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May 19, 2026 Mohamed Keynan, Authorized Agent Cedar Adult Day Care Services Center 415 Cedar Avenue South License Number: 1097782 (Rule 223) CORRECTION ORDER Dear Mohamed Keynan: On May 7, 2026, a licensing review of Cedar Adult Day Care Services Center located at 415 Cedar 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.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 first, middle, and last name of the recipient; · the time of day that the recipient was dropped off; and · the time of day that the recipient was picked up. Corrective Action Ordered: Immediately, you must maintain documentation of actual attendance for each adult day service recipient. Concerns regarding the provider’s attendance documentation and billing for adult day care services were referred to the Department of Human Services, Office of Inspector General, Program Integrity and Oversight Division. Compliance with this order will be reviewed onsite. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (b) and Minnesota Rules, part 9555.9700, subpart 3. Violation: For three of three participants whose records were reviewed (P1, P2, and P3), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP). a. The license holder did not develop an IAPP for P1 and P2 as part of P1 and P2’s initial individual program plan or service plan that included: · an individualized assessment of P1 and P2-’s susceptibility to abuse by other individuals, including other vulnerable adults; · P1 and P2’s risk of abusing other vulnerable adults; and · statements of the specific measures to be taken to minimize the risk of abuse to P1 and P2, and other vulnerable adults. b. The license holder did not review P1-P3’s IAPPs quarterly as part of the review of the program plan or service plan. c. The license holder did not review P3’s IAPP with P3’s interdisciplinary team, at least annually, using the individual assessment and any reports of abuse relating to the person.
· review P3’s IAPP quarterly as part of the review of the program plan or service plan and document the review and date the review occurred; and · review P3’s IAPP annually with P3’s interdisciplinary team and document the review. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subdivision and subpart. 3. Citation: Minnesota Rules, part 9555.9660, subpart 1. Violation: For three participants whose records were reviewed (P1, P2, and P3), the license holder did not include information in the participant’s written record as required. a. The license holder did not include the following information in P1’s participant record: · an application form signed by P1 or P1’s caregiver that included: o P1’s source of referral; o the name and telephone number of the person to call in case of an emergency involving P1, and name and number of another person to call if that person cannot be reached; · a medical report, dated within the three months prior to or 30 days after P1’s admission to the center signed by a physician or signed by a physician assistant or registered nurse and cosigned by a physician. P1 was admitted to the center on June 3, 2025, the license holder maintained a medical report signed by a physician assistant, that was dated April 21, 2026; · P1’s service agreement with the center, that specified the responsibilities of the person and the center with respect to payment for and provision of services and signed by P1 or P1’s caregiver and the center director; · participation reports and progress notes that are recorded at least monthly; and · a statement signed by the center director and P1 at the time of admission specifying the basis on which P1 was determined to be capable or incapable of taking appropriate actions for self-preservation under emergency conditions. b. The license holder did not include the following information in P2’s participant record: · an application form signed by P2 or P2’s caregiver that included: o P2’s living arrangement, o a telephone number for P2; o P2’s source of referral; o the name and telephone number of the person to call in case of an emergency involving P2, and name and number of another person to call if that person cannot be reached; o the name and telephone number of P2’s physician or medical provider; · a medical report, dated within the three months prior to or 30 days after P2’s admission to the center signed by a physician or signed by a physician assistant or registered nurse and cosigned by a physician, that included: o a report on a physical examination; o a medical history of P2; o indication of dietary restrictions and medication regimen, including the need for medication assistance, that apply to P2; o a release signed by the physician indicating whether P2 may engage in a structured exercise program; and o documentation that P2 was free of communicable disease or infestations, as specified in parts 4605.7000 to 4605.7090, that would endanger the health of other participants; · P2’s service agreement with the center, that specified the responsibilities of the person and the center with respect to payment for and provision of services and signed by P2 or P2’s caregiver and the center director; · participation reports and progress notes that were recorded at least monthly; · notes on special problems, medication changes, and need for medication assistance that apply to P2; and · a statement signed by the center director and P2 at the time of admission specifying the basis on which P2 was determined to be capable or incapable of taking appropriate actions for self-preservation under emergency conditions. c. The license holder did not include the following information in P3’s participant record: · a report on a physical examination for P3 that was updated annually in 2025; and · participation reports and progress notes that were recorded at least monthly.
4. Citation: Minnesota Rules, part 9555.9700, subpart 2. Violation: For two participants whose records were reviewed (P1 and P2), the license holder did not complete initial service planning as required. a. The license holder did not develop a needs assessment for P1 within 30 days of P1’s admission to the center. The license holder maintained a needs assessment that was not dated; therefore, it was unable to be determined the date the needs assessment was conducted. b. The license holder did not develop a needs assessment for P2 that included P2's physical status, determined by observation, from the intake screening interview, and from the medical report received from P2's physician. c. The license holder did not develop a preliminary service plan for P1 within 30 days of admission to the center that included: · P1’s nutritional needs, and where applicable, dietary restrictions; and · the role of P1’s caregiver or caregivers in carrying out the service plan. The license holder maintained a preliminary service plan for P1 that was not dated; therefore, it was unable to be determined the date the preliminary service plan was conducted.
· develop needs assessments for P1 and P2 that includes the information detailed above; · develop a preliminary service plan for P1 that includes the information detailed above. Compliance with this order will be reviewed onsite. On an ongoing basis, you must maintain compliance as required in this subpart. 5. 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. a. The license holder did not develop a written plan of care for P1 within 90 days of P1’s admission to the center that included: · an update of the preliminary service plan and additional services required by P1; · short and long term objectives for P1 stated in concrete, measurable and time specific outcomes; and · provisions for quarterly reviews and quarterly revisions of the individual plan of care. The license holder maintained a plan of care for P1 that was not dated; therefore, it was unable to be determined the date the plan of care was conducted. b. The license holder did not develop a written plan of care for P2 that included: · an update of the preliminary service plan and additional services required by P2; · short and long term objectives for P2 stated in concrete, measurable and time specific outcomes; and · provisions for quarterly reviews and quarterly revisions of the individual plan of care. c. The license holder did not develop a written plan of care for P3 that included provisions for quarterly reviews and quarterly revisions of the individual plan of care. Repeat Violation: In a Correction Order that DHS issued on February 3, 2023, you were previously found in violation of this same rule. 6. Citation: Minnesota Rules, part 9555.9650, items A and B. Violation: For one of two staff persons whose records were reviewed (SP2), and two consultants whose records were reviewed, the license holder did not maintain personnel records as required. a. The license holder did not maintain documentation of an annual performance evaluation for SP2. b. The license holder did not maintain a copy of a signed contract or letter of appointment specifying conditions and terms of employment for the registered dietician. c. The license holder did not maintain documentation that the person under contract meets any licensure registration, or certification requirements required to perform the services specified in the contract for the registered nurse and registered dietician. Repeat Violation: In a Correction Order that DHS issued on February 3, 2023, 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 personnel records. Compliance with this order will be reviewed onsite. On an ongoing basis, you must maintain compliance as required in these items. 7. Citation: Minnesota Rules, part 9555.9690, subpart 4. Violation: For one staff person whose record was reviewed (SP2), the license holder did not provide in-service training annually as required. The license holder did not provide SP2 with eight hours of annual training as required. Corrective Action Ordered: Within 30 days of receiving this order, you must provide SP2 with eight hours of in-service training. Compliance with this order will be reviewed onsite. On an ongoing basis, you must maintain compliance as required in this subpart. 8. Citation: Minnesota Rules, part 9555.9710, subpart 1, 3 and 7. Violation: The license holder did not provide services as required. a. The license holder did not maintain a current and accurate contract with their food service provider that prepared food off-site. b. The license holder did not offer a midmorning and a midafternoon snack. c. The license holder did not ensure the menus for all meals and snacks were approved by a registered dietitian and met all applicable state rules and laws and United States Department of Agriculture regulations. d. The license holder did not maintain a record indicating the menu for all meals served for at least six months. e. The license holder did not ensure a registered nurse provided consultation and review of the health services at least monthly, including: · monitoring participants’ health status and reporting changes to the participant’s caregiver and physician and the center director; · educating and counseling participants on good health practices; and · maintaining a listing of professional health resources available for referrals as needed by people. f. The license holder did not maintain a family and social history for P3 that was updated annually in 2026. The license holder maintained a social history for P3 that was most recently updated in April 2025. Repeat Violation: In a Correction Order that DHS issued on February 3, 2023, you were previously found in violation of this same rule. Corrective Action Ordered: Within 30 days of receiving this order, you must maintain, offer and ensure the services detailed above are provided. Compliance with this order will be reviewed onsite. On an ongoing basis, you must maintain compliance as required in these subparts. 9. Citation: Minnesota Rules, part 9555.9720, subparts 7 and 8.
a. The license holder did not ensure equipment and furniture was in good repair, including: · cracked and broken bathroom tiles; and · a water leak from a toilet in the women’s restroom. b. The license holder did not ensure areas used by participants receiving services were free from debris, loose plaster and peeling paint.
Corrective Action Ordered: Within 30 days of receiving this order, you must ensure safety as detailed above. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in these subparts. 10. Citation: Minnesota Rules, part 9555.9730, subpart 3.
Corrective Action Required: Immediately, you must ensure restrooms used by participants are equipped with a mechanism that participants could use to signal staff members by light or by sound if participants need assistance. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. 11. Citation: Minnesota Statutes, section 245A.65, subdivision 1, paragraph (a), part (2).
Violation: The license holder did not establish written policies and procedures related to suspected or alleged maltreatment as required.
The license holder failed to identify the secondary person or position to whom internal reports may be made and the secondary person or position responsible for forwarding the internal reports to the common entry point.
Corrective Action Ordered: Immediately, you must update your policies and procedures related to suspected or alleged maltreatment of vulnerable adults to include the secondary person or position to whom internal reports may be made and a secondary person or position responsible for forwarding the internal reports to the common entry point. Compliance with this order will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subdivision. 12. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a).
Violation: The license holder did not establish a PAPP (Program Abuse Prevention Plan), as required. The license holder did not establish a written PAPP, that included: · an assessment of the population, including an evaluation of the following factors: o age, gender, mental functioning, physical and emotional health or behavior of the client; o the need for specialized programs of care for clients; o the need for training of staff to meet identified individual needs; and o the knowledge a license holder may have regarding previous abuse that is relevant to minimizing risk of abuse for clients; · an assessment of the physical plant where the licensed services were provided, including an evaluation of the following factors: o the condition and design of the building as it relates to the safety of the clients; and o the existence of areas in the building which are difficult to supervise; and · an assessment of the environment for the facility, including an evaluation of the following factors: o the location of the program in a particular neighborhood or community; o the type of grounds and terrain surrounding the building; o the type of internal programming; o the program's staffing patterns; and o a statement of specific measures to be taken to minimize the risk of abuse. Additionally, the license holder did not review the PAPP at least annually. Corrective Action Ordered: Within 30 days of receiving this order, you must establish a PAPP that includes the information detailed above. A copy of the PAPP must be posted in a prominent location in the program. Compliance with this order will be reviewed onsite. On an ongoing basis, you must maintain compliance as required in this subdivision. 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. Kristopher Oberg, HCBS Human Services Licensor Licensing Division Office of Inspector General 651-431-6589
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