2021. b. The license holder failed to include a medical report in P2’s record that included a report on a physical examination updated annually in 2022. The most recent report on a physical examination that the license holder maintained for P2 was dated August 2021. c. The license holder failed to maintain a medical report, dated within the three months prior to or 30 days after P5’s admission to the center. P5’s admission date was January 3, 2022; however, the license holder maintained a medical report for P5 dated February 25, 2022. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain a report on P2’s physical examination in P2’s record. On an ongoing basis, you must maintain compliance as required in this part. 2. §Citation: Minnesota Rules, part 9555.9700, subpart 3. Violation: For two participants whose records were reviewed (P4 and P5), the license holder did not develop a written plan of care as required. The license holder failed to develop written plans of care for P4 and P5 that included§ an update of the preliminary service plan and additional services required by the participant. §Corrective Action Ordered: Within 30 days of receiving this order, you must update P4 and P5’s written plans of care to include an update of the preliminary service plan and additional services required by the participant. On an ongoing basis, you must maintain compliance as required in this subpart. 3. Citation: Minnesota Rules, part 9555.9650, item A. Violation: For one of three staff persons whose records were reviewed (SP1), the license holder did not maintain a personnel record as required. The license holder failed to maintain a job description in SP1’s personnel record. §Corrective Action Ordered: Within 30 days of receiving this order, you must maintain a job description in SP1’s personnel record. On an ongoing basis, you must maintain compliance as required in this subpart. 4. Citation: Minnesota Rules, part 9555.9710, subpart 1. Violation: The license holder did not offer services as required. The license holder failed to offer a midafternoon snack. §Corrective Action Ordered: Immediately, you must offer a midafternoon snack. On an ongoing basis, you must maintain compliance as required in this subpart. 5. Citation: Minnesota Rules, part 9555.9720, subpart 8. Violation: The license holder did not ensure safety as required. The license holder failed to ensure rugs had nonskid backing. §Corrective Action Ordered: Within 30 days of receiving this order, you must ensure your rugs have nonskid backing. 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 regarding this Correction Order, please contact your licensor, Desiree Tiller, at 651-431-4622. Brittany Raddatz, Supervisor Licensing Division Office of Inspector General
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