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May 8, 2026 Mohamed Jama, Authorized Agent Nicollet Senior Center LLC 3601 Nicollet Avenue Suite 100B License Number: 1117185 (Rule 223) CORRECTION ORDER Dear Mohamed Jama: On February 5, 2026, a licensing review of Nicollet Senior Center LLC located at 3601 Nicollet Avenue, 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 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.
2. Citation: Minnesota Rules, part 9555.9660, subpart 1. Violation: For one of three participants whose records were reviewed (P1, P2, and P3), the license holder did not include information in the participant’s record as required. The license holder did not include an application form in P1, P2, and P3’s record that included the participants’ source of referral. Repeat Violation: In a Correction Order that DHS issued on October 14, 2025, you were previously found in violation of this same rule. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain P1, P2, and P3’s source of referral in the participants record. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. 3. Citation: Minnesota Rules, part 9555.9700, subpart 3. Violation: For three participants whose records were reviewed (P1, P2, and P3), the license holder did not develop a written plan of care as required. The license holder did not develop written plans of care for P1, P2, and P3 that included an update of the preliminary service plan and additional services required by the participant. Repeat Violation: In a Correction Order that DHS issued on October 14, 2025, you were previously found in violation of this same rule. Corrective Action Ordered: Within 30 days of receiving this order, you must update P1, P2, and P3’s written plan of care to include an update of the preliminary service plan and additional services required by the participant. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. 4. Citation: Minnesota Rules, part 9555.9720, subpart 8. Violation: The license holder did not ensure safety as required. The license holder failed to ensure the areas used by participants were free from loose plaster and peeling paint, including peeling paint and chipped sheetrock throughout the center.
5. Citation: Minnesota Statutes, section 245A.02, subdivision 2a and Minnesota Rules, part 9555.9710, subparts 1 and 6. Violation: The license holder did not provide and offer adult day services as required. "Adult day care," "adult day services," and "family adult day services" means a program operating less than 24 hours per day that provides functionally impaired adults with an individualized and coordinated set of services including health services, social services, and nutritional services that are directed at maintaining or improving the participants' capabilities for self-care. Adult day care, adult day services, and family adult day services do not include programs where adults gather or congregate primarily for purposes of socialization, education, supervision, caregiver respite, religious expression, exercise, or nutritious meals. a. The license holder did not provide a coordinated set of services including social services and nutritional services. During the licensing review, licensors observed a lack of services in the following ways: · participants sitting on couches in silence; · activities were not being offered or facilitated; · meals were not offered or provided to participants; and · little to no interaction with staff. b. The license holder did not ensure the center provided refrigeration for dairy products and other perishable foods. At the time of the licensing review, licensors observed pre-packaged meals sitting on the kitchen counter between 12:02 and 2:20pm. c. The license holder did not serve a meal to participants who were at the center for more than 4-1/2 hours. At approximately 1:30pm, licensors observed no food had been provided to participants who had been at the center for more than 4-1/2 hours. Licensors asked the center director when they typically serve lunch, the center director told the licensors soon. Licensors spoke with the center director about the meals sitting on the counter, and the center director began to bag them and pass them out for people to take home. d. The license holder did not implement their monthly plan for diversified daily program activities. The license holder maintained an activity calendar that listed the following activities: · 10:30am to 11am: Brain games and snack; · 11am to 12:30pm: Lunch, prayer and reflection; · 12:30pm to 1pm: Social time and departure; · 12pm: Arrival and social tea time; · 12:30pm to 2pm: Lunch, prayer and reflection; and · 2pm to 2:30pm: Gentle chair yoga/stretching for seniors. These activities were not observed throughout the licensing review. Repeat Violation: In a Correction Order that DHS issued on October 14, 2025, you were previously found in violation of this same rule. 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. Recommendations The following recommendation is not a requirement of Minnesota Rules or laws governing your service or facility. These recommendations are provided to call your attention to areas where your facility is in minimum compliance with the requirements of rules or laws, but it would be advisable to strengthen your efforts in these areas. Failure to follow these recommendations will not result in a fine or action against your license at this time. However, should failure to follow recommendations result in a violation of rules or laws at a future date, you will be cited for noncompliance and may be subject to fines or action against your license. Areas of Minimal Compliance: Minnesota Rules, part 9555.9710, subpart 6. You must provide a monthly plan for diversified daily program activities. Program activities shall be designed to meet the needs and interests of the participants and shall include: · socialization activities, such as group projects and recreational activities; · cultivation of personal interests, such as arts, crafts, and music; and · activities designed to increase the participants knowledge and awareness of the environment and to enhance language and conceptual skills. You maintained a daily program activity plan that included the following: · 7am: Arrival and social tea time; · 9am: Breakfast (light, nutritious options); · 10am to 10:30am: Gentle chair yoga/stretching for seniors; · 10:30am to 11am: Brain games (dominoes or memory challenges) and snack; · 11am to 12:30pm: Lunch and prayer and reflection; · 12:30pm to 1pm: Social time and departure; · 12pm: Arrival and social tea time; · 12:30pm to 2pm: Lunch and prayer and reflection; · 2pm to 2:30pm: Gentle chair yoga/stretching for seniors; · 2:30 to 4:30pm: Brain games (dominoes or memory challenges) and snack; · 4:30pm to 5pm: Exercise and relaxation time; and · 5pm to 6pm: Social time and departure. You are licensed to operate from 7am to 7pm. Your daily program activity plan does indicate activities to be offered during all hours that you are licensed to operate and does not provide diversified daily program activities. Over seven hours of your current activity plan are focused on socialization, meals/eating, or religious expression. Recommendation: It is recommended that: · you update your activity calendar to include the diversified daily program activities that are detailed above; and · update your activity calendar to reflect your complete hours of operation. C. 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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