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June 13, 2025 Jacob Thomas Margarit 2485 Como Ave Saint Paul, MN 55108 RE: Report No. 202310677 LSS Juneberry License No. 1070007/1069963 Dear Jacob Thomas Margarit: CORRECTION ORDER An investigation of LSS Juneberry was completed regarding report number 202310677 which alleged violation of Minnesota Statutes, section 626.557, and Minnesota Statutes, Chapter 245D. This maltreatment allegation concerned financial exploitation, adverse deprivation, emotional abuse, and neglect. The disposition of the investigation report is inconclusive and 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.095, subdivision 5. Violation: For three staff persons whose records were reviewed (SP1, SP2, and SP3), the license holder did not maintain personnel records as required. As a part of this investigation of alleged maltreatment, a DHS investigator requested copies of SP1’s-SP3’s personnel records that included documentation of: · SP1’s-SP3’s training on a consumer’s (C1’s) individual service recipient needs/ plans · SP1’s and SP2’s training on a consumer’s (C2’s) individual service recipient needs/plans The license holder was unable to provide this information to the DHS investigator. Corrective Action Ordered: Correct 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, Diana Arzen. Sincerely,
Christine Cavanaugh, Investigator Office of Inspector General Licensing Division christine.cavanaugh@state.mn.us 651-431-3444 Enclosure
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