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April 30, 2025 Adriana Shelton, Authorized Agent Alianza Elder Support Center 3928 Princeton Trail License Number: 1105167 (Rule 223) CORRECTION ORDER Dear Adriana Shelton: On February 14, 2025 a licensing review of Alianza Elder Support Center located at 882 Robert Street South, West 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, subpart 1. Violation: For one of two participants whose record was reviewed (P1), the license holder did not include information in the participant’s written record as required. The license holder failed to include a medical report dated within three months prior to or 30 days after P1’s admission to the center in P1’s participant record. P1 was admitted to the center on April 18, 2024 and the license holder maintained a medical report for P1 on August 7, 2024. Repeat Violation: In a Correction Order that DHS issued on August 1, 2022, you were previously found in violation of this same rule. 2. Citation: Minnesota Rules, part 9555.9700, subpart 2. Violation: For one participant whose record was reviewed (P1), the license holder did not complete initial service planning as required. The license holder failed to develop a preliminary service plan within 30 days of P1’s admission to the center that included: · the role of P1’s caregiver or caregivers in carrying out the service plan; and · services and activities in which P1 will take part in immediately upon admission. Repeat Violation: In a Correction Order that DHS issued on August 1, 2022, you were previously found in violation of this same rule. On an ongoing basis, you must maintain compliance as required in this subpart. 3. Citation: Minnesota Rules, part 9555.9700, subpart 3. Violation: For one participant whose record was reviewed (P1), the license holder did not develop a written plan of care as required. The license holder failed to develop a written plan of care for P1 within 90 days of admission to the center that included: · an update of the preliminary service plan and additional services required by P1; · short and long term objectives for P1 stated in concrete, measurable and time specific outcomes; · the staff members responsible for implementing the individual plan of care; and · the anticipated duration of the individual plan of care as written. Repeat Violation: In a Correction Order that DHS issued on August 1, 2022, you were previously found in violation of this same rule. 4. Citation: Minnesota Rules, part 9555.9650, item A. The license holder failed to maintain documentation of an annual performance evaluation in SP2’s personnel record. Repeat Violation: In a Correction Order that DHS issued on August 1, 2022, you were previously found in violation of this same rule. · complete a performance evaluation for SP2 and maintain documentation of the evaluation in SP2’s personnel record; and · submit documentation of SP2’s annual performance evaluation to your licensor. On an ongoing basis, you must maintain compliance as required in this item. 5. Citation: Minnesota Rules, part 9555.9690, subpart 4. Violation: For one staff person whose record was reviewed (SP2), the license holder did not provide in-service training annually as required. The license holder failed to provide SP2 a minimum of eight hours of in-service training annually in the following areas: · areas related to care of center participants, including provision of medication assistance; and · review of parts 9555.9600 to 9555.9730.
· provide the required in-service training detailed above to SP2; and · submit the completed annual training record for SP2 to your licensor. On an ongoing basis, you must maintain compliance as required in this subpart. 6. Citation: Minnesota Rules, part 9555.9710, subparts 4 and 7. Violation: The license holder did not offer services as required. a. The license holder failed to ensure the registered physical therapist provided consultation and review of the exercise program, at least quarterly in 2024. b. The license holder failed to maintain a family and social history in P2’s record that was updated annually in 2024.
· ensure your registered physical therapist provides consultation and review of the exercise program at least quarterly; and · review P2’s family and social history, document the review, and update P2’s family and social history, if applicable. On an ongoing basis, you must maintain compliance as required in these subparts. 7. Citation: Minnesota Statutes, section 245A.65, subdivision 1, paragraph (a) section 626.557, subdivision 14. Violation: The license holder did not establish a program abuse prevention plan as required. The license holder failed to establish a written PAPP that included: · an assessment of the population, including: o the need for training of staff to meet identified individual needs; and o the knowledge the license holder may have regarding previous abuse that is relevant to minimizing risk of abuse for participants; · an assessment of the environment, including: o the location of the program in a particular neighborhood or community; o the type of grounds and terrain surrounding the building; o the type of internal programming; o the program’s staffing patterns; and · a statement of specific measures to be taken to minimize the risk of abuse. Repeat Violation: In a Correction Order that DHS issued on August 1, 2022, you were previously found in violation of this same rule. · establish a PAPP that includes the information detailed above; and · submit your updated PAPP and the date it was developed to your licensor. Additionally, a copy of the PAPP must be posted in a prominent location in the program. 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. 1. By secure email at alexandra.devick@state.mn.us; or 2. If you are unable to submit corrective action ordered securely through email, you can mail or fax using the information below: Commissioner, Department of Human Services ATTN: Alexandra Devick Licensing Division PO Box 64242 St. Paul, MN 55164-0242 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 me as soon as possible. Alexandra Devick, HCBS Human Services Licensor Licensing Division Office of Inspector General 651-431-4626
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