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October 2, 2025 Deq Mohamud Ahmed, Authorized Agent ACTIVE CARE SERVICES LLC 821 Raymond Avenue Suite 400 Saint Paul, Minnesota 55114 License Number: 1102623 (245D – HCBS) CORRECTION ORDER Dear Deq Mohamud Ahmed: On September 4, 2025, a licensing review of ACTIVE CARE SERVICES LLC, located at 821 Raymond Avenue, Saint Paul, 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 245A.65, subdivision 2, paragraph (b). Violation: For one of four persons whose record was reviewed (P4), the license holder did not develop an individual abuse prevention plan (IAPP) as required. The license holder developed an IAPP for P4 that indicated the person was susceptible to abuse. The license holder did not include statements of the specific measures to be taken to minimize the risk of abuse to P4 and other vulnerable adults. Corrective Action Ordered: Within 30 days of receiving this order, you must review and revise the IAPP for P4 to include statements of the specific measures to be taken to minimize the risk of abuse to the person and other vulnerable adults. Additionally, you must provide P4 and their case manager the opportunity to participate in the development of the IAPP. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245D.04, subdivision 1. Violation: For three persons whose records were reviewed (P1-P3), the license holder did not provide the service recipient rights as required. Minnesota Statutes, section 245A.02, subdivision 2b defines “annual” or “annually” to mean prior to or within the same month of the subsequent calendar year. a. The license holder did not provide P1 and P2 a written notice that identified the service recipient rights, and an explanation of those rights annually in 2023. The license holder provided P1 the required written notice in September 2024. The license holder provided P2 the required written notice in November 2022 and March 2024. b. The license holder did not provide P3 a written notice that identified the service recipient rights, and explanation of those rights annually in 2023 and 2025. The license holder provided P3 the required written notice in November 2022, March 2024 and May 2025. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, section 245D.05, subdivision 1, paragraph (b). Violation: For one person whose record was reviewed (P3), the license holder did not provide health services as required. The license holder did not maintain documentation on how P3’s health needs would be met, including a description of the procedures to follow in order to use medical equipment, devices, or adaptive aides and technology safely and correctly according to written instructions from a licensed health professional. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain the above documentation for P3. On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.07, subdivision 2, paragraph (c). Violation: For one person whose record was reviewed (P3), the license holder did not provide basic support services planning as required. The license holder did not review and revise as needed P3’s preliminary support plan addendum to document the services that would be provided including how, when, and by whom services would be provided, and the person responsible for overseeing the delivery and coordination of services within 60 calendar days of service initiation. Corrective Action Ordered: Within 30 days of receiving this order, you must review and revise P3’s support plan addendum to document the information detailed above. Additionally, you must provide orientation on the updates to P3’s support plan addendum to all staff that provide direct support to P3. On an ongoing basis, you must maintain compliance as required in this subdivision. 5. Citation: Minnesota Statutes, section 245D.071, subdivision 4, paragraph (b). Violation: For one person whose record was reviewed (P1), the license holder did not document service outcomes and supports as required. The license holder did not document the following supports and methods to be implemented to support P1 and accomplish outcomes related to acquiring, retaining, or improving skills and physical, mental, and emotional health and well-being: · the methods or actions that will be used to support the person and to accomplish the service outcomes, including information about; o any changes or modifications to the physical and social environments necessary when the service supports are provided; o any equipment and materials required; and o techniques that are consistent with the person’s communication mode and learning style; · the measurable and observable criteria for identifying when the desired outcomes had been achieved and how the data would be collected; · the projected starting date for implementing the supports and methods and the date by which progress towards accomplishing the outcomes will be reviewed and evaluated; and · the names of the staff or position responsible for implementing the supports and methods. Corrective Action Ordered: Within 30 days of receiving this order, you must develop and document supports and methods that include the information listed above in P1’s support plan addendum. On an ongoing basis, you must maintain compliance as required in this subdivision. 6. Citation: Minnesota Statutes, section 245D.071, subdivision 5. Violation: For one person whose record was reviewed (P1), the license holder did not complete service plan review and evaluation as required. a. The license holder did not to meet with P1, P1’s legal representative, and P1’s case manager annually in 2024 and 2025 as required according to P1’s support plan addendum. b. The license holder did not to have a discussion with P1’s support team of how technology might be used to meet P1’s outcomes at least once per year in 2023 and 2024. Corrective Action Ordered: Within 30 days of receiving this order, you must: · discuss with P1, P1’s legal representative and P1’s case manager and other members of P1’s support team of how technology might be used to meet P1's desired outcomes; and; · document a summary of this discussion in P1’s support plan that includes: o a statement regarding any decision that is made regarding the use of technology; and o a description of any further research that needs to be completed before a decision regarding the use of technology can be made. On an ongoing basis, you must maintain compliance as required in this subdivision. 7. Citation: Minnesota Rules, 9544.0030, subpart 1. Violation: For four persons whose records were reviewed (P1-P4), the license holder did not evaluate positive support strategies as required. The license holder did not review and evaluate the positive support strategies with P1-P4 at least every six months. Corrective Action Ordered: Within 30 days of receiving this order, you must: · review and evaluate the identified positive support strategies with P1-P4; and · based upon the results of the evaluation determine whether changes are needed in the positive support strategies used, and if so, make appropriate changes. On an ongoing basis, you must maintain compliance as required in this subpart. 8. Citation: Minnesota Statutes, section 245D.09, subdivision 4 and 4a. Violation: For three of six staff persons whose records were reviewed (SP3, SP5 and SP6), the license holder did not provide and ensure completion of orientation as required. a. The license holder did not ensure SP3 and SP5 received orientation on the following topics within 60 calendar days of hire: · the safe and correct use of manual restraint on an emergency basis according to the requirements in section 245D.061 or successor provisions, and what constitutes the use of restraints, time out, and seclusion, including chemical restraint; and · strategies to minimize the risk of sexual violence, including concepts of healthy relationships, consent, and bodily autonomy of people with disabilities. b. The license holder did not ensure SP5 reviewed and received instruction on the person’s support plan addendum as it relates to the responsibilities assigned to the license holder, including the use of SP5’s wheelchair. c. The license holder did not ensure SP6 received orientation on strategies to minimize the risk of sexual violence, including concepts of healthy relationships, consent, and bodily autonomy of people with disabilities within 60 calendar days of hire. Corrective Action Ordered: Within 30 days of receiving this order, you must: · provide SP3, SP5 and SP6 with orientation on the above-mentioned topics; and · maintain the documentation of the completed trainings in SP3, SP5 and SP6’s personnel record according to Minnesota Statutes, section 245D.095, subdivision 5. On an ongoing basis, you must maintain compliance as required in this subdivision. 9. Citation: Minnesota Statutes, section 245D.09, subdivision 5. Violation: For two staff persons whose records were reviewed (SP3 and SP4), the license holder did not provide annual training as required. a. The license holder did not provide SP3 with the following annual training in 2024: · data privacy requirements according to sections 13.01 to 13.10 and 13.46, the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff responsibilities related to complying with data privacy practices; · the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights according to the requirements in section 245D.04; · sections 245A.65, 245A.66, and 626.557 and chapter 260E governing maltreatment reporting and service planning for children and vulnerable adults, and staff responsibilities related to protecting persons from maltreatment and reporting maltreatment. This orientation must be provided within 72 hours of first providing direct contact services and annually thereafter according to section 245A.65, subdivision 3; · the principles of person-centered service planning and delivery as identified in section 245D.07, subdivision 1a, and how they apply to direct support service provided by the staff person; · the safe and correct use of manual restraint on an emergency basis according to the requirements in section 245D.061 or successor provisions, and what constitutes the use of restraints, time out, and seclusion, including chemical restraint; · staff responsibilities related to prohibited procedures under section 245D.06, subdivision 5, or successor provisions, why such procedures are not effective for reducing or eliminating symptoms or undesired behavior, and why such procedures are not safe; · basic first aid; and · strategies to minimize the risk of sexual violence, including concepts of healthy relationships, consent, and bodily autonomy of people with disabilities. b. The license holder did not provide SP4 with the following annual trainings in 2023 and 2024: · data privacy requirements according to Minnesota Statutes, sections 13.01 to 13.10 and 13.46, the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff responsibilities related to complying with data privacy practices; · the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights according to the requirements in Minnesota Statutes, section 245D.04; · sections 245A.65, 245A.66, and 626.557 and chapter 260E, governing maltreatment reporting and service planning for children and vulnerable adults, and staff responsibilities related to protecting persons from maltreatment and reporting maltreatment; · the principles of person-centered service planning and delivery as identified in Minnesota Statutes, section 245D.07, subdivision 1a, and how they applied to direct support service provided by the staff person; · the safe and correct use of manual restraint on an emergency basis according to the requirements in section 245D.061 and what constitutes the use of restraints, time out, and seclusion, including chemical restraint; · staff responsibilities related to prohibited procedures under section 245D.06, subdivision 5, why such procedures are not effective for reducing or eliminating symptoms or undesired behavior, and why such procedures are not safe; · basic first aid; and · strategies to minimize the risk of sexual violence, including concepts of healthy relationships, consent, and bodily autonomy of people with disabilities. c. The license holder did not provide SP4 with strategies to minimize the risk of sexual violence, including concepts of healthy relationships, consent, and bodily autonomy of people with disabilities in 2025. Corrective Action Ordered: Within 30 days of receiving this order, you must provide SP4 with strategies to minimize sexual violence, including concepts of health relationships, consent, and bodily autonomy of people with disabilities. You must document SP4’s training according to Minnesota Statutes, section 245D.095, subdivision 5. 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 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. Tammi Mitei, HCBS Human Services Licensor Licensing Division Office of Inspector General 651-431-6341
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