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August 20, 2025 Margaret Tolbert, Authorized Agent 8525 Edinbrook Crossing Suite 102B Minneapolis MN 55443-1967 RE: Report No. 202404882 Guaranteed Home Health Care LLC License No. 1121144/1077901 Dear Margaret Tolbert: CORRECTION ORDER An investigation of Guaranteed Home Health Care LLC was completed regarding report number 202404882 which alleged violation of Minnesota Statutes, section 626.557, and Minnesota Statutes, Chapter 245D. This maltreatment allegation concerned neglect. The disposition of the investigation report is inconclusive. Four violations were noted. VIOLATIONS AND CORRECTION ORDERS The following violations of state and (or) federal laws and rules were observed. Corrective action for each 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. 1. Citation: Minnesota Statutes, section 245D.095, subdivision 5. Violation: For four of five staff persons whose records were reviewed (SP1, SP2, SP3, and SP4), the license holder did not maintain personnel records as required. As a part of an investigation, a DHS investigator requested copies of personnel records that included documentation of: · SP1’s, SP2’s, SP3’s, and SP4’s orientation and training on two consumers (C1’s and C2’s) individual service recipient needs, including: o the support plan or support plan addendum as it relates to the responsibilities assigned to the license holder; o the individual abuse prevention plan, to achieve and demonstrate an understanding of the person as a unique individual, and how to implement those plans. · SP1’s, SP2’s, SP3’s, and SP4’s annual training on 245A.65 and 626.557, governing maltreatment reporting and service planning for vulnerable adults, and staff responsibilities related to protecting persons from maltreatment and reporting maltreatment. 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. 2. Citation: Minnesota Statutes, section 245D.095, subdivision 3. Violation: For C1 and C2, the license holder did not maintain service recipient records as required. The license holder failed to maintain the following service recipient records for C1 and C2 on the premises where the services are provided or coordinated: · Service information, including documentation verifying that the services have been provided as identified in the support plan or support plan addendum according to paragraph (a); · health information, including medical history, special dietary needs, and allergies, and when the license holder is assigned responsibility for meeting the person’s health service needs according to section 245D.05; · current orders for medication, treatments, or medical equipment and a signed authorization from the person or the person’s legal representative to administer or assist in administering the medication or treatments; and · the current support plans. As a part of an investigation, a DHS investigator requested copies of the C1’s and C2’s plans that were in place at the time of the incident. The license holder was unable to provide this information to the DHS investigator. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, section 245D.04, subdivision 3. Violation: For C1, the license holder did not provide free access to common areas in the residence. C1’s bedroom was in the lower level of the home. C1 used a wheelchair and was unable to access the upper level of the home without going outside the facility and using a ramp. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.05, subdivision 1, paragraph (a). Violation: For C1, the license holder failed to provide C1 with the health service needs according to C1’s plans for his/her wound care appointments. The facility was responsible for ensuring C1 attended appointments and C1 missed several appointments resulting in his/her suspension from a wound care clinic. Corrective Action Ordered: 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, Elizabeth Schiefelbein, Elizabeth.Schiefelbein@state.mn.us. Sincerely,
Christine Cavanaugh, Investigator Office of Inspector General Licensing Division christine.cavanaugh@state.mn.us 651-431-3444 Enclosure
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