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August 1, 2023 Belinda Evjen, Authorized Agent Evjen Foster Care Services 2572 190th Avenue Porter, Minnesota 56280 License Number: 1070087 (245D - HCBS) CORRECTION ORDER Dear Belinda Evjen: On July 18, 2023, a licensing review of Evjen Foster Care Services, located at 2572 190th Avenue, Porter, 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. Citation: Minnesota Statutes, section 245D.04, subdivision 1, paragraph (1). Violation: For one of one person whose record was reviewed (P1), the license holder did not provide the person or their legal representative with a written notice that identified the service recipient rights as required. The license holder failed to provide P1 with a notice that identified the service recipient rights and an explanation of those rights annually in 2023. Corrective Action Ordered: Within 30 days of receiving this order, you are ordered to provide P1 or the person’s legal representative, with the above mentioned written notice. This notice must also be provided annually thereafter. On an ongoing basis, you must maintain compliance throughout your program 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 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 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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