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 Child Care Programs Report Provider Organization: Inner County Outreach, Inc. DHR DHR Licensing Agency: Contracting Agency(s): Program Administrator: Pastor Nathaniel Johnson Certification # A00139 Exp. Date: 12/31/2015 Type of Inspection: Quarterly Site Name Gender Age License DHR License#/ Date of site Range Capacity Contract Exp. date Inspection Limit Harewood Males 14-18 6 6 9/11/2014 11/4/2015 9/12/2014 Overlea Males 16-20 6 6 #00504/ 9/11/2014 11/4/2015 9/12/2014 Inspection Summary Number of Records Reviewed: Youth 3 3 Number of Interviews: Youth 1 Staff 4 Physical Plant Inspection: APPROVED COMAR Violation: Yes X No If Yes, list Violation(s) below: Violation(s) Findings 14.31.06.15 B Three out Three records reviewed did not have a safe environment plan. 14.31.06.17 B (5) One record out of three did not have an admission intake form. 14.31.06.17 C(1) One record out of three did not have a preliminary assessment. 14.31.06.17 B(4) One record out of three did not have an initial service plan. 14.31.06.12C One record out of three did not have documentation of life skills. 14.31.06.05E (1)(b) One record out of three did not have documentation of three references. 14.31.06.05E(1)(e) One record out of three did not have documentation of a criminal background clearance. Corrective Action Plan: Yes X No If yes, date of CAP: September 12, 2014 Complaint Outcome: N/A Current Status of License: Continued Licensing Odetta Bulluck 9/23/2014 Coordinator: Date: Email: Thomas 9/23/2014 Program Manager: Date 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 Child Care Programs Report Provider Organization: Inner County Outreach, Inc. Licensing Agency: DHR Contracting Agency(s): DHR Program Administrator: Pastor Nathaniel Johnson Certification # A00139 Exp. Date: 12/31/2015 Type of Inspection: Quarterly Site Name Gender Age Range License Capacity DHR Contract Limit License#/ Exp. date Date of site Inspection Harewood Males 14-18 6 6 11/4/2015 9/11/2014 9/12/2014 Overlea Males 16-20 6 6 #00504/ 11/4/2015 9/11/2014 9/12/2014 Inspection Summary Number of Records Reviewed: Youth 3 3 Number of Interviews: Youth 1 Staff 4 Physical Plant Inspection: APPROVED COMAR Violation: Yes X No If Yes, list Violation(s) below: Violation(s) Findings 14.31.06.15 B Three out Three records reviewed did not have a safe environment plan. 14.31.06.17 B (5) One record out of three did not have an admission intake form. 14.31.06.17 C(1) One record out of three did not have a preliminary assessment. 14.31.06.17 B(4) One record out of three did not have an initial service plan. 14.31.06.12C One record out of three did not have documentation of life skills. 14.31.06.05E (1)(b) One record out of three did not have documentation of three references. 14.31.06.05E(1)(e) One record out of three did not have documentation of a criminal background clearance. Corrective Action Plan: Yes X No If yes, date of CAP: September 12, 2014 Complaint Outcome: N/A Current Status of License: Continued Licensing Coordinator: Odetta Bulluck Date: 9/23/2014 Email: Program Manager: Thomas Date 9/23/2014 Email:
InnerCounty%20Qtly%20Sept.%202014.docx