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February 16, 2024 Fartun Weli, Authorized Agent Peace of Mind Care Center 2518 North Second Street Suite 116 Minneapolis, Minnesota 55411 License Number: 1108645 (245D – HCBS) CORRECTION ORDER Dear Fartun Weli: On December 6, 2023, a licensing review of Peace of Mind Care Center, located at 2518 North Second Street Suite 116, Minneapolis, 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. 1. Citation: Minnesota Statutes, section 245D.05, subdivision 2.
Violation: For one of two persons whose record was reviewed (P1), the license holder did not implement medication administration procedures as required.
The license holder began administering medications to P1 at the time of P1’s service initiation on June 26, 2023, however, the license holder failed to include notation in P1’s medication administration record of when a medication or treatment was started, administered, changed, or discontinued for each medication that was administered to P1. Corrective Action Ordered: Immediately you must include notation in P1’s medication administration record of when a medication or treatment was started, administered, changed, or discontinued for each medication that was administered to P1. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.071, subdivision 3, paragraph (d). Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not complete initial service planning for intensive support services as required. The license holder stated that a discussion of how technology might be used to meet the desired outcomes for P1 and P2 was included in each person’s 45-day planning meeting, however, the license holder failed to include a summary of these discussions in each person’s support plan or support plan addendum. Corrective Action Ordered: Within 30 days of receiving this order you must discuss with P1 and P2’s interdisciplinary teams about how technology might be used to meet the desired outcomes for P1 and P2. Additionally, you must also include a summary of this discussion in P1 and P2’s support plan addendums. On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, section 245A.65, subdivision 3. Violation: For one of two staff persons whose record was reviewed (SP1), the license holder did not provide orientation to vulnerable adult maltreatment reporting as required. The license holder failed to provide orientation training to SP1 within 72 hours of SP1 first providing direct contact with persons receiving services. The license holder failed to maintain documentation in SP1's personnel record of SP1's first date of direct contact with persons receiving services; therefore, it was undetermined whether the license holder provided orientation training to SP1 within 72 hours of SP1 first providing direct contact with persons receiving services. Corrective Action Ordered: Immediately, you must provide SP1 orientation to vulnerable adult maltreatment reporting and document the orientation in SP1’s personnel record. On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.09, subdivision 4. Violation: For one staff person whose record was reviewed (SP1), the license holder did not provide orientation training as required. The license holder failed to provide SP1 orientation on the following topics: · a job description and how to complete specific job functions; and · strategies to minimize the risk of sexual violence, including concepts of healthy relationships, consent, and bodily autonomy of people with disabilities. Corrective Action Ordered: Within 30 days of receiving this order, you must provide SP1 orientation to the following topics: · a job description and how to complete specific job functions; and · strategies to minimize the risk of sexual violence, including concepts of healthy relationships, consent, and bodily autonomy of people with disabilities. On an ongoing basis, you must maintain compliance as required in this subdivision. 5. Citation: Minnesota Statutes, section 245D.095, subdivision 5. Violation: For one staff person whose record was reviewed (SP1), the license holder did not maintain personnel records as required.
The license holder failed to include the following in SP1’s personnel record: · documentation of training, including the date the training was completed, the number of hours per subject area, and the name of the trainer or instructor; and · documentation to determine SP1’s first date of supervised direct contact and first date of unsupervised direct contact. Corrective Action Ordered: Within 30 days of receiving this order, you must: · audit all staff personnel records to ensure each staff person has documentation of the number of hours per subject area; and · audit all staff to ensure each staff person’s first date of supervised direct contact and first date of unsupervised direct contact is maintained. 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 ATTN: Legal Unit Licensing Division PO Box 64242 St. Paul, MN 55164-0242 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, Katie Johnson, at 651-431-4113. Brittany Raddatz, HCBS Unit Supervisor Licensing Division Office of Inspector General
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