State of Michigan DEPARTMENT OF HUMAN SERVICES August 7, 2013

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
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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.
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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
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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
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