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May 27, 2025 Betaleham Walle, Authorized Agent Smart Choice Adult Daycare Center LLC 521 Cedar Avenue Minneapolis, Minnesota 55454 License Number: 1094784 (Rule 223) CORRECTION ORDER Dear Betaleham Walle: On May 13, 2025, a licensing review of Smart Choice Adult Daycare Center LLC, located at 521 Cedar Avenue, Minneapolis, 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 Statutes, section 245A.65, subdivision 1, paragraph (c) and subdivision 2, paragraph (a). Violation: For one of four participants whose record was reviewed (P2), the license holder did not provide orientation to the license holder’s internal and external reporting procedures related to suspected or alleged maltreatment and the program abuse prevention plan (PAPP) as required. The license holder failed to provide orientation to P2 on the licensor holder’s internal and external reporting procedures and PAPP within 24 hours of admission. Corrective Action Required: Immediately, you must: · provide an orientation to P2 on your internal and external reporting procedures and PAPP; and · document that P2 was provided the orientation in P2’s record. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in these subdivisions. 2. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (b), and Minnesota Rules, part 9555.9700, subpart 3. Violation: For four participants whose records were reviewed (P1-P4), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP). a. The license holder failed to develop an IAPP for P2 as part of the participant’s initial individual program plan or service plan. b. The license holder failed to review P4’s IAPP quarterly as part of the review of the program plan or service plan. The license holder maintained documentation that P4’s IAPP was most recently reviewed in July 2024. c. The license holder failed to review P1, P3, and P4’s IAPPs with their interdisciplinary teams, at least annually, using the individual assessment and any reports of abuse relating to the person. Corrective Action Ordered: Immediately, you must develop an IAPP for P2. Within 30 days of receiving this order, you must: · review P1, P3, and P4’s IAPP with their interdisciplinary teams and document the review; and · if applicable, revise P1, P3, and P4’s IAPP to reflect the results of the review. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subdivision and subpart. 3. Citation: Minnesota Rules, part 9555.9640. Violation: For one participant whose record was reviewed (P2), the license holder did not distribute policies and program information to participants and their caregivers upon admission as required. a. The license holder failed to distribute the following policies and program information to P2, and the participants’ caregivers upon admission: · the scope of the programs, services, and care offered by the center; · a description of the population to be served by the center; · a description of individual conditions which the center is not prepared to accept, such as a communicable disease requiring isolation, a history of violence to self or others, unmanageable incontinence or uncontrollable wandering; · the center's policy on and arrangements for providing transportation; · the center's policy on providing meals and snacks; · the center's fees, billing arrangements, and plans for payment; · the center's policy governing the presence of pets in the center; · the center's policy on smoking in the center; · types of insurance coverage carried by the center; · a statement of the center's compliance with Minnesota Statutes, section 626.557, and rules adopted under that section; · a statement that center admission and employment practices and policies comply with Minnesota Statutes, chapter 363, the Minnesota Human Rights Act; · the terms and conditions of the center's licensure by the department, including a description of the population the center is licensed to serve under part 9555.9730; and · the telephone number of the department's licensing division. b. The license holder failed to distribute the participants' rights to P2 upon admission. Corrective Action Required: Immediately, you must: · distribute the policies, program information, and participants’ rights listed above to P2 and P2’s caregiver; and · document the distribution of the policies, program information, and participants’ rights in P2’s record. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this part. 4. Citation: Minnesota Rules, part 9555.9660, subpart 1. Violation: For four participants whose records were reviewed (P1-P4), the license holder did not include information in the participant’s written record as required.
a. The license holder failed to maintain participation reports and progress notes in P1’s record that were recorded at least monthly. b. The license holder failed to include the following information in P2’s record: · an application form signed by P2 and P2’s caregiver that included: o P2’s date of admission or readmission and source of referral; o the name and telephone number of a secondary person to call in case of an emergency involving P2; and o the name and telephone number of P2’s physician or medical provider; · a service agreement with the center that specified the responsibilities of P2 and the center with respect to payment for and provision of services and was signed by P2 or P2’s caregiver and the center director; · participation reports and progress notes that are recorded at least monthly; and · a statement signed by the center director and P2 at the time of P2’s admission specifying the basis on which the participant was determined to be capable or not capable of taking appropriate action for self-preservation under emergency conditions. c. The license holder failed to include the following information in P3’s participant record: · an application form signed by P3 or P3’s caregiver that included: o P3’s living arrangement; and o the name and telephone number of the person to call in case of emergency involving the person and name and number of another person to call if that person cannot be reached. · a medical report, dated within the three months prior to or 30 days after P3’s admission to the center signed by a physician or signed by a physician assistant or registered nurse and cosigned by a physician; and · participation reports and progress notes that are recorded at least monthly. d. The license holder failed to include the following information in P4’s participant record: · a report on a physical examination for P4, updated annually in 2025; and · participation reports and progress notes that are recorded at least monthly. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain the information detailed above in P1-P4’s participant records. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. 5. Citation: Minnesota Rules, part 9555.9700, subpart 2. Violation: For two participants whose records were reviewed (P2 and P3), the license holder did not complete initial service planning as required. a. The license holder failed to conduct a needs assessment within 30 days of P2’s admission that included: · P2’s psychosocial status (for example, awareness level, personal care needs, need for privacy or socialization); · P2’s functional status (for example, endurance and capability for ambulation, transfer, and managing activities of daily living); and · P2’s physical status, determined by observation, from the intake screening interview, and from the medical report received from P2's physician. b. The license holder failed to develop a preliminary service plan for P2 that included: · scheduled days of P2’s attendance at the center; · transportation arrangements for getting the participant to and from the center; · P2’s nutritional needs and, where applicable, dietary restrictions; · the role of P2’s caregiver or caregivers in carrying out the service plan; and · services and activities in which P2 would take part immediately upon admission. c. The license holder failed to: · conduct a needs assessment for P3 that addressed P3’s physical status, determined by observation, from the intake screening interview, and from the medical report received from P3’s physician; and · develop a preliminary service plan for P3 that included: o scheduled days of P3’s attendance at the center; and o the role of the P3’s caregiver or caregivers in carrying out the service plan.
· conduct a needs assessment for P2 that includes the information detailed above; · update P3’s needs assessment to include P3’s physical status based on information received from P3’s medical report; · develop a preliminary service plan P2 that includes the information and specifications detailed above; and · update P3’s preliminary service plan to include the information as detailed above. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. 6. Citation: Minnesota Rules, part 9555.9700, subpart 3. Violation: For three participants whose records were reviewed (P2-P4), the license holder did not develop a written plan of care as required. a. The license holder failed to develop a written plan of care for P2 and P3 within 90 days of admission to the center that included: · an update of the preliminary service plan and additional services required by the participant; · short and long term objectives for the participant stated in concrete, measurable and time specific outcomes; · the staff members responsible for implementing the individual plan of care; · the anticipated duration of the individual plan of care as written; and · provisions for quarterly reviews and quarterly revisions of the individual plan of care. b. The license holder failed to develop a written plan of care for P4 that included provisions for quarterly reviews and quarterly revisions of the individual plan of care. Corrective Action Ordered: Within 30 days of receiving this order, you must: · develop a written plan of care for P2 and P3 that includes the information detailed above; and · review P4’s written plan of care with P4 and revise the plan of care, if necessary. Compliance with this order will be reviewed onsite. On an ongoing basis, you must maintain compliance as required in this subpart. 7. Citation: Minnesota Rules, part 9555.9710, subpart 7. Violation: The license holder did not offer services as required. The license holder failed to maintain a family and social history for P4 that was updated annually in 2024. Corrective Action Ordered: Within 30 days of receiving this order, you must provide services as stated above. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. 8. Citation: Minnesota Rules, part 9555.9720, subparts 7 and 8. Violation: The license holder did not ensure safety as required. a. The license holder failed to ensure the equipment and furniture was in good repair that included: · graffiti on the front windows and doors of the center; · carpet with large stains; · ceiling tiles with significant water damage; and · a missing tile exposing pipes in the ceiling. b. The license holder failed to ensure the areas used by participants were free from loose plaster and peeling paint, including areas with chipped sheetrock and peeling paint within the center.
9. Citation: Minnesota Rules, part 9555.9730, subpart 3. Violation: The license holder did not ensure physical and space requirements.
Corrective Action Required: Immediately, you must ensure restrooms used by participants are equipped with a mechanism that participants could use to signal staff members by light or by sound if participants need assistance. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. 10. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a). Violation: The license holder did not review their program abuse prevention plan (PAPP) as required. The license holder failed to ensure the license holder’s governing body or the governing body’s delegated representative reviewed the PAPP at least annually. Corrective Action Ordered: Within 30 days of receiving this order, you must review your PAPP using the assessment factors in the plan and any substantiated maltreatment findings that occurred since the last review. 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 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. Desiree Tiller, HCBS Licensor Licensing Division Office of Inspector General 651-431-4622
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