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July 13, 2026 CERTIFIED MAIL Rahma Aboker Kassim, Authorized Agent 1912 3rd Street Southwest Rochester, Minnesota 55902 License Numbers: 1088316 (245D - HCBS) 1086510 (Adult Foster Care _AFC) AMENDED ORDER OF LICENSE REVOCATION Notice: This Amended Order of License Revocation supersedes the original Order of License Revocation dated April 7, 2026. This document includes the following four amendments: · additional false and misleading information violation and 7 additional licensing violations from a licensing review conducted on May 19, 2026; · updated violations 15 and 17 to correctly reflect training noncompliance; · updated the total number of violations in the nature, severity, chronicity, and commissioner’s evaluation to include the additional licensing violations from May 19, 2026; · the license holder’s new program address; and · updated the description of the right to appeal. The original Order of License Revocation, dated April 7, 2026, must be destroyed. Dear Rahma Aboker Kassim: The Department of Human Services (DHS) is revoking your licenses to provide Family Adult Foster Care (AFC) and Home and Community-Based Services (HCBS) at 1912 3rd Street Southwest, Rochester, Minnesota. This revocation is based on violations of applicable laws and rules, and the Commissioner’s evaluation of your program. Details of our findings are provided below. Our next steps and your options are also detailed. The revocation goes into effect on April 21, 2026, at 4:00 P.M. to allow time for delivery of this order and ten days for you to inform the Commissioner whether you intend to appeal the license revocation explained below. REASON FOR LICENSE REVOCATION 1. False or misleading information False or misleading information determined on May 19, 2026 DHS determined that you knowingly gave false or misleading information regarding compliance with applicable laws and rules. P1 was admitted to the hospital on May 17, 2026, and the license holder told DHS licensors that they had reported the hospitalization to P1’s case manager on May 18, 2026. DHS licensors had spoken to the case manager before the licensing review and the case manager stated the license holder did not notify him of the May 17, 2026, hospitalization. The DHS licensor asked the license holder to show the licensor her cell phone call log to prove the license holder called the case manager on May 18, 2026. The license holder then admitted that she had not reported the incident to the case manager. Additionally, P1 contacted emergency services on May 2, 2026. The license holder reported to DHS licensors that the May 2, 2026 incident was reported to P1’s case manager on May 18, 2026. After the DHS licensor asked to look at the license holder’s cell phone call log for May 18, 2026, the license holder admitted she did not call the case manager to notify him of the emergency services. False or misleading information determined on February 13, 2026 DHS determined that you knowingly withheld relevant information or provided false or misleading information regarding compliance with applicable laws and rules. DHS gave the license holder notice that they would be conducting a licensing review on February 13, 2026, and that they would be reviewing all program records. Minnesota Statutes, section 245D.04, subdivision 2, requires license holders responsible for medication administration to document when medications are administered or the reason they are not administered at the prescribed time. At the licensing review the license holder gave the licensors two different medication administration records (MARS) for P1 for February 2026. The MARS were documents with a table for staff to mark in the boxes that medications were administered as prescribed each day. The evidence shows you prepared P1’s MARS to make it appear that you documented the administration of P1’s medications at the time they were given, when the evidence shows the documentation was not prepared at the time of administration. · There were two different MARS for P1 for February 2026, with conflicting information regarding when medications were to be administered and whether they had been administered. · The licensing review was conducted on February 13, 2026, but one of the MARs included staff documentation that some medications were administered through the end of February. · You documented that you administered a medication to P1 from February 1st to 13th of 2026, yet at the licensing review the designated manager stated the medication was discontinued so P1 was no longer taking the medication in February 2026. Based on this information, DHS determined that you knowingly withheld relevant information or provided false or misleading information regarding compliance with applicable laws and rules. Legal Authority: Minnesota Statutes, section 245A.07, subdivision 3(a)(3). 2. Failure to comply with laws and rules NEW LICENSING VIOLATIONS DETERMINED ON MAY 19, 2026 1. Violation: The license holder did not develop a program abuse prevention plan as required. The license holder did not complete an assessment of the physical plant where the licensed services were provided, including an evaluation of the following factors: the condition and design of the building as it relates to the safety of the clients; and the existence of areas in the building which are difficult to supervise. Additionally, the license holder did not complete an assessment of the environment for each facility and for each site when living arrangements are provided by the agency shall include an evaluation of the following factors: the location of the program in a particular neighborhood or community; the type of grounds and terrain surrounding the building; the type of internal programming; and the program's staffing patterns. Statute Violated: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a). 2. Violation: For one person whose record was reviewed (P1), the license holder did not document how health service needs would be met as required. The license holder was responsible for preparing the prescribed injectable medication for P1 to self-administer. The license holder did not document the procedures the license holder would follow to prepare the injectable medication for P1. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 1, paragraph (b). 3. Violation: For one person whose record was reviewed (P1), the license holder did not implement medication administration procedures as required. P1 was prescribed a psychotropic medication. The license holder did not document in P1’s MAR information on the prescription label or the prescriber’s current written or electronically recorded order that included P1’s name, description of the medication to be provided, and the frequency and other information needed to safely and correctly administer the medication to ensure effectiveness. Additionally, the license holder did not document a notation of whether or not this psychotropic medication was administered to P1 from April 1, 2026, to May 16, 2026. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 2. 4. Violation: For one person whose record was review (P1), the license holder did not review and report medication administration records as required. The license holder did not complete an accurate MAR review. The license holder documented on May 13, 2026, that a MAR review had been completed for March 6, 2026, through May 13, 2026, and that no medication errors were identified; however, DHS licensors identified medication errors on the April 2026 and May 2026 MAR. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 4. 5. Violation: For one person whose record was reviewed (P1), the license holder did not meet the protection standards of incident response and reporting as required.
· April 9, 2026; · May 2, 2026; and · May 17, 2026. Statute Violated: Minnesota Statutes, section 245D.06, subdivision 1. 6. Violation: For one person whose record was reviewed (P1), the license holder did not provide person-centered planning and service delivery as required. The license holder did not provide services in a manner that supported the accomplishment of P1’s service outcomes. SP3 developed and documented an outcome for P1 on February 6, 2026; however, there was no data maintained for the outcome. DHS licensors asked SP2 about the outcome, and SP2 indicated that they did not know what the outcome was. Statute Violated: Minnesota Statutes, section 245D.07, subdivision 1a. 7. Violation: For one person whose record was reviewed (P1), the license holder did not prohibit the use of prohibited procedures. The license holder told P1 if P1 did not comply with directions from the license holder that the state would remove P1 from her care. The license holder indicated that this was her technique to deter him from calling 911. The license holder did not prohibit the use of a prohibited procedure when they spoke to P1 in a threatening manner to reduce or eliminate behavior, as punishment, or for staff convenience. Statute Violated: Minnesota Rule, 9544.0060, subpart 2. PREVIOUS LICENSING VIOLATIONS DETERMINED ON FEBRUARY 13, 2026 DHS determined that your program failed to follow licensing rules and statutes, as described below. Program Coordination, Evaluation, and Oversight Violation 1. Violation: The license holder did not provide program coordination, evaluation, and oversight. a. The license holder identified SP3 as the designated coordinator. The license holder did not ensure that SP3 fulfilled the duties of coordination of service delivery and evaluation for persons served by the program. Citations 1 through 6 are evidence of the license holder’s lack of program coordination and oversight of the services provided including: · oversight of the license holder's responsibilities assigned in the person's support plan and the support plan addendum; · taking the action necessary to facilitate the accomplishment of the outcomes according to the requirements in section 245D.07; · 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. The designated coordinator may delegate the direct observation and competency assessment of the service delivery activities of direct support staff to an individual whom the designated coordinator has previously deemed competent in those activities; and · evaluation of the effectiveness of service delivery, methodologies, and progress on the person's outcomes based on the measurable and observable criteria for identifying when the desired outcome has been achieved according to the requirements in section 245D.07. b. The license holder identified SP3 as the designated manager. The license holder did not ensure that SP3 provided program management and oversight of the services provided by the license holder. Citations 1 through 9 are evidence of the license holder’s lack of program management and oversight of the services provided including: · maintain a current understanding of the licensing requirements sufficient to ensure compliance throughout the program; · ensuring the program implements corrective action identified as necessary by the program following review of incident and emergency reports according to the requirements in section 245D.11, subdivision 2, clause (7). An internal review of incident reports of alleged or suspected maltreatment must be conducted according to the requirements in section 245A.65, subdivision 1, paragraph (b); · evaluation of satisfaction of persons served by the program, the person's legal representative, if any, and the case manager, with the service delivery and progress toward accomplishing outcomes identified in sections 245D.07 and 245D.071, and ensuring and protecting each person's rights as identified in section 245D.04; · 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;and · evaluating the information identified in clauses (1) to (6) to develop, document, and implement ongoing program improvements. Repeat Violation: In a Correction Order that DHS issued on October 7, 2025, you were previously found in violation of this same statute. Statute Violated: Minnesota Statutes, section 245D.081, subdivision 2 and 3. Service Recipient Violations 2. Violation: For one of one person whose record was reviewed (P1), the license holder did not develop an individual abuse prevention plan (IAPP) as required. The license holder did not develop an IAPP for P1 that included an accurate description of P1’s susceptibility to self-abuse. The license holder developed an IAPP for P1 that indicated that P1 neglected or refused to take medications. This is inconsistent with what the license holder reported to DHS licensors. The license holder indicated that P1 does not neglect or refuse medications and often requests to take additional medication outside of prescribed times. Repeat Violation: In a Correction Order that DHS issued on July 21, 2020, and October 7, 2025, you were previously found in violation of this same statute. Statute Violated: Minnesota Statutes, section 245A.65, subdivision 2. 3. Violation: For one person whose record was reviewed (P1), the license holder did not meet the requirements for health needs as required. 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 to support P1 with their identified health needs. · The license holder did not maintain documentation or instructions of how to administer P1’s pro re nata (PRN) psychotropic medications. · P1’s support plan addendum documented that supervision was needed for all appointments; however, the license holder did not document a procedure the license holder would follow to assist P1 with all health service appointments. The license holder did not provide constant supervision at appointments, including emergency hospital appointments, as assigned in the support plan addendum. · The license holder was responsible for preparing the prescribed injectable medication for P1 to administer to self-administer. The license holder did not document the procedures the license holder will follow to administer a diabetic medication to P1. Repeat Violation: In a Correction Order that DHS issued on July 21, 2020, you were previously found in violation of this same statute. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 1, paragraph (b). 4. Violation: For one person whose record was reviewed (P1), the license holder did not implement medication administration procedures as required. The license holder did not implement medication administration procedures to ensure P1 took medications as prescribed. · The license holder maintained a MAR that documented P1 was to be administered a diuretic only with prior approval from P1’s primary care physician. The license holder documented that it was administered daily from January 1, 2026, through February 13, 2026. The license holder did not maintain documentation that prior approval was received from P1’s primary care physician. · Four of P1’s medications were prescribed to be administered PRN; however, the license holder documented on the February 2026 MAR that these medications were to be administered at a scheduled frequency each day. The license holder documented that these medications were administered multiple times per day. · A prescribed cream was documented as PRN on the MAR but this was inconsistent with an after visit summary for P1 that indicated the cream was to be administered daily before reapplying his leg wraps. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 2, paragraph (b), clause 1. 5. Violation: For one person whose record was reviewed (P1), the license holder did not implement medication administration procedures as required. The license holder did not implement their medication administration policies and procedures as required. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 2, paragraph (b), clause 3. 6. Violation: For one person whose record was reviewed (P1), the license holder did not document on the medication administration record as required. The license holder did not document the information on the current prescription label or the prescriber's current written or electronically recorded order or prescription that includes the person's name, description of the medication or treatment to be provided, and the frequency and other information needed to safely and correctly administer the medication or treatment to ensure effectiveness. The license holder maintained a medication administration record that documented the license holder would administer a medication used to treat and prevent chest pain at first signs of chest pain, repeat every five minutes until relief, a maximum of 3 times within 15 minutes. If no relief call 911. The license holder maintained a handwritten note on the January 2026 and February 2026 MAR to administer this medication once every 15 minutes. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 2, paragraph (c), clause 1. 7. Violation: For one person whose record was reviewed (P1), the license holder did not document on the medication administration record as required. The license holder did not document information on any risks or other side effects that are reasonable to expect, and any contraindications to its use. The license holder did not document side effects for several medications in February 2026. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 2, paragraph (c), clause 2. 8. Violation: For one person whose record was reviewed (P1), the license holder did not document on the medication administration record as required. The license holder did not document the possible consequences if the medication or treatment is not taken or administered as directed. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 2, paragraph (c), clause 3. 9. Violation: For one person whose record was reviewed (P1), the license holder did not document on the medication administration record as required.
· P1’s after visit summary dated February 2026 indicated that P1 was prescribed an antibiotic medication to be administered for 7 days. The license holder did not document the antibiotic on the MAR; however, the license holder reported that they began administering the medication without it being transcribed on the MAR. · The license holder documented on P1’s MAR that an expectorant was discontinued; however, the after visit summary dated February 2026 indicated that the expectorant was a current prescribed medication. The line drawn by the license holder that was intended to indicate the discontinuation was drawn through notations of administration between February 1, 2026, and February 14, 2026. It was unclear to DHS licensors what date the license holder discontinued the medication. Statute Violated: Minnesota Statutes, section 245D.05, subdivision 2, paragraph (c), clause 6. 10. Violation: For one person whose record was reviewed (P1), the license holder did not develop, implement, and maintain documentation regarding psychotropic medications as required. "Target symptom" refers to any perceptible diagnostic criteria for a person's diagnosed mental disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or successive editions, that has been identified for alleviation. The license holder did not document a description of the target symptoms that each psychotropic medication was to alleviate for P1. Statute Violated: Minnesota Statutes, section 245D.051, subdivision 1, paragraph (b). 11. Violation: For one person whose record was reviewed (P1), the license holder did not meet the protection standards of incident response and reporting as required. The license holder did not notify P1’s case manager within 24 hours of the incidents that occurred on the following dates: · November 29, 2025; · February 3, 2026; and · February 10, 2026. Repeat Violation: In a Correction Order that DHS issued on October 7, 2025, you were previously found in violation of this same statute. Statute Violated: Minnesota Statutes, section 245D.06, subdivision 1. 12. Violation: For one person whose record was reviewed (P1), the license holder did not maintain service recipient records as required. a. The license holder documented on P1’s MAR that six medications, comprising one entire page of the MAR, were administered February 1, 2026, through February 28, 2026. The licensing review occurred on February 13, 2026; therefore, the license holder had improperly completed documentation on the MAR in advance of the medications being administered. b. The license holder did not maintain current orders for medication, treatments, or medical equipment for P1. Statute Violated: Minnesota Statutes, section 245D.095, subdivision 3. 13. Violation: For one person whose record was reviewed (P1), the license holder did not complete service plan review and evaluation as required. The license holder did not discuss the following with P1 and members of P1’s expanded support team at least once per year in 2025: · how technology might be used to meet P1’s desired outcomes; and · options for transitioning out of a community setting controlled by a provider and into a setting not controlled by a provider. Repeat Violation: In a Correction Order that DHS issued on July 21, 2020, and October 7, 2025, you were previously found in violation of this same statute. Statute Violated: Minnesota Statutes, section 245D.071, subdivision 5. 14. Violation: For one person whose record was reviewed (P1), the license holder did not ensure health and welfare as required. The license holder did not follow their “Policy and Procedure on Reviewing Incidents and Emergencies” by not maintaining incident reports for P1 that included the following required information: · the name of the person or persons involved in the incident; · a description of the incident or emergency; · a description of the response to the incident or emergency and whether a person's support plan addendum or program policies and procedures were implemented as applicable; · the name of the staff person or persons who responded to the incident or emergency; and · the determination of whether corrective action is necessary based on the results of the review. Statute Violated: Minnesota Statutes, section 245D.11, subdivision 2, clauses (6) and (7). Staffing Standards 15. Violation: For one of two staff persons whose records were reviewed (SP2), the license holder did not provide orientation training within 60 days of hire: The license holder did not provide SP2 with the following orientation training within 60 days of hire: · the license holder’s current policies and procedures required under Minnesota Statutes, chapter 245D, including their location and access and staff responsibilities related to implementation of those policies and procedures: o consumer grievance and compliant procedures. This was provided to SP2 on November 10, 2025; o consumer temporary service suspension and service termination; o emergency use of manual restraint; o health service coordination and care; o service admission; o emergency response, reporting, and reviewing; and o incident response, reporting, and reviewing. This was provided to SP2 on November 10, 2025. · 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. This was provided to SP2 on November 10, 2025; · 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. This was provided to SP2 on November 10, 2025; · 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. This orientation must be provided within 72 hours of first providing direct contact services and annually thereafter according to section 245A.65, subdivision 3. This was provided on January 16, 2025 and February 12, 2026; · 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. Repeat Violation: In a Correction Order that DHS issued on July 21, 2020, and October 7, 2025, you were previously found in violation of this same statute. Statute Violated: Minnesota Statutes, section 245D.09, subdivision 4. 16. Violation: For one staff person whose record was reviewed (SP1), the license holder did not provide orientation to individual service recipient needs as required. The license holder failed to provide SP1 with the following training on P1’s medication administration procedures as established in P1’s support plan addendum prior to administering medications to P1: · completion of a medication administration training, from a training curriculum developed by a registered nurse or appropriate licensed health professional; and · completion of an observed medication administration skill assessment by the trainer. Repeat Violation: In a Correction Order that DHS issued on July 21, 2020, and October 7, 2025, you were previously found in violation of this same statute. Statute Violated: Minnesota Statutes, section 245D.09, subdivision 4a. 17. Violation: For two staff persons whose records were reviewed (SP1 and SP2), the license holder did not provide annual training as required. Minnesota Statutes, 245A.02, subdivision 2b defines “annual” or “annually” to mean prior to or within the same month of the subsequent year. a. The license holder did not provide the following annual training to SP1 in 2025: · 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 · 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. b. The license holder did not provide the following annual training to SP2 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 and 626.557 governing maltreatment reporting and service planning for 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. The license holder did not provide the following annual training to SP2 in 2025: · 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. Repeat Violation: In a Correction Order that DHS issued on October 7, 2025, you were previously found in violation of this same statute. Statute Violated: Minnesota Statutes, section 245D.09, subdivision 5. Nature, chronicity, or severity of violations and the effect of violations on the health, safety, or rights of person served by the program. The Commissioner considered the nature, chronicity, and severity of the violations of law or rule and the effect of the violation on the health, safety or rights of persons served by the program: • Nature: There were 24 violations in this order related to the health, safety, and rights of the persons served. In addition, you provided false and misleading information to DHS, which is an independent basis to revoke a license. The citations involved your inability to understand applicable laws and rules, the failure to document the services you were to provide, and you failed to properly train staff. • Chronicity: The information below summarizes your licensing history: July 13, 2026, Amended Revocation: 24 violations April 7, 2026, Revocation: 17 violations (8 repeat) October 7, 2025, Conditional License: 20 violations July 21, 2020, Correction Order: 20 violations · Severity: The 24 violations pertain directly to the health and safety of the individual served, with particular concern for P1’s chronic medical conditions and the management of their medications. You have demonstrated that you lack competent knowledge and skills to provide the assigned responsibility of medication administration. Specifically, medications were given when they should not have been administered, and two different MARS for P1 had inconsistent instructions on when a psychotropic medication should be administered and how frequently. For example, one February MAR stated a psychotropic medication should be given up to four times a day, only as needed, and the other MAR stated it was to be administered four times each day. In addition to medications being administered at incorrect frequencies, you did not attend appointments with P1, resulting in a lack of awareness of changes to medication orders. Furthermore, documentation reflects that medications were recorded as administered on dates that had not yet occurred. Collectively, these actions reflect a profound lack of competency in medication management and constitute a significant risk to the physical and mental well-being of P1. Additionally, you did not maintain incident reports, did not assess incidents to determine appropriate corrective actions to benefit the person served, and did not report these incidents to required team members. Further, during the licensing review, DHS determined that you knowingly provided false or misleading information to the Commissioner. Licensing reviews require license holders to provide complete transparency and honesty, without which DHS has no assurance you can be trusted with the care of vulnerable adults in the absence of constant supervision. Legal Authority: Minnesota Statutes, section 245A.07, subdivision 3(a)(1). 3. Commissioner’s evaluation of program In determining whether a licensing action is warranted, DHS evaluated the facts, conditions, and circumstances concerning your program’s operation, the well-being of a person served, the qualifications of staff persons, and the license holder’s ability to demonstrate competent knowledge of applicable statutes and rules. The Commissioner determined revocation is appropriate based on the relevant factors discussed below: Regarding the competency of personnel, your designated manager (SP3) and designated coordinator (SP3) did not ensure compliance with laws and rules resulting in 24 violations. SP3 did not complete the corrective action order by the commissioner in the October 7, 2025, order. Regarding the program’s operation and well-being of persons served, you did not meet the established standards of care required to appropriately support chronic medical conditions and to ensure accurate medication administration. Performance in this area was significantly deficient across all expectations, raising serious concerns regarding the health and safety of the individual served. Other violations, not specific to medication administration, also involve your lack of competent knowledge of the applicable requirements of statutes and rules for providing Home and Community-Based Services. Based on the level of significant noncompliance, DHS has determined that you do not have competent knowledge of applicable statutes and rules to operate a HCBS program and is concerned about the health, safety, and rights of the people you serve. Legal Authority: Minnesota Statutes, section 245A.04, subdivision 6. 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 Home and Community-Based Services is revoked. YOUR RIGHT TO APPEAL You have the right to appeal the revocation. You have already appealed the original Order of License Revocation dated April 7, 2026, so you do not need to submit a new appeal request. Your case is scheduled for a contested case hearing in front of an Administrative Law Judge. Following this hearing, the Commissioner of DHS will issue a final order. Legal authority for this licensing action · This action is taken under Minnesota Statutes, section 245A.07, subdivision 3, which describes under which conditions DHS may revoke a license. · The timeline to appeal a revocation order is provided in Minnesota Statutes, section 245A.07, subdivision 3(b). · “Controlling individual” is defined under Minnesota Statutes, section 245A.02, subdivision 5a. · Minnesota Statutes, section 245A.07, subdivision 3, paragraph (c), clause (4)(iv) states that license holders shall pay a $200 for each background study violation. · License holders have a right to appeal licensing actions and request a contested case hearing, under Minnesota Statutes, chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. · If a license holder files a timely appeal of a revocation order, the license holder may continue to operate the program pending a final order of the appeal under Minnesota Statutes, section 245A.07, subdivision 1(b). · Under Minnesota Statutes, section 245A.04, subdivision 7, paragraph (d), clause (5), when a license issued under this chapter is revoked under clause (1) or (3), the license holder and controlling individual may not hold any license under chapter 245A for five years following the revocation, and other licenses held by the applicant, license holder, or controlling individual shall also be revoked. · Under Minnesota Statutes, section 245A.07, subdivision 1, paragraph (b), the commissioner may include terms the license holder must follow pending a final order on appeal. · Under Minnesota Statutes, section 13.46, subdivision 3(c), the commissioner may disclose the existence of an investigation of possible overpayments of public funds to a service provider or recipient or the reduction or withholding of payments if the commissioner determines that it will not compromise the investigation. Questions If you have any further questions regarding this matter, you may contact Leota Bemis, Supervisor, at 651-431-5637. Sincerely,
Christala Culhane, Unit Manager Licensing Division Office of Inspector General
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