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January 28, 2025 Simon Nyamari, Authorized Agent Amani Health Care Services LLC 1705 Southcross Drive #105 Burnsville, Minnesota 55306 License Number: 1091055 (245D – Home and Community-Based Services) CORRECTION ORDER Dear Simon Nyamari: On January 16, 2025, a licensing review of Amani Health Care Services LLC, located at 1705 Southcross Drive #105, Burnsville, 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.07, subdivision 1a. Violation: For one of four person whose record was reviewed (P3), the license holder did not provide services in response to the person’s identified needs, interests and preferences as required. P3’s individual abuse prevention plan, dated May 14, 2024, had the name of another service recipient in the document. DHS licensors could not determine this plan was developed for P1. The license holder failed to develop a plan that identified P3’s needs interests and preferences. Corrective Action Ordered: Within 30 days of receipt of this order, you must develop an individual abuse prevention plan that is specific to P3’s identified needs, interests and preferences. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.10, subdivision 4, paragraph (b). Violation: For one person whose record was reviewed (P2), the license holder did not inform and provide copies of the policies and procedures affecting a person’s rights under section 245D.04, as required. P2’s services were initiated on October 16, 2024. The license holder failed to provide P2’s case manager with copies of the following policies and procedures affecting a person’s rights under section 245D.04, within five working days of service initiation: · grievance policy and procedure; · service suspension policy and procedure; and · service termination policy and procedure. Corrective Action Ordered: Within 30 days of receiving this order, you must inform and provide P2’s case manager with copies of the policies and procedures required above. On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, section 245D.11, subdivision 1 and 3. Violation: For one person whose record was reviewed (P3), the license holder did not enforce policies and procedures as required. P3’s individual abuse prevention plan, dated May 14, 2024, had P3’s name in the beginning of the document and there was another person served mentioned in the body of the document. This plan was given to P3 and P3’s case manager. The license holder failed to follow their data privacy policy. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required with 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 64953 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 me as soon as possible. Diana Arnzen, Human Services Licensor Licensing Division Office of Inspector General 651-431-6638
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