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June 16, 2026 CERTIFIED MAIL Betaleham Walle, Authorized Agent Smart Choice Adult Daycare Center LLC 521 Cedar Avenue South License Number: 1094784 (Rule 223) ORDER OF CONDITIONAL LICENSE Dear Betaleham Walle: The Department of Human Services (DHS) is placing your license to provide adult day care at Smart Choice Adult Daycare Center LLC, located at 521 Cedar Avenue South, Minneapolis, Minnesota on conditional status for two years, beginning June 16, 2026. This means you must meet certain conditions to maintain your license, detailed below. This order is based on your noncompliance with adult day care licensing requirements. Details of our findings are also provided below. Our next steps and your options are also detailed. REASON FOR THE CONDITIONAL LICENSE On May 22, 2026, DHS licensors conducted a licensing review at your facility located at 521 Cedar Avenue South, Minneapolis, Minnesota. As a result of this licensing visit, the DHS licensors determined that your program failed to comply with the laws and rules that apply to licensed Adult Day Services, citing 9 violations. Licensing Violations determined on May 22, 2026 PARTICIPANT RECORD VIOLATIONS 1. Violation: For one of four participants whose records were reviewed (P3), the license holder did not provide orientation to the license holder’s internal and external reporting procedures related to suspected or alleged maltreatment and the program abuse prevention plan (PAPP) as required. The license holder did not provide orientation to P3 on the licensor holder’s internal and external reporting procedures and PAPP within 24 hours of admission. Statute Violated: Minnesota Statutes, section 245A.65, subdivision 1, paragraph (c) and Repeat Violation: In a Correction Order that DHS issued on October 23, 2025, you were previously found in violation of this same statute. Corrective Action Required: Immediately, you must: · provide an orientation to P3 on your internal and external reporting procedures and PAPP; and · document that P3 was provided the orientation in P3’s record. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in these subdivisions. 2. Violation: For two participants whose records were reviewed (P1 and P3), the license holder did not meet the requirements for an individual abuse prevention plan (IAPP). a. The license holder did not review P1’s IAPP quarterly as part of the review of the program plan or service plan. The license holder maintained documentation that P1’s IAPP was most recently reviewed in October 2025. b. The license holder did not develop an IAPP for P3 as part of the participant’s initial individual program plan or service plan. Statute Violated: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (b) and Minnesota Rules, part 9555.9700, subpart 3.
Corrective Action Ordered: Within 60 days of receiving this order, you must: · develop an IAPP for P3; · review P1’s IAPP with their interdisciplinary teams and document the review; and · if applicable, revise P1’s IAPP to reflect the results of the review. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subdivision and subpart. 3. Violation: For one participant whose record was reviewed (P3), the license holder did not distribute policies and program information to participants and their caregivers upon admission as required. a. The license holder did not distribute the following policies and program information to P3 and P3’s caregiver upon admission: · the scope of the programs, services, and care offered by the center; · a description of the population to be served by the center; · a description of individual conditions which the center is not prepared to accept, such as a communicable disease requiring isolation, a history of violence to self or others, unmanageable incontinence or uncontrollable wandering; · the center's policy on and arrangements for providing transportation; · the center's policy on providing meals and snacks; · the center's fees, billing arrangements, and plans for payment; · the center's policy governing the presence of pets in the center; · the center's policy on smoking in the center; · types of insurance coverage carried by the center; · a statement of the center's compliance with Minnesota Statutes, section 626.557, and rules adopted under that section; · a statement that center admission and employment practices and policies comply with Minnesota Statutes, chapter 363, the Minnesota Human Rights Act; · the terms and conditions of the center's licensure by the department, including a description of the population the center is licensed to serve under part 9555.9730; and · the telephone number of the department's licensing division. b. The license holder did not distribute the participants' rights to P3 upon admission. Rule Violated: Minnesota Rules, part 9555.9640. Repeat Violation: In a Correction Order that DHS issued on October 23, 2025, you were previously found in violation of this same rule. Corrective Action Required: Within 60 days of receiving this order, you must: · distribute the policies, program information, and participants’ rights listed above to P3 and their caregiver; and · document the distribution of the policies, program information, and participants’ rights in P3’s record. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this part. 4. 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 a medical report in P1’s records that included a physical examination, updated annually in 2025 and 2026. The most recent report on a physical examination that the license holder maintained for P1 was dated March 25, 2024. b. The license holder did not include participation reports and progress notes that are recorded at least monthly in P2 and P3’s record. Rule Violated: Minnesota Rules, part 9555.9660, subpart 1. Repeat Violation: In a Correction Order that DHS issued on October 23, 2025, you were previously found in violation of this same rule. Corrective Action Required: Within 60 days of receiving this order, you must maintain the information detailed above in P1, P2, and P3’s records. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. 5. Violation: For three participants whose records were reviewed (P1, P2, and P4), the license holder did not develop a written plan of care as required. The license holder did not develop a written plan of care for P1, P2, and P4 that included provisions for quarterly review and quarterly revisions of the individual plan of care. Rule Violated: Minnesota Rules, part 9555.9700, subpart 3. Repeat Violation: In a Correction Order that DHS issued on October 23, 2025, you were previously found in violation of this same rule. Corrective Action Required: Within 60 days of receiving this order, you must develop a written plan of care for P1, P2, and P4 that includes the information detailed above. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. SERVICE AND PROGRAM VIOLATIONS 6. Violation: The license holder did not offer services as required. The license holder did not maintain family and social histories for P1 and P4 that were updated annually. Rule Violated: Minnesota Rules, part 9555.9710, subpart 7. Repeat Violation: In a Correction Order that DHS issued on October 23, 2025, you were previously found in violation of this same rule. Corrective Action Required: Within 60 days of receiving this order, you must maintain an updated family and social history in P1 and P4’s records. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. SAFETY VIOLATIONS 7. Violation: The license holder did not ensure safety as required. The license holder did not ensure the equipment and furniture was in good repair, including: · graffiti on the front windows and doors of the center; and · ceiling tiles with water damage. Rule Violated: Minnesota Rules, part 9555.9720, subpart 7. Repeat Violation: In a Correction Order that DHS issued on October 23, 2025, you were previously found in violation of this same rule. Corrective Action Required: Immediately, you must ensure the equipment and furniture used by participants receiving services are in good repair. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subpart. POLICY AND PROCEDURES VIOLATIONS 8. Violation: The license holder did not establish policies and procedures related to suspected or alleged maltreatment as required. The license holder did not establish policies and procedures related to suspected or alleged maltreatment that identified the primary secondary person or position: · to whom internal reports may be made; · responsible for forwarding internal reports to the common entry point; and · who would ensure that, when required, internal reviews were completed. Statute Violated: Minnesota Statutes, section 245A.65, subdivision 1, paragraph (b). Corrective Action Required: Immediately, you must establish policies and procedures related to suspected or alleged maltreatment that includes the information detailed above. Additionally, you must post a copy of the internal and external reporting policies and procedures in a prominent location in the program. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subdivision. 9. Violation: The license holder did not establish a written program abuse prevention plan (PAPP) as required. The license holder did not ensure the license holder’s governing body or the governing body’s delegated representative reviewed the PAPP annually in 2025. The license holder maintained documentation that the PAPP was most recently reviewed in August 2024. Statute Violated: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a). Corrective Action Required: Within 60 days of receiving this order, you must: · ensure the license holder’s governing body or governing body’s delegated representative reviews the PAPP using the assessment factors in the plan, and any substantiated maltreatment findings that occurred since the last review; · the governing body or governing body’s delegated representative must revise the plan if necessary to reflect the review results; and · maintain documentation of the review. Compliance will be reviewed on site. On an ongoing basis, you must maintain compliance as required in this subdivision. Corrective action required You must correct the violations as described above. If you do not demonstrate substantial compliance with adult day care requirements or with the terms of your conditional license that are provided below, DHS may take an additional licensing action, including revocation, against your license. · Nature: DHS determined you were responsible for nine licensing violations related to the health, safety, and rights of the persons served. Additionally, of those nine licensing violations, seven were repeat violations that you were previously cited for in a Correction Order issued · Chronicity: Your program received its license on June 8, 2018. Since that time, your program has demonstrated a history of noncompliance with licensing rules and statutes. The information below summarizes this history: o December 15, 2022 Correction Order: 9 violations o May 27, 2025 Correction Order: 10 violations (6 repeat) o October 23, 2025 Correction Order: 7 violations (7 repeat) o June 16, 2026 Conditional License (this order): 9 violations (7 repeat) · Severity: Many of the violations involve your inability to properly maintain records for participants, including your inability to develop and review individual abuse prevention plans, maintain annual physical examinations, review plans of care and ensure safety requirements were met. You have continued to demonstrate an inability to follow admission and initial service planning requirements including distributing your programs policies and procedures to participants which exist to protect the health and safety of the participants you serve. Additionally, you have shown ongoing noncompliance with distributing your program abuse prevention plan to participants and ensure the plan is reviewed annually. You’ve also demonstrated an inability to maintain a compliant maltreatment of vulnerable adults reporting policy. It is apparent that these violations are not isolated to one area of concern but have been found amongst many areas of service delivery and program requirements putting the health and safety of the vulnerable adults served by your program at risk. Your inability to ensure compliance with participant records, services, safety, and policies and procedures as identified above, causes significant concern to DHS about your ability to demonstrate competent knowledge of the applicable requirements of statutes and rules that pertain to adult day services. DHS must rely on license holders to demonstrate competent knowledge of the applicable requirements of rules and statutes as DHS is unable to provide continuous oversight of license holders and programs. Due to the significant noncompliance, DHS has no assurance you can be trusted with the well-being of the vulnerable adults in your care.
DHS is concerned about your program’s operation, well-being of the participants being served by your program, and your ability to demonstrate competent knowledge of applicable laws. DHS is concerned about your program’s operation and your ability to demonstrate competent knowledge of applicable laws and rules that apply to licensed adult day centers. Since your program has been licensed, you have continued to demonstrate significant and ongoing noncompliance with licensing rules and statutes. In a Correction Order that DHS issued on May 27, 2025, DHS issued 10 violations. In a Correction Order that DHS issued on October 23, 2025, DHS issued 7 violations all of which were repeat violations. DHS licensors had extensive and informative exit interviews following each licensing review where licensors discussed areas of noncompliance throughout your program. During these exit interviews, you confirmed you understood what needed to be done to meet compliance with the deficiencies identified by licensors. Despite DHS providing ongoing resources and support, you have continued to demonstrate an unwillingness and inability to follow the laws and rules in place intended to ensure the health and safety of vulnerable adults. DHS’ concerns about the well-being of persons served by your program is demonstrated in your inability to comply with requirements pertaining to participant records, services and programming, policies and procedures and safety. These requirements protect the health and safety of persons served and are minimum standards for license holders. Inability to comply with these requirements impedes the Commissioner’s ability to ensure the level of care that is required by persons served is being provided as mandated by law. Participant records and service planning requirements are essential to keeping vulnerable adults safe and ensuring persons served are receiving necessary services. Your lack of service planning and documentation of needs posed a risk that staff would not know about the unique needs of the vulnerable people served. Moreover, your inability to maintain a compliant maltreatment of vulnerable adults reporting policy and review your program abuse prevention plan as required demonstrates a lack of understanding of the licensing rules and statutes. DHS has determined that an Order of Conditional License is appropriate based on the violations identified above and the program evaluation. Due to the serious and chronic nature of these violations, and the conditions in the program, which impact the health and safety of persons served in your care, your license to provide adult day services is placed on a conditional status. CONDITIONAL LICENSE TERMS In addition to the adult day care licensing rules and statutes, you are required to comply with the following terms: 1. Within 15 days of receiving this order, you must notify current persons receiving services, all parties who refer persons to the program, and all payer sources of the conditional status of your license. The notification must be approved by DHS Licensing prior to being sent to persons receiving services and all other parties. Therefore, the draft notice must be submitted to DHS for approval within 10 days of receiving this order. The notification must specify the length of time of the conditional status of your license, the reasons your license was made conditional, and it must include either a copy of the Order of Conditional License or an offer to provide a copy of the order upon request. While the license is on conditional status, you must notify new persons receiving services, referral sources, and payer sources that the license is on conditional status before they begin receiving adult day care services. The notification to new persons receiving services must specify the length of time of the conditional status of the license, the reasons the license was made conditional, and it must include either a copy of the Order of Conditional License or an offer to provide a copy of the order upon request. Within 30 days of receiving this order, you must submit to the DHS Licensing Division a list of the individuals and parties that received the notice. Additionally, while the license is on conditional status, you must maintain documentation of the names of individuals you’ve provided the notification to and the date the individual was provided the notification. 2. Within 30 days of receiving this order, you must: · submit the name of a new center director, other than SP3, to your licensor; · submit a copy of the new center director’s resume detailing how they meet the center director qualifications according to Minnesota Rules, part 9555.9680, subpart 1; · submit a copy of their signed job description that indicates the license holder’s responsibility ensuring the center director meets all of the responsibilities and duties of this role; 3. Within 60 days of receiving this order, you must: · complete an audit of all participant and personnel records; · submit the date to your DHS licensor that all participant and personnel records will be brought into compliance based on the results of your audit. The date that all participant and personnel records will be brought into compliance must be no later than within 90 days of receiving this order; and · maintain the results of the audit at your center in a manner that is accessible to the commissioner for review. 4. You may not increase the hours or days of operation of you program or increase the capacity of your program for the duration of the conditional license. 5. You may not apply for other DHS-issued licenses without prior approval from DHS for the duration of this conditional license. Submissions required as part of a corrective action ordered must be sent to your Licensor: 1. by secure email at: Desiree.B.Tiller@state.mn.us; or 2. send fax to: 651-431-7673 ATTN: Desiree Tiller YOUR RIGHT TO REQUEST RECONSIDERATION You have the right to request reconsideration of this order and the cited violations. Your request must: · Be in writing · Clearly state that you are requesting reconsideration of the conditional license · List each citation you are challenging and identify what is inaccurate or incomplete about the information in the order · Supply information that is accurate or more complete · State why you believe your license should not be on a conditional status · Be made before the deadlines provided below If you are mailing your request, it must be sent by certified mail and postmarked within 10 calendar days from when you received this order. If you do not meet this deadline, you lose your right to request reconsideration. The timeline to appeal began when you received this order. Please send it to: Commissioner, Department of Human Services Office of Inspector General Legal Counsel’s Office Attn: Licensing Legal Unit PO Box 64953 St. Paul, MN 55164-0953 If your request is being personally delivered, it must be received by DHS within 10 calendar days from when you received this order. Please bring it to: Commissioner, Department of Human Services Office of Inspector General Legal Counsel’s Office Attn: Licensing Legal Unit 444 Lafayette Road North St. Paul, MN 55155 Conditional license stayed pending reconsideration If you request reconsideration within the timeframes described above, the terms of the conditional license will not take effect until a decision is issued by DHS. If the conditional license is affirmed on reconsideration, the terms would take effect on the date of the reconsideration decision, and run for two from that date. You continue to be required to comply with all adult day care laws and rules. Legal authority for this licensing action · This action is taken under Minnesota Statutes, section 245A.06, subdivision 1. · Adult day care centers are required to follow Minnesota Statutes, chapters 245A and 245C and Minnesota Rules, parts 9550.9600 to 9555.9730. · The timeline to request reconsideration of the order is provided in Minnesota Statutes, section 245A.06, subdivision 4. · If a license holder files a timely reconsideration request, the terms of the conditional license are stayed pending a decision by DHS under Minnesota Statutes, section 245A.06, subdivision 4. · Minnesota Statutes, section 245A.06, subdivision 3 states that DHS may impose additional licensing actions against a license holder that does not correct the violations cited in a conditional license order. Questions If you have any further questions regarding this matter, you may contact Desiree Tiller, HCBS Licensor, at 651-431-4622. Sincerely,
Brittany Fogarty, HCBS Unit Supervisor Licensing Division Office of Inspector General
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