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January 10, 2024 Stacy Roe 7000 78th Ave N Minneapolis, MN 55445 RE: Report No. 202305991 Mains'l Services Inc., 43rd Street North License No. 1070239/1070210 Dear Stacy Roe: CORRECTION ORDER An investigation of Mains'l Services Inc., 43rd Street North was completed regarding report number 202305991 which alleged violation of Minnesota Statutes, section 626.557, and Minnesota Statutes, Chapter 245D. This maltreatment allegation concerned neglect, emotional abuse, and financial exploitation. The disposition of the investigation report is false. One violation was noted. VIOLATIONS AND CORRECTION ORDERS The following violation of state and (or) federal laws and rules was observed. Corrective action for the violation is required by Minnesota Statutes, section 245A.06, and is hereby ordered by the Commissioner of Human Services. Failure to correct the violations within the prescribed amount of time may result in fines and/or action against your license, as provided for in Minnesota Statutes, sections 245A.06 and 245A.07. Citation: Minnesota Statutes, section 245D.05, subdivision 2, paragraph (c), clause (6) and 245D.11, subdivision 2, paragraph (3). Violation: The license holder did not ensure that medication documentation was completed in accordance with facility policy. The license holder failed to ensure that documentation of administration of prescribed medications was completed as required. Information obtained from interviews with seven staff persons showed that staff persons did not always document in a timely manner that medications were administered to two consumers (C1 and C2). Corrective Action Ordered: Beginning immediately and on an ongoing basis you must maintain compliance as required in this subdivision. If you believe any of the citations are in error, you may ask the Commissioner of Human Services to reconsider the parts of the correction order that you believe to be in error. If you choose to exercise this right, your request for reconsideration must be in writing and received by the Commissioner within 20 calendar days after receipt of this letter. Your request for reconsideration must be sent to: Commissioner Minnesota Department of Human Services c/o Licensing Division PO Box 64242 St. Paul, MN 55164-0242 You must include any and all information, documentation, or other evidence you have to support your request for reconsideration. Please note that a request for reconsideration does not stay any provisions of the correction order. If you have any questions regarding the investigation, contact me immediately. If you have any questions regarding compliance with this Correction Order or applicable rules, contact your licensor, Nichole Dawson, at 651-431-6646. Sincerely,
Scout Peterson, Investigator Office of Inspector General Licensing Division scout.peterson@state.mn.us 651-431-6578 Enclosure
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