Maryland Department of Human Resources Office of Licensing and Monitoring 311 W. Saratoga Street Baltimore, Maryland 21201 Office: 410.767.7871 Fax: 410.333.8408 Residential Care Programs Report Provider Organization: Maryland Children’s Salem Trust Inc. DHR DHR and DJS Licensing Agency: Contracting Agency(s): Program Administrator: Todd Mechem Certification # A00022 Exp. Date: 12/31/13 Type of Inspection: Quarterly Site Name Gender Age License DHR License#/ Date of site Range Capacity Contract Exp. date Inspection Limit Maryland Children’s Salem Trust M/F 9-18 8 8 #00515 10/4/13 3/13/15 Maryland Children’s Salem Trust M/F 9-18 24 24 #00246 10/4/13 3/13/15 Inspection Summary Number of Records Reviewed: Youth 5 Staff 6 Number of Interviews: Youth 0 Staff 1 Physical Inspection: Approved COMAR Violation: Yes No X If Yes, list Violation(s) below: Violation(s) Scope of Violation(s) Impact of Violation(s) Corrective Action Plan: Yes No X If yes, date of CAP: Complaint Outcome: N/A Current Status of License: Continued Licensing Coordinator: Bernadette Barmore Date: 11/12/13 Email: Program Manager: André Thomas Date 11/12/13 Email:
Maryland Department of Human Resources Office of Licensing and Monitoring 311 W. Saratoga Street Baltimore, Maryland 21201 Office: 410.767.7871 Fax: 410.333.8408 Residential Care Programs Report Provider Organization: Maryland Children’s Salem Trust Inc. Licensing Agency: DHR Contracting Agency(s): DHR and DJS Program Administrator: Todd Mechem Certification # A00022 Exp. Date: 12/31/13 Type of Inspection: Quarterly Site Name Gender Age Range License Capacity DHR Contract Limit License#/ Exp. date Date of site Inspection Maryland Children’s Salem Trust M/F 9-18 8 8 #00515 3/13/15 10/4/13 Maryland Children’s Salem Trust M/F 9-18 24 24 #00246 3/13/15 10/4/13 Inspection Summary Number of Records Reviewed: Youth 5 Staff 6 Number of Interviews: Youth 0 Staff 1 Physical Inspection: Approved COMAR Violation: Yes No X If Yes, list Violation(s) below: Violation(s) Scope of Violation(s) Impact of Violation(s) Corrective Action Plan: Yes No X If yes, date of CAP: Complaint Outcome: N/A Current Status of License: Continued Licensing Coordinator: Bernadette Barmore Date: 11/12/13 Email: Program Manager: André Thomas Date 11/12/13 Email: