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September 04, 2025 Stephanie Matthews, Authorized Agent Mount Olivet Day Services 5601 Lyndale Avenue South License Number: 809494 (Rule 223) CORRECTION ORDER Dear Stephanie Matthews: On August 20, 2025, a licensing review of Mount Olivet Day Services located at 5601 Lyndale Avenue South, 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 2, paragraph (b) and Minnesota Rules, part 9555.9700, subpart 3. Violation: For two of three participants whose records were reviewed (P2 and P3), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP). The license holder did not review P2 and P3’s IAPPs quarterly as part of the review of the program plan or service plan. Corrective Action Ordered: Within 30 days of receiving this order, you must review P2 and P3’s IAPP and document the reviews. On an ongoing basis, you must maintain compliance as required in this subdivision and subpart. 2. Citation: Minnesota Rules, part 9555.9660, subpart 1. Violation: For two participants whose records were reviewed (P1 and P2), the license holder did not include information in the participant’s written records as required. a. The license holder did not include a medical report in P1’s record, that was signed by a physician or signed by a physician assistant or registered nurse and cosigned by a physician that included a release signed by the physician indicating whether P1 may engage in a structured exercise program. b. The license holder did not include P2’s date of admission in P2’s record. Repeat Violation: In a Correction Order that DHS issued on December 12, 2022, you were previously found in violation of this same rule. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain the information detailed above in P1 and P2’s participant records. On an ongoing basis, you must maintain compliance as required in this subpart. 3. Citation: Minnesota Rules, part 9555.9700, subpart 3. Violation: For two participants whose records were reviewed (P2 and P3), the license holder did not develop a written plan of care as required. The license holder did not develop a written plan of care for P2 and P3 that included provisions for quarterly review and quarterly revisions of the individual plan of care. Repeat Violation: In a Correction Order that DHS issued on December 12, 2022, you were previously found in violation of this same rule. Corrective Action Ordered: Within 30 days of receiving this order, you must develop written plans of care for P2 and P3 that includes provisions for quarterly review and quarterly revisions. On an ongoing basis, you must maintain compliance as required in this subpart. 4. Citation: Minnesota Rules, part 9555.9690, subpart 4. Violation: For one of three staff persons whose record was reviewed (SP3), the license holder did not provide in-service training annually as required. The license holder did not provide SP3 a review of parts 9555.9600 to 9555.9730 annually in 2024.
5. Citation: Minnesota Rules, part 9555.9710, subparts 1 and 7. Violation: The license holder did not offer services as required. a. The license holder did not provide a midmorning snack. b. The license holder did not maintain a family and social history in P3’s record that was updated annually in 2024. Repeat Violation: In a Correction Order that DHS issued on December 12, 2022, you were previously found in violation of this same rule.
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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