State of Michigan DEPARTMENT OF HUMAN SERVICES BUREAU OF CHILDREN AND ADULT LICENSING RICK SNYDER MAURA D. CORRIGAN GOVERNOR DIRECTOR August 7, 2013 Johnny Carson, Jr. Carson's Adult Foster Care, Inc. 19384 James Couzens Detroit, MI 48235 RE: License #: AM820009861 Investigation #: 2013A0901027 Carson AFC #2 Dear Mr. Carson, Jr.: Attached is the Special Investigation Report for the above referenced facility. Due to the violations identified in the report, a written corrective action plan is required. The corrective action plan is due 15 days from the date of this letter and must include the following: • • • • • How compliance with each rule will be achieved. Who is directly responsible for implementing the corrective action for each violation. Specific time frames for each violation as to when the correction will be completed or implemented. How continuing compliance will be maintained once compliance is achieved. The signature of the responsible party and a date. If you desire technical assistance in addressing these issues, please feel free to contact me. In any event, the corrective action plan is due within 15 days. Failure to submit an acceptable corrective action plan will result in disciplinary action. P.O. BOX 30650 • LANSING, MICHIGAN 48909-8150 www.michigan.gov • (517) 335-6124 Please review the enclosed documentation for accuracy and feel free to contact me with any questions. In the event that I am not available and you need to speak to someone immediately, please feel free to contact the local office at (313) 456-0380. Sincerely, Regina Buchanan, Licensing Consultant Bureau of Children and Adult Licensing Cadillac Pl. Ste 11-350 3026 W. Grand Blvd Detroit, MI 48202 (313) 949-3029 enclosure MICHIGAN DEPARTMENT OF HUMAN SERVICES BUREAU OF CHILDREN AND ADULT LICENSING SPECIAL INVESTIGATION REPORT I. IDENTIFYING INFORMATION License #: AM820009861 Investigation #: 2013A0901027 Complaint Receipt Date: 07/03/2013 Investigation Initiation Date: 07/08/2013 Report Due Date: 09/01/2013 Licensee Name: Carson's Adult Foster Care Inc Licensee Address: 19384 James Couzens Detroit, MI 48235 Licensee Telephone #: (313) 863-7050 Administrator: Johnny Carson, Jr. Licensee Designee: Johnny Carson, Jr. Name of Facility: Carson AFC #2 Facility Address: 5825 Livernois Detroit, MI 48210 Facility Telephone #: (313) 895-9000 Original Issuance Date: N/A License Status: REGULAR Effective Date: 05/24/2013 Expiration Date: 05/23/2015 Capacity: 11 Program Type: DEVELOPMENTALLY DISABLED MENTALLY ILL AGED 1 II. ALLEGATION(S) Residents health needs are somewhat neglected. III. METHODOLOGY 07/03/2013 Special Investigation Intake 2013A0901027 07/08/2013 Special Investigation Initiated - On Site No one home 07/12/2013 Inspection Completed On-site No one home 07/15/2013 Contact - Telephone call made Licensee-Johnny Carson 07/16/2013 Inspection Completed On-site Licensee-Johnny Carson Residents A-F Staff-Lajuana Davis 07/16/2013 Inspection Completed-BCAL Sub. Compliance 07/16/2013 Exit Conference Licensee-Johnny Carson ALLEGATION: Residents health needs are somewhat neglected. INVESTIGATION: On 07/16/2013 the licensee, Johnny Carson, was interviewed. He was not aware of any of the residents having any medical issues that required follow-care. He stated all the residents had recent physical examinations and were scheduled for medication reviews on 07/26/2013. On 07/16/2013 the home manager, Lajuana Davis, was interviewed. She indicted that none of the residents were on special diets due to health problems. Everyone was on a regular diet. On 07/16/2013 Residents A-F were interviewed. They each reported receiving annual physical exams and stated staff take them to all their medical appointments. 2 No one reported having missed any appointments or having ongoing medical problems they needed to see a doctor for. On 07/16/2013 Residents A-I health care appraisals were reviewed. Special diets were recommended for seven of the residents. Four of the residents were diagnosed with hypertension and the doctor recommended a low salt diet. A low fat/low cholesterol diet was recommended for three of the residents. Ms. Davis stated she was not of aware of this. It was suggested that she review the health care appraisals and she was given suggestions on how to accommodate the diets. An exit conference was held with Mr. Carson. He stated that he would ensure that the special diets are implemented and adhered to. APPLICABLE RULE R 400.14310 Resident health care. ANALYSIS: CONCLUSION: (1) A licensee, with a resident's cooperation, shall follow the instructions and recommendations of a resident's physician or other health care professional with regard to such items as any of the following: (a) Medications. (b) Special diets. (c) Susceptibility to hyperthermia and hypothermia and related limitations for physical activity, as appropriate. (d) Other resident health care needs that can be provided in the home. The refusal to follow the instructions and recommendations shall be recorded in the resident's record. The allegations are confirmed. Special diets were recommended for seven of the nine residents by their doctor. Mr. Carson and Ms. Davis were not aware of the diets, although they were documented of the residents’ health care appraisals; therefore they were not being implemented. VIOLATION ESTABLISHED 3 IV. RECOMMENDATION Upon receipt of an acceptable corrective action plan, I recommend the status of the license remain unchanged. ____________________________________08/06/2013 Regina Buchanan Date Licensing Consultant Approved By: ____________________________________08/07/2013 Ardra Hunter Date Area Manager 4