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 Child Placement Agency Report Provider Organization: Kennedy Krieger Institute Licensing Agency: DHR Contracting Agency(s): DHR, DDA Elizabeth Thompson Name of Chief Administrator: Email: Treatment Foster Care Quarterly License Type: Type of Inspection: Name and Address of CPA Office License DHR Census by Placing License#/ Date of site Capacity Contract Agency Exp. date Inspection Limit Kennedy Krieger Institute Unlimited SED 50 DHR 54 #00357/ 4/9 & 2901 Biddle Street Medical 9/16/2014 15/2014 Baltimore, MD 21213 50 Inspection Summary 6 3 5 N/A Number of Records Reviewed: Youth Staff Foster Parent Adoptive Parent Number of Interviews: Youth 0 Staff 4 Foster Parent 0 CPA Office Inspection: Approved Number of ILP Apartments Inspected: N/A Number of Foster Homes Inspected: 0 X COMAR Violation: Yes No If Yes, list Cited Violation(s) below: Violation(s) Findings 07.02.21.10 D (3) 4/6 client records didn’t document foster parent progress notes 07.05.02.18 D (6) 1/6 document health history client records didn’t 07.05.02.17 A (1) 1/6 physical exam client records didn’t document 3/6 face sheets 07.05.02.18 D (1) client records didn’t document 1/6 client record education/Infant Toddler evaluation/therapy 07.05.02.18 (D) (8) didn’t document 2/3 staff records were hired prior to receipt of CPS clearances 07.05.01.09 A (2) X 4/15/2014 Corrective Action Plan: Yes No If yes, date of CAP: Complaint Outcome: N/A Current Status of License: Continued Licensing Coordinator: Lisa Beeman Date: 4/16/2014 Email: Program Manager: Richard Berger Date 4/16/2014 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 Child Placement Agency Report Provider Organization: Kennedy Krieger Institute Licensing Agency: DHR Contracting Agency(s): DHR, DDA Name of Chief Administrator: Elizabeth Thompson Email: License Type: Treatment Foster Care Type of Inspection: Quarterly Name and Address of CPA Office License Capacity DHR Contract Limit Census by Placing Agency License#/ Exp. date Date of site Inspection Kennedy Krieger Institute 2901 Biddle Street Baltimore, MD 21213 Unlimited SED 50 Medical 50 DHR 54 #00357/ 9/16/2014 4/9 & 15/2014 Inspection Summary Number of Records Reviewed: Youth 6 Staff 3 Foster Parent 5 Adoptive Parent N/A Number of Interviews: Youth 0 Staff 4 Foster Parent 0 CPA Office Inspection: Approved Number of ILP Apartments Inspected: N/A Number of Foster Homes Inspected: 0 COMAR Violation: Yes X No If Yes, list Cited Violation(s) below: Violation(s) Findings 07.02.21.10 D (3) 4/6 client records didn’t document foster parent progress notes 07.05.02.18 D (6) 1/6 client records didn’t document health history 07.05.02.17 A (1) 1/6 client records didn’t document physical exam 07.05.02.18 D (1) 3/6 client records didn’t document face sheets 07.05.02.18 (D) (8) 1/6 client record didn’t document education/Infant Toddler evaluation/therapy 07.05.01.09 A (2) 2/3 staff records were hired prior to receipt of CPS clearances Corrective Action Plan: Yes X No If yes, date of CAP: 4/15/2014 Complaint Outcome: N/A Current Status of License: Continued Licensing Coordinator: Lisa Beeman Date: 4/16/2014 Email: Program Manager: Richard Berger Date 4/16/2014 Email: