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June 16, 2025 Teresa Reeves, Authorized Agent Victory Care LLC 1736 84th Court North Brooklyn Park, Minnesota 55444 License Number: 1103082 (245D – HCBS) CORRECTION ORDER Dear Teresa Reeves: On June 4th, 2025, a licensing review of Victory Care LLC, located at 151 Island Park Drive Northeast, Apartment 12, Fridley, 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.071, subdivision 4. Violation: For three of four persons whose records were reviewed (P1, P3 and P4), the license holder did not develop service outcomes and supports as required. The license holder failed to develop and document the following supports and methods to be implemented for P1, P3 and P4, to support the person and accomplish outcomes related to acquiring, retaining, or improving skills and physical, mental, and emotional health and well-being within 10 working days of the 45 or 60-day planning meeting: · the methods or actions that will be used to support the person and accomplish the service outcomes, including information about: o any changes or modifications to the physical and social environments necessary when the service supports were provided; o any equipment and materials required; and o techniques that were consistent with the person’s communication mode and learning style; · the measurable and observable criteria for identifying when the desired outcome had been achieved and how data would be collected; · the projected starting date for implementing the supports and methods and the date by which progress towards accomplishing the outcomes would be reviewed and evaluated; and · the names of the staff persons or positions responsible for implementing the supports and methods. Corrective Action Ordered: Within 30 days of receiving this order, you must: · develop a service plan for P3 that documents the abovementioned supports and methods; and · review the supports and methods with P3, P3’s legal representative, P3’s case manager, and other members of the support team. You must maintain documentation in P3’s support plan addendum with the date the supports and methods were reviewed. On an ongoing basis, you must maintain compliance as required in this subdivision. Repeat Violation: In a Correction Order that DHS issued on February 18, 2025, you were previously found in violation of this same statue. 2. Citation: Minnesota Statutes, section 245D.071, subdivision 5. Violation: For three persons whose records were reviewed (P1, P2 and P3), the license holder did not meet the requirements for service plan review and evaluation as required. a. The license holder failed to summarize P1 and P2’s status and progress toward achieving their identified outcomes and make recommendations and identify the rationale for changing, continuing, or discontinuing implementation of supports and methods identified in subdivision 4 in a report available at the time of the progress review meeting. P2 no longer receives services from this license holder. b. The license holder failed to have a discussion of how technology might be used to meet P3's desired outcomes when meeting with P3, P3’s case manager, and other members of the support team on March 5, 2025. The support plan failed to include a summary of this discussion, including a statement regarding any decision that was made regarding the use of technology and a description of any further research that needed to be completed before a decision regarding the use of technology could be made. Corrective Action Ordered: Within 30 days of receiving this order, you must: · have a discussion of how technology might be used to meet P3's desired outcomes; · include a summary of this discussion, including a statement regarding any decision that is made regarding the use of technology; · a description of any further research that needs to be completed before a decision regarding the use of technology can be made; and · provide a status and progress review report for P1, P1’s legal representative and P1’s case manager. On an ongoing basis, you must maintain compliance as required in this subdivision. Repeat Violation: In a Correction Order that DHS issued on February 18, 2025, you were previously found in violation of this same statue. 3. Citation: Minnesota Statutes, section 245D.09, subdivision 5. Violation: For one of three staff persons whose record was reviewed (SP2), the license holder did not provide annual training as required. The license holder failed to provide SP2 with annual training on basic first aid in 2025. Corrective Action Ordered: Within 30 days of receiving this order, you must provide SP2 with annual training on basic first aid. On an ongoing basis, you must maintain compliance as required in this subdivision. Repeat Violation: In a Correction Order that DHS issued on February 18, 2025, you were previously found in violation of this same statue. 4. Citation: Minnesota Statutes, section 245D.095, subdivision 5. Violation: For one staff person whose record was reviewed (SP3), the license holder did not maintain personnel record as required. The license holder failed to maintain a personnel record for SP3 that documented the date the trainings were completed, the number of hours per subject area, and the name of the trainer or instructor. Corrective Action Ordered: Immediately, upon receipt of this order you must begin maintaining a personnel record that includes the above-mentioned requirements. 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. Kelly Bosch, HCBS Licensor Licensing Division Office of Inspector General 651-431-6621
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