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September 03, 2025 Tinbit Helsabo, Authorized Agent Cross Cultural Care Center LLC 11374 Wagon Wheel Curve License Number: 1105240 (Rule 223) CORRECTION ORDER Dear Tinbit Helsabo: On July 23, 2025, a licensing review of Cross Cultural Care Center LLC located at 7001 78th Avenue North, 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.14, subdivision 14, paragraph (c). Violation: The license holder did not meet the requirements for attendance record documentation. The license holder did not maintain documentation of actual attendance for each adult day service recipient for which the license holder was reimbursed by a governmental program that included: · the time of day that the recipient was dropped off; and · the time of day that the recipient was picked up. Corrective Action Ordered: Immediately, you must maintain documentation of actual attendance for each adult day service recipient. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Rules, part 9555.9660, subpart 1. Violation: For one of two participants whose records were 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 for P1 that was dated within three months prior to or 30 days after P1’s admission to the center. P1 was admitted to the center on November 4, 2024. The license holder maintained a medical report for P1 that was dated January 6, 2025.
3. Citation: Minnesota Rules, part 9555.9720, subparts 7 and 8. Violation: The license holder did not ensure safety as required. a. The license holder did not ensure equipment and furniture were in good repair. On July 23, 2025, DHS licensors observed a non-secure shelving unit on the wall with damaged corners, and a cracked and broken floor tile. b. The license holder did not ensure the areas used by participants receiving services were free from loose plaster and peeling paint. On July 23, 2025, DHS licensors observed areas throughout the center with chipped sheetrock and peeling paint.
Corrective Action Required: Immediately, you must: · ensure the equipment and furniture used by participants receiving services are in good repair; and · ensure the areas used by participants receiving services are free from loose plaster and peeling paint. On an ongoing basis, you must maintain compliance as required in these subparts. 4. Citation: Minnesota Rules, part 9555.9730, subpart 3. Violation: The license holder did not ensure physical plant and space requirements. The license holder did not ensure restrooms used by participants were equipped with a mechanism that participants can use to signal staff members by light or by sound if participants need assistance. Corrective Action Required: Immediately, you must ensure all restrooms used by participants are equipped with a mechanism that participants can use to signal staff members. On an ongoing basis, you must maintain compliance as required in this subpart. 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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