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March 7, 2023 Pay Soung, Authorized Agent Twin Cities Adult Day Services LLC 848 Aspen Circle Little Canada, Minnesota 55109 License Number: 1076130 (Rule 223) CORRECTION ORDER Dear Pay Soung: On February 28, 2023, a licensing review of Twin Cities Adult Day Services LLC, located at 2231 11th Avenue East, Saint Paul, 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, subparts 1 and 3. Violation: For three of three participants whose records were reviewed (P1, P2 and P3), the license holder did not include information in the participant’s written record as required. a. The license holder failed to include attendance and participation reports and progress notes that were recorded at least monthly in P1’s record. b. The license holder failed to include the following information in P2’s record: · a medical report that included an indication of dietary restrictions and medication regimen, including the need for medication assistance, that apply to P2; · attendance and participation reports and progress notes that were recorded at least monthly; and · notes on special problems, medication changes, and need for medication assistance. c. The license holder failed to include the following information in P3’s record: · attendance and participation reports and progress notes that were recorded at least monthly; and · notes on special problems, medication changes, and need for medication assistance. Repeat Violation: You were cited for a similar violation in an Order of Conditional License on October 14, 2022. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain all information detailed above in P1, P2 and P3’s participant records. On an ongoing basis, you must maintain compliance as required in this part. 2. Citation: Minnesota Rules, part 9555.9720, subpart 9. Violation: The license holder failed to have written plans for emergencies caused by fire that included instructions on location and use of fire extinguishers as required. Repeat Violation: You were cited for a similar violation in an Order of Conditional License on October 14, 2022. Corrective Action Ordered: Immediately you must develop written plans for emergencies caused by fire that include instructions on location and use of fire extinguishers. On an ongoing basis, you must maintain compliance as required in this subpart. 3. Citation: Minnesota Statutes, section 245A.65, subdivision 1, paragraph (d) and subdivision 2, paragraph (a). Violation: The license holder did not post a copy of the internal and external reporting policies and procedures and program abuse prevention plan in a prominent location in the program as required. Repeat Violation: You were cited for a similar violation in an Order of Conditional License on October 14, 2022. Corrective Action Required: Immediately, you must post a copy of your internal and external reporting policies and procedures, including the telephone number of the common entry point as defined in section 626.5572, subdivision 5, and your program abuse prevention plan in a prominent location in the program. On an ongoing basis, you must maintain compliance as required in these subdivisions. 4. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a). Violation: The license holder did not establish a program abuse prevention plan (PAPP) as required. The license holder failed to establish a written PAPP, including an assessment of the population that included an evaluation of the need for training of staff to meet identified individual needs. Repeat Violation: You were cited for a similar violation in an Order of Conditional License on October 14, 2022. Corrective Action Ordered: Within 30 days of receiving this order, you must establish a PAPP that includes the information detailed above. On an ongoing basis, you must maintain compliance as required in this subdivision. 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: Commissioner, Department of Human Services Office of Inspector General Legal Counsel’s Office Attention: Licensing Legal Unit PO Box 64953 St. 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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