Minnesota

December 17, 2025

Hayad Mohamud, Authorized Agent

Jiicle Care Inc

830 Orange Avenue East, Unit #5

Saint Paul, Minnesota 55106

License Number: 1106728 (245D – HCBS)

CORRECTION ORDER

Dear Hayad Mohamud,

On September 4, 2025, a licensing review of Jiicle Care Inc located at 830 Orange Avenue East, Unit #5, 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.

Violation: For two of two people whose records were reviewed, (P1 and P2), the license holder did not establish and enforce a written program abuse prevention plan (PAPP) as required under section 626.557, subdivision 14.

The license holder provided intensive services to P1 and P2 at a location that was within the control of the license holder. The license holder failed to establish a written PAPP that assessed the population, the physical plant, and the environment within the control of the license holder and the location where licensed services were provided.

Corrective Action Ordered: Within 30 days of receiving this order, you must:

· establish and enforce a written PAPP for locations where licensed services are provided and are within your control. The plan must contain an assessment of the physical plant, its environment, and its population, identifying factors which may encourage or permit abuse, and a statement of specific measures to be taken to minimize the risk of abuse;

· provide an orientation to the PAPP for P1, P2, and all service recipients receiving services at these locations and maintain documentation of the orientation in each person’s record. If applicable, the service recipient’s legal representative must be notified of the orientation;

· provide staff persons providing direct support to persons at these locations with an orientation to the PAPPs. You must document this orientation in each staff person’s personnel record according to the requirements in 245D.095; and

· post a copy of the PAPP in a prominent location in the program and have available upon request to mandated reporters, persons receiving services, and legal representatives.

Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision.

2. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (b).

Violation: For two people whose records were reviewed (P1 and P2), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP) as required.

a. The license holder initiated P1’s services on December 18, 2024. The license holder did not develop an IAPP for P1 prior to or upon service initiation. The license holder developed P1’s IAPP on January 10, 2025. Additionally, the license holder did not develop an accurate IAPP for P1 as part of the individual program plan that included:

• an individualized assessment of P1’s susceptibility to abuse by other individuals including other vulnerable adults and P1’s risk of abusing other vulnerable adults;

• statements of the specific measures to be taken to minimize the risk of abuse to P1 and other vulnerable adults; and

• the specific actions the license holder would take to minimize the risk of abuse to P1 within the scope of licensed services.

The license holder maintained an IAPP for P1 that indicated P1 had no vulnerabilities to abuse; however, this was not consistent with information documented elsewhere in P1’s plan.

b. The license holder assessed P2 as susceptible to sexual abuse, physical abuse, and financial exploitation in P2’s IAPP dated February 21, 2025. The license holder did not identify specific measures the program would take to minimize the risk of abuse within the scope of licensed services.

Corrective Action Ordered: Within 30 days of receiving this order, you must:

· review and revise P1’s IAPP to include the above-mentioned information;

· document in P2’s IAPP the specific measures to be taken to minimize the risk of abuse in all assessed areas.

Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision.

3. Citation: Minnesota Statutes, section 245D.10, subdivision 4, paragraph (b).

Violation: For two people whose records were reviewed (P1 and P2), the license holder did not inform the case manager of policies and procedures as required.

a. The license holder did not inform P1’s case manager and provide copies of the policies and procedures affecting P1’s rights within five working days of service initiation.

b. The license holder initiated P2’s intensive service on February 20, 2025. The license holder did not inform P2’s case manager of the policies and procedures affecting a person’s rights within five days of service initiation. The policies and procedures were provided to P2’s case manager on April 30, 2025.

Corrective Action Ordered: Within 30 days of receiving this order, you must inform P1’s case manager and provide copies of the above mentioned policies and procedures. Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision.

4. Citation: Minnesota Statutes, section 245D.05, subdivision 1.

Violation: For one person whose record was reviewed (P1), the license holder did not document health needs as required.

The license holder was assigned the responsibility of meeting P1’s health service needs in P1’s support plan addendum. The license holder did not maintain documentation on how P1’s health needs would be met, including a description of the procedures the license holder would follow in order to provide medication assistance and assist with or coordinate medical, dental, and other health service appointments.

Corrective Action Ordered: Within 30 days of receiving this order, you must document and maintain the above-mentioned information in P1’s record. Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision.

5. Citation: Minnesota Statutes, section 245D.07, subdivision 1a.

Violation: For one person whose record was reviewed (P2), the license holder did not provide services as assigned in the support plan and in compliance with the requirements of this chapter and federal waiver plans as required.

a. The license holder maintained documentation that indicated the license holder would assist P1 with medication reminders for 30 minutes every day to be included as part of P1’s service agreement. The license holder stated that P1 was independent with self-administering medication, and staff did not provide reminders as P1 did not require this support. The license holder did not provide services in compliance with federal waiver plans.

b. P2’s support plan, dated August 1, 2025, documented the license holder was assigned responsibility for administering P2’s medications. P2’s support plan addendum, developed by the license holder, documented that the license holder would provide P2 with medication assistance. The license holder did not provide services in response to P2’s identified needs as specified in P2’s support plan.

c. The license holder was assigned the responsibility to provide P1 with 7 direct contact hours and 1 hour of remote support daily with flexible use of the approved hours within a weekly service period. Documentation maintained by the license holder for the period of May 21, 2025, through September 4, 2025, indicated that the license holder consistently did not provide P1 with the assigned 7 direct contact hours daily across multiple consecutive weeks to meet the weekly service period requirements. The license holder did not provide services as assigned to P1.

d. The license holder was assigned the responsibility to provide P2 with 18 direct contact hours daily with flexible use of the approved hours within a weekly service period. Documentation maintained by the license holder for the period of May 10, 2025, through September 4, 2025, indicated that the license holder consistently did not provide P2 with the assigned 18 direct contact hours daily across multiple consecutive weeks to meet the weekly service period requirements. The license holder did not provide services as assigned to P2.

Corrective Action Required: Corrective Action Ordered: Within 30 days of receiving this order, you must provide services to P1 and P2 as they are assigned in P1’s and P2’s support plan and support plan addendum. Compliance with this subdivision will be monitored onsite. On an ongoing basis, you must maintain compliance as required in this subdivision.

6. Citation: Minnesota Statutes, section 245D.071, subdivision 3, paragraph (a).

Violation: For one person whose record was reviewed (P1), the license holder did not complete a preliminary support plan addendum as required.

The license holder initiated P1’s services on December 18, 2024. The license holder did not complete a preliminary support plan addendum based on the support plan within 15 calendar days of service initiation.

Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. Compliance with this order will be reviewed at an upcoming compliance monitoring visit.

7. Citation: Minnesota Statutes, section 245D.071, subdivision 3, paragraph (b).

Violation: For one person whose record was reviewed (P1), the license holder did not complete assessments as required.

The license holder did not assess P1’s ability to self-manage symptoms or behavior that may otherwise result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension or termination of services by the license holder, or other symptoms or behaviors that may jeopardize the health and safety of the person or others. Additionally, the license holder’s assessments of P1’s ability to self-manage health and medical needs did not produce information about the person that described the person’s behaviors or symptoms.

Corrective Action Ordered: Within 30 days of receiving this order, you must:

· complete the required assessments for P1 that produce information about the person that describes the person’s overall strengths, functional skills, and abilities, and behaviors or symptoms; and

· review the results of the assessments with P1, P1’s case manager and members of the support team. You must document this review.

Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision.

8. Citation: Minnesota Statutes, section 24D.071, subdivision 3, paragraph (c).

Violation: For two people whose records were reviewed (P1 and P2), the license holder did not meet initial service planning requirements for intensive support services as required.

a. The license holder initiated P1’s services on December 18, 2024. The license holder did not meet with P1, P1’s case manager, and other members of P1’s support team within 45 days of service initiation to determine the following:

· opportunities to develop and maintain essential and life-enriching skills, abilities, strengths, interests, and preferences;

· opportunities to develop and strengthen personal relationships with other persons of the person choice in the community; and

· a discussion of how technology might be used to meet the person's desired outcomes including:

o a statement regarding any decision that is made regarding the use of technology and a description of any further research that needs to be completed before a decision regarding the use of technology can be made.

b. The license holder initiated P2’s services on February 20, 2025. The license holder did not meet with P2, P2’s case manager, and other members of P2’s support team within 45 days of service initiation to determine the following:

· opportunities to develop and maintain essential and life-enriching skills, abilities, strengths, interests, and preferences;

· opportunities for community access, participation, and inclusion in preferred community activities;

· opportunities to develop and strengthen personal relationships with other persons of the person’s choice in the community; and

· a discussion of how technology might be used to meet the person's desired outcomes including:

Corrective Action Ordered: Within 30 days of receiving this order, you must meet with P1, P1’s case manager, and P2, P2’s case manager, and other members of their support teams to determine the information listed above. You must document the date of the meeting, the names of who attended the meeting and what was determined at the meeting in P1’s and P2’s support plan addendum. Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision.

9. Citation: Minnesota Statutes, section 245D.071, subdivision 4.

Violation: For two people whose records were reviewed (P1 and P2), the license holder did not develop service outcomes and supports as required.

a. The license holder did not document the following supports and methods for P1 to accomplish the outcome developed on January 30, 2025:

· the methods or action that will be used to support the person and to accomplish outcomes, including information about:

o any changes or modifications to the physical and social environments necessary when the service supports were provided;

o any equipment or materials required; and

o techniques that were consistent with the person’s communication mode and learning style;

· the measurable and observable criteria for identifying when the desired outcome had been achieved;

· how data would be collected;

· the projected starting date for implementing the supports and methods and the date by which progress towards accomplishing the outcomes would be reviewed and evaluated; and

· the names of the staff or position responsible for implementing the supports and methods.

b. The license holder did not document the following supports and methods for P2 to accomplish the outcome developed on April 30, 2025:

· the methods or action that will be used to support the person and to accomplish outcomes, including information about:

o any changes or modifications to the physical and social environments necessary when the service supports were provided;

o any equipment or materials required; and

o techniques that were consistent with the person’s communication mode and learning style;

· the measurable and observable criteria for identifying when the desired outcome had been achieved; 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 a service plan that documents the service outcomes and supports listed above for P1 and P2;

· audit all persons served records to ensure all persons receiving intensive services have service plans that document the service outcomes and supports listed above and maintain documentation of this audit;

· train all staff persons who provide direct contact to persons receiving intensive services on how to implement the service outcomes and supports for each person. You must maintain documentation of this training in staff persons’ personnel records according to the requirements in 245D.095, subdivision 5.

Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in this subdivision.

10. Citation: Minnesota Statutes, section 245D.095, subdivision 3

Violation: For one person whose record was reviewed (P1), the license holder did not maintain service recipient records as required.

The license holder did not maintain progress or daily log notes for P1 that were recorded by the program from December 18, 2024, through May 20, 2025.

Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision.

11. Citation: Minnesota Statutes, section 245D.09, subdivisions 4 and 4a.

Violation: For two staff people whose records were reviewed (SP2 and SP3), the license holder did not provide orientation training as required.

a. SP1 began in a role providing direct contact in February 2025. The license holder did not provide the following orientation training:

· 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 behaviors are not effective for reducing or eliminating symptoms or undesired behavior, and why such procedures are not safe; and

· basic first aid.

b. SP2 began in a role related to managing the provision of direct support services in June 2024. The license holder did not provide the following orientation training within 60 days of hire:

The license holder failed to provide SP1 and SP2 with the following trainings within 60 days of hire:

· a job description and how to complete specific job functions including:

o responding to and reporting incidents as required in Minnesota Statutes, section 245D.06, subdivision 2,

o following safety practices established by the license holder and as required in section 245D.06, subdivision 2; SP2 received this training on February 21, 2025;

· the license holder’s current policies and procedures, including their location and access, and staff responsibilities relate to implementation of those policies and procedures; SP2 received this training on February 21, 2025;

· data privacy requirements according to Minnesota Statutes, section 13.01 to 13.10 and 13.46, the federal Health Insurance Portability and Accountability Act of 1996 (HIPPA), and staff responsibilities related to complying with data privacy practices; SP2 received this training on December 7, 2024;

· 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; SP2 received this training on December 7, 2024;

· sections 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; SP2 received this training on December 8, 2024;

· 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 services provided by the staff; SP2 received this training on December 8, 2024;

· 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; SP2 received this training on February 21, 2025; and

· strategies to minimize the risk of sexual violence, including concepts of health relationships, consent, and bodily autonomy of people with disabilities. SP2 received this training on December 7, 2024.

c. SP3 was hired on October 31, 2024. The license holder did not provide the following orientation training within 60 days of hire:

· The license holder’s policies and procedures, including their location and access, and staff responsibilities relate to implementation of those policies and procedures;

· basic first aid.

d. The license holder did not review and provide instruction to SP1 and SP3 on the person’s support plan or support plan addendum as it relates to the responsibilities assigned to the license holder, and the person’s individual abuse prevention plan, to achieve and demonstrate an understanding of the person as a unique individual, and how to implement those plans before having unsupervised direct contact with a person served by the program.

Corrective Action Ordered: SP3 is no longer employed by the license holder. Within 30 days of receiving this order, you must:

· provide SP1 with the above mentioned trainings;

· provide SP2 with training on 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; and 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.

· you must maintain documentation of the trainings in SP1’s and SP2’s personnel records.

· you must audit all personnel records and ensure that staff providing direct contact have received orientation training as required and is documented in each staff’s personnel record. You must maintain documentation of this audit.

Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance with this subdivision as required.

12. Citation: Minnesota Statutes, section 245D.095, subdivision 5.

Violation: For 3 staff persons whose record were reviewed (SP1-SP3), the license holder did not maintain personnel records as required.

a. The license holder did not maintain documentation in SP1’s personnel record sufficient to determine SP1’s first supervised and unsupervised direct contact with a person served by the program.

b. The license holder did not maintain documentation in SP2’s and SP3’s personnel record sufficient to determine SP2’s and SP3’s date of hire, the employee’s first supervised direct contact with a person served by the program, and the date of first unsupervised direct contact with a person served by the program.

Corrective Action Ordered: SP3 is no longer employed by the license holder. Within 30 days of receiving this order, you must audit all personnel records and ensure the above mentioned information is documented in each personnel record. Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance with this subdivision as required.

13. Citation: Minnesota Statutes, section 245D.06, subdivision 9.

Violation: The license holder did not maintain policies and procedures for emergency use of manual restraint as required.

The license holder did not maintain an emergency use of manual restraints (EUMR) policy that identified the person or position responsible for reporting an emergency use of manual restraint.

Corrective Action Ordered: Within 30 days of receiving this order, you must:

· develop a policy that identifies the person or position responsible for reporting an emergency us of manual restraint;

· provide an orientation of the EUMR policy to all service recipients, their legal representatives, if applicable, and case managers and maintain documentation of the orientation in each person’s record; and

· provide staff persons providing direct support to persons at these locations with an orientation to the policy. You must document this orientation in each staff person’s personnel record according to the requirements in 245D.095.

Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance with this subdivision as required.

14. Citation: Minnesota Statutes, section 245D.10, subdivision 2.

Violation: The license holder did not develop a policy and procedures that promoted service recipient rights by providing a simple complaint process for persons served by the program and their authorized representatives to bring a grievance as required.

The license holder established a grievance policy dated December 17, 2024, that identified both SP1 and SP2 as the highest level of authority in the program. The license holder did not establish a grievance policy that allowed a person to bring a complaint to the highest level of authority in the program and that provides the name, address, and telephone of that person.

Corrective Action Ordered: Within 30 days of receiving this order, you must:

· develop a policy that identifies the highest level of authority in the program that provides the name, address, and telephone number of that person;

· provide an orientation of the grievance policy to all service recipients, their legal representatives, if applicable, and case managers and maintain documentation of the orientation in each person’s record; and

Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance with this subdivision as required.

15. Citation: Minnesota Statutes, section 245D.11, subdivision 1.

Violation: The license holder did not maintain policies and procedures for intensive support services as required.

The license holder did not establish and maintain an emergency response, reporting, and review policy that included a description of the actions staff would take in the event of a fire, including the designated meeting place when evacuating outside. Additionally, the license holder did not include a description of the actions staff will take in even of a power failure, including where to report power failures, and where emergency supplies are located.

Corrective Action Ordered: Within 30 days of receiving this order, you must:

· review and revise your emergency response, reporting, and review policy to include the above mentioned information;

Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance with this subdivision as required.

16. Citation: Minnesota Statutes, section 245D.081, subdivisions 2 and 3.

Violation: The license holder did not ensure program coordination and evaluation as required.

a. The license holder did not ensure that the designated coordinator (SP1) provided supervision, support, and evaluation of the following activities. See citations 1 through 15 for the designated coordinator’s failure to:

· oversee the license holder's responsibilities assigned in the person's support plan and the support plan addendum; and

· instruction and assistance to direct support staff implementing the support plan and the service outcomes, including direct observation of service delivery sufficient to assess staff competency.

b. The license holder did not ensure that the designated manager (SP1) provided program management and oversight of the services provided. See citations 1 through 15 for the designated manager’s failure to:

· maintain a current understanding of the licensing requirements sufficient to ensure compliance throughout the program as identified in section 245A.04, subdivision 1, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21, paragraph (b);

· ensure the duties of the designated coordinator are fulfilled according to the requirements in subdivision 2; and

· ensuring staff competency requirements are met according to the requirements in section 245D.09, subdivision 3, and ensuring staff orientation and training is provided according to the requirements in section 245D.09, subdivisions 4, 4a, and 5.

Corrective Action Ordered: Within 30 days of receiving this order, you must:

· ensure the staff person(s) identified as designated coordinator and designated manager for the program understands and has acknowledged their responsibilities as required in Minnesota Statutes, section 245D.081, subdivision 2 and 3; and

· maintain a signed document that the designated coordinator(s) and designated manager(s) have acknowledged their responsibilities as required in Minnesota Statutes, section 245D.081, subdivisions 2 and 3 in your program’s records.

Compliance with this order will be reviewed at an upcoming compliance monitoring visit. On an ongoing basis, you must maintain compliance as required in these subdivisions.

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.

Nicole Riley, Senior Human Services Licensor

Licensing Division

Office of Inspector General

651-431-3657

PO Box 64242 • Saint Paul, Minnesota • 55164-0242 • An Equal Opportunity and Veteran Friendly Employer
https://mn.gov/dhs/general-public/licensing/