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September 16, 2025 Salah Mohamed, Authorized Agent Karibu Care Services LLC 1027 7th Street Northwest Suite 206 Rochester, Minnesota 55901-2666 License Number: 1106816 (245D – HCBS) CORRECTION ORDER Dear Salah Mohamed: On August 21, 2025 a licensing review of Karibu Care Services LLC, located at 1027 7th Street Northwest Suite 206, 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, paragraph (c). Violation: For one of 2 persons whose record was reviewed (P2), the license holder did not develop a service plan that documented the service outcomes and supports as required. The license holder did not submit the assessment and support plan addendum to P2’s legal representative and case manager and obtain dated signatures from P2's legal representative and case manager to document completion and approval of the assessment and support plan addendum within twenty working days of the initial planning meeting on April 6, 2023. Corrective Action Ordered: Within 30 days of receiving this order you must submit a service plan that documents the service outcomes and supports and obtain signatures from P2’s legal representative and case manager to document approval of the assessment and support plan addendum. If, within ten working days of the submission of the assessment or support plan addendum, P2’s legal representative or case manager has not signed and returned the assessment and support plan addendum or has not proposed written modifications to the license holder's submission, the submission is deemed approved and the assessment and support plan addendum become effective and remain in effect until the legal representative or case manager submits a written request to revise the assessment or support plan addendum. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.095, subdivision 3, paragraph (b), clause (3). Violation: For two persons whose records were reviewed (P1 and P2), the license holder did not maintain a service recipient record as required. The license holder did not maintain a signed statement authorizing the license holder to act in a medical emergency when P1’s and P2’s legal representative cannot be reached or is delayed in arriving. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain a signed statement from P1’s and P2’s legal representatives authorizing you to act in a medical emergency. On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statues, section 245D.10, subdivision 4, paragraph (b). Violation: For one person whose record was reviewed (P1), the license holder did not inform and provide copies of policies and procedures as required. The license holder did not inform P1’s case manager of the policies and procedures affecting a person’s rights under section 245D.04 and did not provide copies of the policies and procedures to P1’s case manager within five working days of service initiation. Correction Action Ordered: Within 30 days of receiving this order, you must inform P1’s case manager of the policies and procedures affecting P1’s rights and provide copies of the policies and procedures to P1’s case manager. On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Rules, chapter 9544.0030, subpart 1. Violation: For one person whose record was reviewed (P2), the license holder did not evaluate positive support strategies as required. The license holder did not evaluate P2’s positive support strategies with P2 every six months. Corrective Action Ordered: Within 30 days of receiving this order, you must evaluate the positive support strategies documented in P2’s support plan addendum with P2. Additionally, you must evaluate with P2 whether changes to the identified positive support strategies are needed, and, if so, make appropriate changes. On an ongoing basis, you must maintain compliance as required in this subpart. 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 ATTN: Legal Unit Licensing Division PO Box 64242 St. Paul, MN 55164-0242 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. Nichol Ginther, Human Services Licensor Licensing Division Office of Inspector General 651-431-4822
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