(41083,221,23,81,10,100,'Free_Text','No asleep staff for the overnight shift was influenced by the staff who was scheduled being ill and no one else available to cover the shift. Other staff were unwilling to cover this shift because the home is further away than most of the provider’s other homes. Also, the asleep shift was likely to be awake because the person was known for having challenging behaviors.  Further supporting staff’s unwillingness to cover this shift was that they would only receive $10/hour.\r\n\r\nAn additional factor that influenced the shift to go unfilled was that the provider didn’t feel pressure to fill the shift. The individual’s team, including the case manager at Hennepin County, had previously agreed that due to known staffing shortages with the provider, when an overnight asleep was not available the individual’s plan would allow for only the one awake overnight staff.\r\n\r\nMinnesota’s Rate Management System (RMS) determines a reimbursement rate for an individuals required supports (staffing pattern), which is agreed upon by the provider and case manager at the county per the DHS 6790 form.  This RMS rate then affects the provider determining they could pay overnight staff $10/hour for asleep shifts.  \r\n\r\nAnother influence was the Minnesota State Legislature, who creates laws governing provider rates, enforcing a 7% decrease in reimbursement rates to providers in July of 2018.  This impacted the provider’s ability to give an annual raises to staff and in turn influenced the provider having a staff shortage.  This was influenced by Federal (CMS) action determining Minnesota’s reimbursement rates were increased too much in recent years, and the Minnesota Department of Human Services’ decision to determine which rates needed to be cut and by how much to come into compliance with the CMS decision.',1,NULL,NULL,NULL,NULL,NULL),(41084,221,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41085,221,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41086,221,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41087,221,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41088,221,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41089,221,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41090,221,23,81,10,101,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41091,221,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41092,221,23,81,10,103,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41093,221,23,81,10,104,'Free_Text','Other staff were unwilling to cover this shift because the home is further away than most of the provider’s other homes. Also, the asleep shift was likely to be awake because the person was known for having challenging behaviors.  Further supporting staff’s unwillingness to cover this shift was that they would only receive $10/hour.\r\n\r\nThis RMS rate then affects the provider determining they could pay overnight staff $10/hour for asleep shifts.  \r\n\r\nAnother influence was the Minnesota State Legislature, who creates laws governing provider rates, enforcing a 7% decrease in reimbursement rates to providers in July of 2018.  This impacted the provider’s ability to give an annual raises to staff and in turn influenced the provider having a staff shortage.  ',1,NULL,NULL,NULL,NULL,NULL),(41094,221,23,81,10,105,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41095,221,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41096,221,23,81,10,107,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41097,221,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41098,221,23,81,10,109,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41099,221,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41100,221,23,81,10,111,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41101,221,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41102,221,23,81,10,113,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41103,221,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41104,221,23,81,10,115,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41105,221,23,81,10,116,'Free_Text','An additional factor that influenced the shift to go unfilled was that the provider didn’t feel pressure to fill the shift. The individual’s team, including the case manager at Hennepin County, had previously agreed that due to known staffing shortages with the provider, when an overnight asleep was not available the individual’s plan would allow for only the one awake overnight staff.',1,NULL,NULL,NULL,NULL,NULL),(41106,221,23,81,10,117,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41107,221,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41108,221,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41109,221,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41110,221,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41111,221,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41112,221,23,81,10,123,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41113,221,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41114,221,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41115,221,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41116,221,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41117,222,23,81,10,76,'Short_Answer','201909221',1,NULL,NULL,NULL,NULL,NULL),(41118,222,23,81,10,77,'Date','2020-01-28',1,NULL,NULL,NULL,NULL,NULL),(41119,222,23,81,10,78,'Multiple_Choice','Sara Romagnoli',1,NULL,NULL,NULL,NULL,NULL),(41120,222,23,81,10,79,'Multiple_Choice','Kelly Sather',1,NULL,NULL,NULL,NULL,NULL),(41121,222,23,81,10,80,'Short_Answer','NHS-Northstar Specialized Services',1,NULL,NULL,NULL,NULL,NULL),(41122,222,23,81,10,81,'Short_Answer','John Briski',1,NULL,NULL,NULL,NULL,NULL),(41123,222,23,81,10,82,'Short_Answer','j.briski@nhs-nss.com',1,NULL,NULL,NULL,NULL,NULL),(41124,222,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41125,222,23,81,10,84,'Multiple_Choice','Medication Error',1,NULL,NULL,NULL,NULL,NULL),(41126,222,23,81,10,85,'Multiple_Choice','St. Louis County',1,NULL,NULL,NULL,NULL,NULL),(41127,222,23,81,10,86,'Date','2019-12-18',1,NULL,NULL,NULL,NULL,NULL),(41128,222,23,81,10,87,'Free_Text','IMPACT/EFFECTS ON VA:\r\nDescription of Caregivers Behavior Creating a Health or Safety Risk for the VA: AP refused to administer medication to VA due to\r\nbehavior, AP told other Staff to not give VA medications\r\nImpact of Caregivers Behavior: VA not receive medication',1,NULL,NULL,NULL,NULL,NULL),(41129,222,23,81,10,96,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41130,222,23,81,10,91,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41131,222,23,81,10,94,'True_or_False','',1,NULL,NULL,NULL,NULL,NULL),(41132,222,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41133,222,23,81,10,98,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41134,222,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41135,222,23,81,10,100,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41136,222,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41137,222,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41138,222,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41139,222,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41140,222,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41141,222,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41142,222,23,81,10,101,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41143,222,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41144,222,23,81,10,103,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41145,222,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41146,222,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41147,222,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41148,222,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41149,222,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41150,222,23,81,10,109,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41151,222,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41152,222,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41153,222,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41154,222,23,81,10,113,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41155,222,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41156,222,23,81,10,115,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41157,222,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41158,222,23,81,10,117,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41159,222,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41160,222,23,81,10,119,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41161,222,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41162,222,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41163,222,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41164,222,23,81,10,123,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41165,222,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41166,222,23,81,10,125,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41167,222,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41168,222,23,81,10,432,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41169,223,23,81,10,76,'Short_Answer','2019-08-SLC-SR',1,NULL,NULL,NULL,NULL,NULL),(41170,223,23,81,10,77,'Date','2019-08-15',1,NULL,NULL,NULL,NULL,NULL),(41171,223,23,81,10,78,'Multiple_Choice','Sara Romagnoli',1,NULL,NULL,NULL,NULL,NULL),(41172,223,23,81,10,79,'Multiple_Choice','Kelly Sather',1,NULL,NULL,NULL,NULL,NULL),(41173,223,23,81,10,80,'Short_Answer','Northland AFC',1,NULL,NULL,NULL,NULL,NULL),(41174,223,23,81,10,81,'Short_Answer','Lindsay Nash',1,NULL,NULL,NULL,NULL,NULL),(41175,223,23,81,10,82,'Short_Answer','Lindsay Nash ',1,NULL,NULL,NULL,NULL,NULL),(41176,223,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41177,223,23,81,10,84,'Multiple_Choice','Elopement',1,NULL,NULL,NULL,NULL,NULL),(41178,223,23,81,10,85,'Multiple_Choice','St. Louis County',1,NULL,NULL,NULL,NULL,NULL),(41179,223,23,81,10,86,'Date','2019-07-21',1,NULL,NULL,NULL,NULL,NULL),(41180,223,23,81,10,87,'Free_Text','Person had confirmed plans with staff to go to the metro area and see a friend. Due to staffing constraints, there was a change resulting in the cancellation or postponement of the trip. \r\n\r\nOn 7/21/19 the person went out for a cigarette at 2am and then allegedly went back to his room. That was the last time he was seen. It was during this time he eloped to Burnsville and MSP. Staff called 911 on or around 5:00 pm the next day once they noticed he was not in his bedroom. \r\n',1,NULL,NULL,NULL,NULL,NULL),(41181,223,23,81,10,96,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41182,223,23,81,10,91,'Short_Answer','Provider cancelled a person\'s planned trip',1,NULL,NULL,NULL,NULL,NULL),(41183,223,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41184,223,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41185,223,23,81,10,98,'Free_Text','Person had been living at this house only months but had been with the same provider in a different home previously. He wanted to visit a friend near the metro area. Staff conveyed because of the distance and time for the trip it made sense that someone who was working a double shift would make the drive with him. Person followed usual and proper channels to schedule the out of town social activity.\r\nStaff felt that scheduling had become complicated at the time due to employees utilizing vacation time and also during that time the agency was very short staffed. The staff who was scheduled to take him on the trip during a double shift ended up not working the double shift because of how vacation was utilized. When the team saw this schedule conflict, the person was informed they couldn’t go on that weekend. He was initially disappointed, but he seemed to handle the news well after the initial disappointment. \r\nThe house manager usually has an assistant who arranges trips for residents. They work hard to prioritize social outings for people, trips and activities are accommodated. That assistant position was vacant and the house manager was feeling the “burn” of long hours and covering duties outside of her position. The staffing shortage made it hard to be sure residents were able to participate in desired activities.\r\nThe day they noticed person had eloped, staff had assumed he was sleeping in. He usually wakes by 9:00 but since he wasn’t utilizing a job coach during that time, there was no regular asleep/awake schedule. Also, there were no required checks in his plan. During counts, they noticed the bedroom door locked, but saw the window was open and that’s when they discovered he wasn’t there. Some of the staff were aware of his schedule change and that he was originally upset but had seemed to be fine with the change. \r\nPerson has history of elopement. He has a hard time making and keeping friends.  All of his housemates have girlfriends. When he elopes, they believe it is to see a female. Some of his housemates take trips together which he can’t attend due to his inability to afford the trips they take. \r\nHis adoptive mother/guardian is seen as unsupportive. There’s an impression among staff his adoptive mom and him bring out the worst in each other. They believe she expects the worst in him, affecting how he sees himself. They believe their relationship impacts his decisions in a negative way. \r\n',1,NULL,NULL,NULL,NULL,NULL),(41186,223,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41187,223,23,81,10,100,'Free_Text','The provider cancelling a planned trip for a person they served had a number of influences. On the morning the person was going to go on the trip, the provider was short staffed. Originally, the overnight staff was going to work a double shift by staying on for the morning shift. This staff ended up unable to work the morning shift, leaving the home with 2 staff instead of the typical 3. The provider agency was short staffed in general and did not fill the 3rd staff position for this day. The home served 4 people, 2 of which frequently exhibited challenging behavior. This level of need impacted the assignation of 3 staff to the day shifts. Also, the person’s CSSP addendum approved by the county required that the person be staffed at least 1:1 for trips, so due to short staffing it was not possible to send another staff on the trip. A factor into why 1:1 was necessary for trips was that the person had a history of abuse and because of this the guardian usually did not allow the person to meet people they met online without the 1:1 supervision required by the CSSP. Playing into the staffing requirements of the home too was the negotiation process between the county and the provider facilitated by DHS Form 6790 which determines staffing levels. This negotiation is impacted by each person in the home’s MnCHOICES assessment of need completed by the lead agency, as well as the Disability Waiver Rate Setting System which calculates service rates based on staffing needs. The Minnesota Legislature created both MnCHOICES and DWRS requirements. \r\nThis specific staff who couldn’t work the morning shift was the staff the person wanted to take him on the trip and he did not want to go with the other available staff. The person did not want the friend he was going to see to know he lived at the group home, and reportedly felt more comfortable going with the staff who was unable to work the morning shift. \r\nAnother influence to cancelling the trip was that the house manager felt burned out. The influences to the manager feeling burned out included the fact that the provider was – as noted above - short staffed as an agency, the scheduler position who typically takes care of trips was also vacant, a number of staff were taking vacations at this time and the manager was filling a number of shifts themselves. Low unemployment rates in Minnesota and the region contributed to the provider’s short staff issue. Also, this specific trip required a staff to work more than 8 hours due to the distance of trip: driving from Duluth to the Twin Cities required 5-6 hours of drive time alone. This is why the overnight staff who was going to work the double was going to take the person. There was not any staff who could work an extra shift to take this person on the trip, let alone a staff the person wanted to go with. Typical policy was that the provider required 2 weeks notice before long trips to accommodate obtaining a guardian’s permission, case manager agreement and putting together the staffing needs, which made accommodating unexpected staff shortages difficult.  \r\nThe last of the influences identified was that this trip wasn’t a top priority for the staff. The person wanted to see a friend they met online in the metro area, but this person had a history of misusing social media. Specifically, when using social media, the person had a history of pretending to be someone else (known as catfishing) and, as mentioned above, had a history of being abused by people they met online. Partly due to this history, the staff wasn’t sure that the person their client wanted to visit was fully aware of who he was. Due to the vulnerability of the person and their history, the spontaneous trip didn’t meet the needs of the person. \r\n',1,NULL,NULL,NULL,NULL,NULL),(41188,223,23,81,10,127,'Short_Answer','Staff did not perform visual checks between 2am and 5pm',1,NULL,NULL,NULL,NULL,NULL),(41189,223,23,81,10,128,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41190,223,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41191,223,23,81,10,130,'Free_Text','Person had been living at this house only months but had been with the same provider in a different home previously. He wanted to visit a friend near the metro area. Staff conveyed because of the distance and time for the trip it made sense that someone who was working a double shift would make the drive with him. Person followed usual and proper channels to schedule the out of town social activity.\r\nStaff felt that scheduling had become complicated at the time due to employees utilizing vacation time and also during that time the agency was very short staffed. The staff who was scheduled to take him on the trip during a double shift ended up not working the double shift because of how vacation was utilized. When the team saw this schedule conflict, the person was informed they couldn’t go on that weekend. He was initially disappointed, but he seemed to handle the news well after the initial disappointment. \r\nThe house manager usually has an assistant who arranges trips for residents. They work hard to prioritize social outings for people, trips and activities are accommodated. That assistant position was vacant and the house manager was feeling the “burn” of long hours and covering duties outside of her position. The staffing shortage made it hard to be sure residents were able to participate in desired activities.\r\nThe day they noticed person had eloped, staff had assumed he was sleeping in. He usually wakes by 9:00 but since he wasn’t utilizing a job coach during that time, there was no regular asleep/awake schedule. Also, there were no required checks in his plan. During counts, they noticed the bedroom door locked, but saw the window was open and that’s when they discovered he wasn’t there. Some of the staff were aware of his schedule change and that he was originally upset but had seemed to be fine with the change. \r\nPerson has history of elopement. He has a hard time making and keeping friends.  All of his housemates have girlfriends. When he elopes, they believe it is to see a female. Some of his housemates take trips together which he can’t attend due to his inability to afford the trips they take. \r\nHis adoptive mother/guardian is seen as unsupportive. There’s an impression among staff his adoptive mom and him bring out the worst in each other. They believe she expects the worst in him, affecting how he sees himself. They believe their relationship impacts his decisions in a negative way. \r\n',1,NULL,NULL,NULL,NULL,NULL),(41192,223,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41193,223,23,81,10,132,'Free_Text','Staff not performing visual checks on a person between 2am and 5pm had a number of influences. On the day the checks were not performed, the staff did not have any reason to believe that the person had eloped. While the person did have a history of elopement, he usually exhibited telltale signs of leaving the house such as telling staff they were leaving and/or taking a bag with him. These typical signs were not present this day. Instead the person left without telling anyone or taking a bag with him. Adding to the lack of reason to believe the person eloped was that the person often slept in, had an inconsistent sleep schedule, and refused to eat breakfast on the weekends, so sleeping in on Saturdays was a norm . This person also did not like to be bothered and often wanted his privacy while in his room. Due to cultural norms to allow privacy to people in their bedrooms along with the provider’s licensing statute – MS 245D – guaranteeing a person the right to privacy, this was wish was respected. \r\nAn additional influence to why checks weren’t performed was that the morning shift was short staffed. The house typically required 3 staff to be on in the morning. The overnight staff was going to work a double shift by staying on for the morning shift, but was unable to work. This left the provider with only 2 staff working in the morning shift. It was a norm at the house that they were comfortable only having 2 staff on if both staff were veteran staff, which was the case this day. Although the veteran staff were comfortable working short staffed, this did mean that the two staff had more responsibilities and were thus somewhat overworked and busy that day . \r\n The last influence identified by the mapping team into why staff did not perform checks was that the person’s plan did not require visual checks when he was at home. The provider typically does not perform visual checks on any person while they are in their own home. This practice is impacted by cultural norms to allow people privacy in their bedroom, an emphasis on person-centered planning and thinking and 245D rights to privacy. The provider noted that the only scenario in which they provide visual checks on a person when they were at home was if the person’s Coordinated Service and Support Plan (CSSP), created by the person’s case manager at the lead agency, indicated a need for them and assigned the provider responsibility for it. But considering the person’s history and his desire for privacy, the CSSP did not identify this as a need for this person at the time . The CSSP is created after a MnCHOICES assessment of the person’s needs is completed and neither the assessment nor the plan identified this level of need. Levels of need identified in the CSSP are reflected in the negotiation between the lead agency and the provider facilitated by the DHS-6790 Form. This form is influenced by the provider’s needs, the lead agency’s identification of the person’s needs and the Disability Waiver Rates System which provides a calculation for the person’s service rates. It was the final 6790 which ultimately allowed for the home to sometimes have 3 staff working the morning shift. \r\n',1,NULL,NULL,NULL,NULL,NULL),(41194,223,23,81,10,101,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41195,223,23,81,10,102,'Free_Text','On the day the checks were not performed, the staff did not have any reason to believe that the person had eloped. While the person did have a history of elopement, he usually exhibited telltale signs of leaving the house such as telling staff they were leaving and/or taking a bag with him. These typical signs were not present this day.',1,NULL,NULL,NULL,NULL,NULL),(41196,223,23,81,10,103,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41197,223,23,81,10,104,'Free_Text','On the morning the person was going to go on the trip, the provider was short staffed. The provider agency was short staffed in general and did not fill the 3rd staff position for this day.',1,NULL,NULL,NULL,NULL,NULL),(41198,223,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41199,223,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41200,223,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41201,223,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41202,223,23,81,10,109,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41203,223,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41204,223,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41205,223,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41206,223,23,81,10,113,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41207,223,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41208,223,23,81,10,115,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41209,223,23,81,10,116,'Free_Text','Typical policy was that the provider required 2 weeks notice before long trips to accommodate obtaining a guardian’s permission, case manager agreement and putting together the staffing needs, which made accommodating unexpected staff shortages difficult.\r\n\r\nThe last influence identified by the mapping team into why staff did not perform checks was that the person’s plan did not require visual checks when he was at home.',1,NULL,NULL,NULL,NULL,NULL),(41210,223,23,81,10,117,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41211,223,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41212,223,23,81,10,119,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41213,223,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41214,223,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41215,223,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41216,223,23,81,10,123,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41217,223,23,81,10,124,'Free_Text','The house typically required 3 staff to be on in the morning. The overnight staff was going to work a double shift by staying on for the morning shift, but was unable to work. This left the provider with only 2 staff working in the morning shift. It was a norm at the house that they were comfortable only having 2 staff on if both staff were veteran staff, which was the case this day.',1,NULL,NULL,NULL,NULL,NULL),(41218,223,23,81,10,125,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41219,223,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41220,223,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41221,224,23,81,10,76,'Short_Answer','SR_Northland AFC-SLC-2020-08',1,NULL,NULL,NULL,NULL,NULL),(41222,224,23,81,10,77,'Date','2020-08-26',1,NULL,NULL,NULL,NULL,NULL),(41223,224,23,81,10,78,'Multiple_Choice','Sara Romagnoli',1,NULL,NULL,NULL,NULL,NULL),(41224,224,23,81,10,79,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41225,224,23,81,10,80,'Short_Answer','Northland AFC',1,NULL,NULL,NULL,NULL,NULL),(41226,224,23,81,10,81,'Short_Answer','Lindsay Nash',1,NULL,NULL,NULL,NULL,NULL),(41227,224,23,81,10,82,'Short_Answer','lindsay@northlandafc.com',1,NULL,NULL,NULL,NULL,NULL),(41228,224,23,81,10,83,'Short_Answer','218-464-3864',1,NULL,NULL,NULL,NULL,NULL),(41229,224,23,81,10,84,'Multiple_Choice','Elopement',1,NULL,NULL,NULL,NULL,NULL),(41230,224,23,81,10,85,'Multiple_Choice','St. Louis County',1,NULL,NULL,NULL,NULL,NULL),(41231,224,23,81,10,86,'Date','2020-07-17',1,NULL,NULL,NULL,NULL,NULL),(41232,224,23,81,10,87,'Free_Text','VA went to his room at 6:45 p.m. Was known to be missing at 8:00 p.m. VA was to be quarantining due to COVID-19 guidelines. ',1,NULL,NULL,NULL,NULL,NULL),(41233,224,23,81,10,96,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41234,224,23,81,10,91,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41235,224,23,81,10,94,'True_or_False','',1,NULL,NULL,NULL,NULL,NULL),(41236,224,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41237,224,23,81,10,98,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41238,224,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41239,224,23,81,10,100,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41240,224,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41241,224,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41242,224,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41243,224,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41244,224,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41245,224,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41246,224,23,81,10,101,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41247,224,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41248,224,23,81,10,103,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41249,224,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41250,224,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41251,224,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41252,224,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41253,224,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41254,224,23,81,10,109,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41255,224,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41256,224,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41257,224,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41258,224,23,81,10,113,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41259,224,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41260,224,23,81,10,115,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41261,224,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41262,224,23,81,10,117,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41263,224,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41264,224,23,81,10,119,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41265,224,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41266,224,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41267,224,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41268,224,23,81,10,123,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41269,224,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41270,224,23,81,10,125,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41271,224,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41272,224,23,81,10,432,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41273,225,23,81,10,76,'Short_Answer','201900095',1,NULL,NULL,NULL,NULL,NULL),(41274,225,23,81,10,77,'Date','2019-05-15',1,NULL,NULL,NULL,NULL,NULL),(41275,225,23,81,10,78,'Multiple_Choice','Sara Romagnoli',1,NULL,NULL,NULL,NULL,NULL),(41276,225,23,81,10,79,'Multiple_Choice','Charles Young',1,NULL,NULL,NULL,NULL,NULL),(41277,225,23,81,10,80,'Short_Answer','REM Arrowhead',1,NULL,NULL,NULL,NULL,NULL),(41278,225,23,81,10,81,'Short_Answer','Corey Labissoniere',1,NULL,NULL,NULL,NULL,NULL),(41279,225,23,81,10,82,'Short_Answer','Corey.LaBissoniere@thementornetwork.com',1,NULL,NULL,NULL,NULL,NULL),(41280,225,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41281,225,23,81,10,84,'Multiple_Choice','Medication Error',1,NULL,NULL,NULL,NULL,NULL),(41282,225,23,81,10,85,'Multiple_Choice','St. Louis County',1,NULL,NULL,NULL,NULL,NULL),(41283,225,23,81,10,86,'Date','2019-10-02',1,NULL,NULL,NULL,NULL,NULL),(41284,225,23,81,10,87,'Free_Text','Several staff administered more than one dose of PRN on several occasions to a person who had been prescribed several PRNs.',1,NULL,NULL,NULL,NULL,NULL),(41285,225,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41286,225,23,81,10,91,'Short_Answer','Staff administered more than one dose of PRN on several days in October 2018.',1,NULL,NULL,NULL,NULL,NULL),(41287,225,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41288,225,23,81,10,97,'Date','2019-06-25',1,NULL,NULL,NULL,NULL,NULL),(41289,225,23,81,10,98,'Free_Text','Several workers administered the medication in the same way resulting in the error. Their decision to administer the medication in the way they did was driven by the instructions on the MAR which they all interpreted the same way, and which was also the incorrect interpretation. The staff interpreted the instruction of “daily” to mean he could have it daily instead it meant a maximum daily (meant once a day and must be 4-6 hours after the last medication and only once a day, not every 4-6 hours daily), thus the over administration. The instructions were on the MAR and not on the med label, which was common practice. The staff followed the policy to check the label and MAR 3x any time there’s a med pass. All staff had received the required training and followed the signature and other MAR review requirements.\r\nThere were four people who signed off as over-administering the PRN. Two were DSPs, one area manager and one program director. The area manager and program director were covering for DSP hours due to a staffing shortage. The DSPs there were new to the agency, as was the program supervisor and the person. It was also noted the person subjected to the overmedication was a new client to the provider. It was conveyed that in a perfect world the provider wouldn’t take new service recipients until all staff were trained specific to a person. He came into a house that was already short-staffed. \r\n\r\nThe person had a high level of care, high needs, compared to others served at the home and was a newer resident of the home, moved there in September and incidents occurred in October. He began receiving services from this home after being in a hospital long after he required a hospital level of care. The transition from the hospital was described as hard: hospital social worker and care team communications were strained and confusing, and the med orders were also described as confusing. When a person with controlled meds transfers from a hospital to a provider, that time was described as being filled with angst. The sense of urgency leads to added stress. He was at the hospital for almost a year and there was extreme pressure to move him out of the hospital. The transition and care planning for this person were complicated by the fact that his guardian and contracted case manager were from Ramsey County. \r\n\r\nHe had multiple controlled meds and overlapping PRNs. For example, one PRN can only be taken X# of hours after another PRN, and there were several of these time lines and instructions to monitor. There was also one other man at the home who had a high contingent of medications. \r\n\r\nThe decision to administer the PRNs was also driven by the prescriber’s instruction to “give him the PRN if he asks for it.” Person had been asking for many PRNs frequently. It was common for him to have more than one agitation a day. He had a diagnosis that included schizophrenia, delusional behavior. He had a long history of chemical abuse. Some of his PRNs included an inhaler, med to reduce nausea, ointment for gums. Staff describe his as having high seeking behavior and describe him as liking to be in control of his medications. He was seen by the staff as being very anxious and demanding. He occasionally raised his voice, swore, used power moves, his thoughts could get “out of control” and turn delusional. It was difficult for staff who had no experience with that. \r\nStaff attribute staffing of the house as a challenge. The house was very short staffed. The provider was not receiving exception rates for the people at this home. They attempted to increase the wage. The location of the home may have been a barrier to keeping it staffed. \r\nThe incident on 11/20/2018, the omission of a medication on the MAR, was influenced by a staffing shortage. The medication was not added to the MAR and it would have been a supervisor’s role to ensure the MAR was correct. The supervisor in charge of the MAR at that time is no longer with the company and was not debriefed. The person who attended the appointment, which was likely the same supervisor, also had a duty to ensure the correct instructions were passed along but that did not happen. ',1,NULL,NULL,NULL,NULL,NULL),(41290,225,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41291,225,23,81,10,100,'Free_Text','Several staff were involved in administering more than one dose of PRN to a person on several dates. This was influenced by a misinterpretation of instructions on the Medication Administration Report (MAR) which is created by the pharmacy. The instructions on the MAR, on the medication bottle and on the referral form for this person were all different. Although the instructions were different enough in wording and readability to create misinterpretation, they were not directly conflicting. For example, the dosage and timing in relation to other PRNs and possible interactions were not fully outlined on each in the same way.  This explains why the confusion may not have been caught despite staff triple checking the instructions each time they administered medications.\r\n\r\nAdding to the potential confusion was that the PRN medication was also prescribed as part of the person’s daily regimen, meaning that in addition to the instructions that it was a daily medication, the PRN was also instructed to be given as needed, but instructions did not specify a timeframe for administering after the daily dose was administered.\r\n\r\nWhile the MAR and other medical instructions are typically reviewed and clarified at intake and then communicated with staff, this transition and intake was perceived as rushed, even urgent. The med instructions were reviewed, but the confusing nature of the instructions along with the rushed intake explain the eventual misinterpretation by staff.There are circumstances that can make a typical intake feel rushed and urgent, which is what happened here. In this case, prior to moving into the home, this person had been in the hospital for a year beyond when he was assessed to no longer require hospital level of care. Hospital administrators feel a high level of pressure to release people. Case managers, in turn, feel that high level of pressure from the hospital. Logically, the provider feels that urgency with which the transition is needed to occur. Since the hospital had been providing services for a year after the person no longer required hospital level of care, staff sensed urgency around the release. Once a provider is found, the timeline for release is nearly immediate. The federal rate structure does not allow for hospitals to bill for services to people who do not require hospital level of care. The length of time the person remained at the hospital was impacted, likely directly caused, by a statewide shortage of community placement options for people with complex needs. \r\nEven under the very best of circumstances, working under an urgent timeline to transition a person with a complex medication schedule, and the fact the residential program was very understaffed, increases the likelihood an incident can occur. The confusing nature of the medication instructions, along with an expedited or “rushed” transition, explains how an error or misunderstanding could occur even if a manager conducted a med review during the transition and intake process. \r\n\r\nAnother factor that contributed to the administration of more than one dose of PRN was staff felt pressure to administer PRNs. The person’s history and diagnosis along with staff wanting to avoid a behavior incident added to the pressure to administer. The person asked for PRNs frequently and it was also the prescriber’s instruction to give the person the PRN when he asked for it. Additional dynamics contributing to the staff feeling a pressure to administer are that the person was new to the home; there were new staff recently hired, not necessarily fully trained for the exact unique needs of the person; and, the management staff covering for a staff shortage were just newly acquainted with the person.\r\n\r\nThe provider desired to make the placement successful, which also added to a perceived pressure to administer. There was a belief that administering PRNs as prescribed and when asked for would be one way to assist in a successful placement. Adding to the desire to facilitate a successful placement was the provider who has incentive to fill open beds which is directly impacted by the Disability Waiver Rates System, whose payment structure is determined by the number of people in a home.',1,NULL,NULL,NULL,NULL,NULL),(41292,225,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41293,225,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41294,225,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41295,225,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41296,225,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41297,225,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41298,225,23,81,10,101,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41299,225,23,81,10,102,'Free_Text','The person’s history and diagnosis along with staff wanting to avoid a behavior incident added to the pressure to administer. The person asked for PRNs frequently and it was also the prescriber’s instruction to give the person the PRN when he asked for it.',1,NULL,NULL,NULL,NULL,NULL),(41300,225,23,81,10,103,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41301,225,23,81,10,104,'Free_Text','Additional dynamics contributing to the staff feeling a pressure to administer are that the person was new to the home; there were new staff recently hired, not necessarily fully trained for the exact unique needs of the person; and, the management staff covering for a staff shortage were just newly acquainted with the person.',1,NULL,NULL,NULL,NULL,NULL),(41302,225,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41303,225,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41304,225,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41305,225,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41306,225,23,81,10,109,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41307,225,23,81,10,110,'Free_Text','Since the hospital had been providing services for a year after the person no longer required hospital level of care, staff sensed urgency around the release. Once a provider is found, the timeline for release is nearly immediate. Even under the very best of circumstances, working under an urgent timeline to transition a person with a complex medication schedule, and the fact the residential program was very understaffed, increases the likelihood an incident can occur. The confusing nature of the medication instructions, along with an expedited or “rushed” transition, explains how an error or misunderstanding could occur even if a manager conducted a med review during the transition and intake process. ',1,NULL,NULL,NULL,NULL,NULL),(41308,225,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41309,225,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41310,225,23,81,10,113,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41311,225,23,81,10,114,'Free_Text','The instructions on the MAR, on the medication bottle and on the referral form for this person were all different. Although the instructions were different enough in wording and readability to create misinterpretation, they were not directly conflicting. For example, the dosage and timing in relation to other PRNs and possible interactions were not fully outlined on each in the same way.  This explains why the confusion may not have been caught despite staff triple checking the instructions each time they administered medications.\r\n\r\nAdding to the potential confusion was that the PRN medication was also prescribed as part of the person’s daily regimen, meaning that in addition to the instructions that it was a daily medication, the PRN was also instructed to be given as needed, but instructions did not specify a timeframe for administering after the daily dose was administered.',1,NULL,NULL,NULL,NULL,NULL),(41312,225,23,81,10,115,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41313,225,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41314,225,23,81,10,117,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41315,225,23,81,10,118,'Free_Text','While the MAR and other medical instructions are typically reviewed and clarified at intake and then communicated with staff, this transition and intake was perceived as rushed, even urgent. The med instructions were reviewed, but the confusing nature of the instructions along with the rushed intake explain the eventual misinterpretation by staff. There are circumstances that can make a typical intake feel more urgent or even rushed, which is what happened here. In this case, prior to moving into the home, this person had been in the hospital for a year beyond when he was assessed to no longer require hospital level of care. Hospital administrators feel a high level of pressure to release people. Case managers, in turn, feel that high level of pressure from the hospital. Logically, the provider feels that urgency with which the transition is needed to occur. Since the hospital had been providing services for a year after the person no longer required hospital level of care, staff sensed urgency around the release. Once a provider is found, the timeline for release is nearly immediate. The federal rate structure does not allow for hospitals to bill for services to people who do not require hospital level of care. The length of time the person remained at the hospital was impacted, likely directly caused, by a statewide shortage of community placement options for people with complex needs. \r\n\r\nThe provider desired to make the placement successful, which also added to a perceived pressure to administer. There was a belief that administering PRNs as prescribed and when asked for would be one way to assist in a successful placement. Adding to the desire to facilitate a successful placement was the provider who has incentive to fill open beds which is directly impacted by the Disability Waiver Rates System, whose payment structure is determined by the number of people in a home.',1,NULL,NULL,NULL,NULL,NULL),(41316,225,23,81,10,119,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41317,225,23,81,10,120,'Free_Text','The length of time the person remained at the hospital was impacted, likely directly caused, by a statewide shortage of community placement options for people with complex needs.',1,NULL,NULL,NULL,NULL,NULL),(41318,225,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41319,225,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41320,225,23,81,10,123,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41321,225,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41322,225,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41323,225,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41324,225,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41325,226,23,81,10,76,'Short_Answer','201906864',1,NULL,NULL,NULL,NULL,NULL),(41326,226,23,81,10,77,'Date','2019-10-15',1,NULL,NULL,NULL,NULL,NULL),(41327,226,23,81,10,78,'Multiple_Choice','Sara Romagnoli',1,NULL,NULL,NULL,NULL,NULL),(41328,226,23,81,10,79,'Multiple_Choice','Tony Gantenbein',1,NULL,NULL,NULL,NULL,NULL),(41329,226,23,81,10,80,'Short_Answer','Stepping Stones for Living',1,NULL,NULL,NULL,NULL,NULL),(41330,226,23,81,10,81,'Short_Answer','Laura Flynn',1,NULL,NULL,NULL,NULL,NULL),(41331,226,23,81,10,82,'Short_Answer','laura.flynn@sslduluth.com',1,NULL,NULL,NULL,NULL,NULL),(41332,226,23,81,10,83,'Short_Answer','218-336-6413',1,NULL,NULL,NULL,NULL,NULL),(41333,226,23,81,10,84,'Multiple_Choice','Staff Sleeping on Duty',1,NULL,NULL,NULL,NULL,NULL),(41334,226,23,81,10,85,'Multiple_Choice','St. Louis County',1,NULL,NULL,NULL,NULL,NULL),(41335,226,23,81,10,86,'Date','2019-09-19',1,NULL,NULL,NULL,NULL,NULL),(41336,226,23,81,10,87,'Free_Text','On 09/19/2019, it was reported that AP was found sleeping during their shift when they were to be supervising VA. At this time it is undetermined how long AP was asleep for. No harm came to VA during this time.',1,NULL,NULL,NULL,NULL,NULL),(41337,226,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41338,226,23,81,10,91,'Short_Answer','One staff fell asleep during the day shift.',1,NULL,NULL,NULL,NULL,NULL),(41339,226,23,81,10,94,'True_or_False','No',1,NULL,NULL,NULL,NULL,NULL),(41340,226,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41341,226,23,81,10,98,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41342,226,23,81,10,99,'Multiple_Choice','Staff No Longer Employed',1,NULL,NULL,NULL,NULL,NULL),(41343,226,23,81,10,100,'Free_Text','St. Louis County (Provider-Stepping Stones for Living)\r\nNarrative-Staff Sleeping\r\n\r\nLearning point: One staff fell asleep during the day shift. \r\n\r\nA DSP was found sleeping during the day shift while supervising two VAs. No harm came to VAs as a result. The staff sleeping was influenced by environmental factors in the home as well as outside factors. \r\n\r\nOne environmental factor in the home the day of the incident was that there were less people for the DSP to supervise than normal. There is usually an additional person to supervise, as the staffing ratio was 1:3. The third person was at an activity at the time. Due to this, the house was more quiet than usual which allowed for a more relaxed environment that lent itself to rest. For residents of the home, their needs are defined by assessment results and outlined in a Community Services and Support Plan. The level of staffing needed to address these needs is agreed to by provider and lead agency via a rate management worksheet called a 6790. The rates for the services which take into account shared and individual staffing are then entered into and set by the Disability Waiver Rates System (DWRS). \r\nAnother environmental factor in the home was the daily program consisted of unstructured home time and TV watching. That day, the house was quiet and there was unstructured TV watching time. Programs or daily schedules for residents are outlined in their CSSP and supported by policies that emphasize and protect personal preference. Personal preference and control over one’s schedule is a tenant of the federal Home and Community Based Services Rule which governs HCBS providers. Additionally, residential providers are required to carry a 245D license which secures a person’s right to choose activities they prefer and have a say in their daily schedule. This unstructured time was an additional factor that led to a quiet house in which the staff experienced down time, leading to sleep. \r\nOutside factors that contributed to staff sleeping were also present. One outside factor is that the DSP was experiencing homelessness and was exhausted from that life stressor. It is not uncommon for DSPs to experience intermittent homelessness. In the Northeast MN region, there is a lack of affordable housing, housing resources and coordination. The governmental body that oversees housing and distribution of housing resources is Housing and Urban Development. \r\nAnother outside factor is the DSP was working extra shifts as the provider had unfilled shifts available. In doing so, the DSP’s basic needs such as having a roof over his head were met. He picked up extra shifts also because the provider was offering overtime pay. The fact the provider had unfilled shifts is due to the well-known and highly publicized state and national workforce shortage. \r\n\r\n',1,NULL,NULL,NULL,NULL,NULL),(41344,226,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41345,226,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41346,226,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41347,226,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41348,226,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41349,226,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41350,226,23,81,10,101,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41351,226,23,81,10,102,'Free_Text','One environmental factor in the home the day of the incident was that there were less people for the DSP to supervise than normal. There is usually an additional person to supervise, as the staffing ratio was 1:3. The third person was at an activity at the time. Due to this, the house was more quiet than usual which allowed for a more relaxed environment that lent itself to rest. For residents of the home, their needs are defined by assessment results and outlined in a Community Services and Support Plan. The level of staffing needed to address these needs is agreed to by provider and lead agency via a rate management worksheet called a 6790. The rates for the services which take into account shared and individual staffing are then entered into and set by the Disability Waiver Rates System (DWRS). \r\nAnother environmental factor in the home was the daily program consisted of unstructured home time and TV watching. That day, the house was quiet and there was unstructured TV watching time. Programs or daily schedules for residents are outlined in their CSSP and supported by policies that emphasize and protect personal preference. Personal preference and control over one’s schedule is a tenant of the federal Home and Community Based Services Rule which governs HCBS providers. Additionally, residential providers are required to carry a 245D license which secures a person’s right to choose activities they prefer and have a say in their daily schedule. This unstructured time was an additional factor that led to a quiet house in which the staff experienced down time, leading to sleep. \r\n',1,NULL,NULL,NULL,NULL,NULL),(41352,226,23,81,10,103,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41353,226,23,81,10,104,'Free_Text','Outside factors that contributed to staff sleeping were also present. One outside factor is that the DSP was experiencing homelessness and was exhausted from that life stressor. It is not uncommon for DSPs to experience intermittent homelessness. In the Northeast MN region, there is a lack of affordable housing, housing resources and coordination. The governmental body that oversees housing and distribution of housing resources is Housing and Urban Development. \r\nAnother outside factor is the DSP was working extra shifts as the provider had unfilled shifts available. In doing so, the DSP’s basic needs such as having a roof over his head were met. He picked up extra shifts also because the provider was offering overtime pay. The fact the provider had unfilled shifts is due to the well-known and highly publicized state and national workforce shortage. \r\n',1,NULL,NULL,NULL,NULL,NULL),(41354,226,23,81,10,105,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41355,226,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41356,226,23,81,10,107,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41357,226,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41358,226,23,81,10,109,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41359,226,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41360,226,23,81,10,111,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41361,226,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41362,226,23,81,10,113,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41363,226,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41364,226,23,81,10,115,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41365,226,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41366,226,23,81,10,117,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41367,226,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41368,226,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41369,226,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41370,226,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41371,226,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41372,226,23,81,10,123,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41373,226,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41374,226,23,81,10,125,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41375,226,23,81,10,126,'Free_Text','Outside factors that contributed to staff sleeping were also present. One outside factor is that the DSP was experiencing homelessness and was exhausted from that life stressor. It is not uncommon for DSPs to experience intermittent homelessness. In the Northeast MN region, there is a lack of affordable housing, housing resources and coordination. The governmental body that oversees housing and distribution of housing resources is Housing and Urban Development. \r\nAnother outside factor is the DSP was working extra shifts as the provider had unfilled shifts available. In doing so, the DSP’s basic needs such as having a roof over his head were met. He picked up extra shifts also because the provider was offering overtime pay. The fact the provider had unfilled shifts is due to the well-known and highly publicized state and national workforce shortage. \r\n',1,NULL,NULL,NULL,NULL,NULL),(41376,226,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41377,227,23,81,10,76,'Short_Answer','SS_BridgesMN-HC-2020-08',1,NULL,NULL,NULL,NULL,NULL),(41378,227,23,81,10,77,'Date','2020-08-26',1,NULL,NULL,NULL,NULL,NULL),(41379,227,23,81,10,78,'Multiple_Choice','Scott Schifsky',1,NULL,NULL,NULL,NULL,NULL),(41380,227,23,81,10,79,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41381,227,23,81,10,80,'Short_Answer','Bridges MN',1,NULL,NULL,NULL,NULL,NULL),(41382,227,23,81,10,81,'Short_Answer','Kelsey Traynor (completed the BIRF)',1,NULL,NULL,NULL,NULL,NULL),(41383,227,23,81,10,82,'Short_Answer','kelseyt@bridgesmn.com',1,NULL,NULL,NULL,NULL,NULL),(41384,227,23,81,10,83,'Short_Answer','651-334-9629',1,NULL,NULL,NULL,NULL,NULL),(41385,227,23,81,10,84,'Multiple_Choice','Elopement',1,NULL,NULL,NULL,NULL,NULL),(41386,227,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41387,227,23,81,10,86,'Date','2020-06-29',1,NULL,NULL,NULL,NULL,NULL),(41388,227,23,81,10,87,'Free_Text','On 06/29/2020 VA packed up his belongings at approximately 6:00 pm and left the home, stating he was going to\r\nChicago to visit his sister. VA then proceeded to walk towards the bus stop and waited. Staff followed the bus once VA got on the bus. Staff\r\ncontacted Metro Transit Police for assistance, who then intervened. The officer called the Supervisor, who then called in the Community\r\nLiving Director (CLD) as well, via phone, to discuss the situation. The CLD explained VA\'s situation and that he is on a commitment and\r\nprovisional discharge, and requested assistance in getting the VA back to the residence. The officer informed the CLD and supervisor that\r\ndue to VA being their own guardian and not being a danger to himself or others, they could not do anything except encourage VA to go with\r\nstaff. The CLD then met VA and staff at the Greyhound Bus Station in Minneapolis a little before 8:00 pm, just as VA was purchasing a bus\r\nticket to Chicago. Staff and CLD attempted every approach they could think of to get VA to reconsider leaving the state, but VA still planned\r\nto get on the bus. VA reported having connections in Chicago and has a plan, but would not share any further details. VA recently\r\npurchased a cell phone, but refused to give staff the phone number to the new phone. The CLD called Fairview Hospital to discuss the\r\nsituation, but they also stated \"our hands are tied\" since VA is his own guardian. Staff remained with VA at the bus station until 1:00 am on\r\n06/30/2020, when VA left on the greyhound bus to Chicago. The CLD filed a missing persons report with the Minneapolis Police\r\nDepartment, who stated they would pass this report along to the Chicago Police Department as well. The CLD attempted to contact VA\'s\r\nmother, but the mother\'s phone was disconnected. The CLD also attempted to call VA\'s grandmother, who did not answer or respond to\r\nthe CLD\'s voicemails.\r\nStaff followed all care plans and attempted to redirect VA into not going on the bus, but VA made the choice to leave. VA did not have any\r\nmedications packed and is due for an injection on 07/08/2020. VA is prescribed multiple psychotropic medications, including an injection.\r\nVA has a history of attempting to ',1,NULL,NULL,NULL,NULL,NULL),(41389,227,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41390,227,23,81,10,91,'Short_Answer','Staff did not follow person’s plan that said the person should not have alone time.',1,NULL,NULL,NULL,NULL,NULL),(41391,227,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41392,227,23,81,10,97,'Date','2020-10-06',1,NULL,NULL,NULL,NULL,NULL),(41393,227,23,81,10,98,'Free_Text','Two night staff from Bridges were de-briefed.  They relieved two second shift staff who followed the person to the bus station and worked to help attempt to help the person return home.  \r\n\r\nThe staff worked by relieving each other in the bus station as there was not adequate parking at the bus station so they had to park on the street and one person needed to remain in the car to assure it did not get towed.   They both stated the person would not talk to them and the bus station was very busy.  The person smoked frequently outside the bus station while waiting for departure.   Staff also had one mask to share while switching spots from the car to inside the bus station next to the person.  Staff would use their shirt as a mask while switching.   The person spent most of their time listening to music and ignoring staff.   Staff attempted several times to have a conversation in an effort to persuade the person to return back to the home.   At about 1:00 AM the person departed on the bus and staff returned back to the home.   Staff were in frequent contact with the home manager for guidance. Staff were instructed to remain with the person at the bus station, however, they were instructed that he was his own guardian and could leave.\r\n',1,NULL,NULL,NULL,NULL,NULL),(41394,227,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41395,227,23,81,10,100,'Free_Text','Learning Point:  Staff were unable to redirect a person from departing on a bus to Chicago.  \r\n\r\nStaff was unable to redirect a person from departing on a bus to Chicago and this was influenced by wanting to go to Chicago to visit their sister. This matter was complicated given the person wouldn’t communicate with staff present.  All efforts to redirect the person were unsuccessful while exhausting all other safe alternatives. The person was earlier hospitalized regarding mental health and aggression and the staff was hesitant at the moment and didn’t want to anger the person further. Another contributing factor was that the person received a COVID stimulus check that created the means for the visit to Chicago.    \r\n\r\nStaff being unable to redirect the person was influenced by the provider ultimately determining the risk was low to take the trip without staff. After many unsuccessful attempts to redirect, the provider reviewed the person’s risk management plan and it was affirmed. Contributing factors that further influenced the staffs’ decision to remain at the bus station was the expectation of the lead agency and CSSP was not to follow a person to another state while eloping and assure full communication with all team members and agency staff.\r\n\r\nAnother influence to the inability to redirect was that staff were hesitant to anger the person. This was further supported by the person having a history of aggressive behavior. The person wouldn’t communicate with the staff present and they were hesitant to coerce the person too much in their efforts to support him in being safe. Staff also did offer to support this trip at a future date with proper planning to assure health and safety. This moment was further complicated by contacting the hospital who stated there was nothing they or staff could do given the person was his own guardian which further limited staff in their efforts to help him return home.\r\n\r\nAn additional feature that impacted the support lent to the person was the agency’s practice of person-centered efforts in trying to find balance of what was important to and for the person while making decisions at that moment. Their operating philosophy supported personal freedoms and choices based on experiences over time.  There is also an overall systemic expectation that providers support experiences, choices, and the person’s rights.   \r\n\r\nStaff being unable to redirect was influenced by the provider exhausting all safe alternatives. The person is their own guardian and did have a provisional discharge from the program.  Furthermore, COVID and the Governor’s stay at home order also influenced the person’s decision to leave as his routine was limited to low activity. This elopement influenced the agency, team, and staff present to honor the person’s civil rights which connected directly to their philosophy of protecting his rights which put him in charge of making the decision to leave on the bus.    \r\n\r\n',1,NULL,NULL,NULL,NULL,NULL),(41396,227,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41397,227,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41398,227,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41399,227,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41400,227,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41401,227,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41402,227,23,81,10,101,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41403,227,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41404,227,23,81,10,103,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41405,227,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41406,227,23,81,10,105,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41407,227,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41408,227,23,81,10,107,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41409,227,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41410,227,23,81,10,109,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41411,227,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41412,227,23,81,10,111,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41413,227,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41414,227,23,81,10,113,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41415,227,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41416,227,23,81,10,115,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41417,227,23,81,10,116,'Free_Text','Staff was unable to redirect a person from departing on a bus to Chicago and this was influenced by wanting to go to Chicago to visit their sister. This matter was complicated given the person wouldn’t communicate with staff present.  All efforts to redirect the person were unsuccessful while exhausting all other safe alternatives. The person was earlier hospitalized regarding mental health and aggression and the staff was hesitant at the moment and didn’t want to anger the person further. Another contributing factor was that the person received a COVID stimulus check that created the means for the visit to Chicago.    \r\n\r\nStaff being unable to redirect the person was influenced by the provider ultimately determining the risk was low to take the trip without staff. After many unsuccessful attempts to redirect, the provider reviewed the person’s risk management plan and it was affirmed. Contributing factors that further influenced the staffs’ decision to remain at the bus station was the expectation of the lead agency and CSSP was not to follow a person to another state while eloping and assure full communication with all team members and agency staff.\r\n\r\nAnother influence to the inability to redirect was that staff were hesitant to anger the person. This was further supported by the person having a history of aggressive behavior. The person wouldn’t communicate with the staff present and they were hesitant to coerce the person too much in their efforts to support him in being safe. Staff also did offer to support this trip at a future date with proper planning to assure health and safety. This moment was further complicated by contacting the hospital who stated there was nothing they or staff could do given the person was his own guardian which further limited staff in their efforts to help him return home.\r\n\r\nAn additional feature that impacted the support lent to the person was the agency’s practice of person-centered efforts in trying to find balance of what was important to and for the person while making decisions at that moment. Their operating philosophy supported personal freedoms and choices based on experiences over time.  There is also an overall systemic expectation that providers support experiences, choices, and the person’s rights.   \r\n\r\nStaff being unable to redirect was influenced by the provider exhausting all safe alternatives. The person is their own guardian and did have a provisional discharge from the program.  Furthermore, COVID and the Governor’s stay at home order also influenced the person’s decision to leave as his routine was limited to low activity. This elopement influenced the agency, team, and staff present to honor the person’s civil rights which connected directly to their philosophy of protecting his rights which put him in charge of making the decision to leave on the bus. ',1,NULL,NULL,NULL,NULL,NULL),(41418,227,23,81,10,117,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41419,227,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41420,227,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41421,227,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41422,227,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41423,227,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41424,227,23,81,10,123,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41425,227,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41426,227,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41427,227,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41428,227,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41429,228,23,81,10,76,'Short_Answer','201908690',1,NULL,NULL,NULL,NULL,NULL),(41430,228,23,81,10,77,'Date','2019-12-16',1,NULL,NULL,NULL,NULL,NULL),(41431,228,23,81,10,78,'Multiple_Choice','Scott Schifsky',1,NULL,NULL,NULL,NULL,NULL),(41432,228,23,81,10,79,'Multiple_Choice','Sara Romagnoli',1,NULL,NULL,NULL,NULL,NULL),(41433,228,23,81,10,80,'Short_Answer','JEC Miller',1,NULL,NULL,NULL,NULL,NULL),(41434,228,23,81,10,81,'Short_Answer','Adam Gregg',1,NULL,NULL,NULL,NULL,NULL),(41435,228,23,81,10,82,'Short_Answer','adam@jecmiller.com',1,NULL,NULL,NULL,NULL,NULL),(41436,228,23,81,10,83,'Short_Answer','952-303-1614',1,NULL,NULL,NULL,NULL,NULL),(41437,228,23,81,10,84,'Multiple_Choice','Elopement',1,NULL,NULL,NULL,NULL,NULL),(41438,228,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41439,228,23,81,10,86,'Date','2019-11-23',1,NULL,NULL,NULL,NULL,NULL),(41440,228,23,81,10,87,'Free_Text','Peter walked to the store down the road from his home. He was gone for roughly 30 minutes. Peter does not have alone time.',1,NULL,NULL,NULL,NULL,NULL),(41441,228,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41442,228,23,81,10,91,'Short_Answer','Staff did not follow person’s plan that said the person should not have alone time',1,NULL,NULL,NULL,NULL,NULL),(41443,228,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41444,228,23,81,10,97,'Date','2020-02-12',1,NULL,NULL,NULL,NULL,NULL),(41445,228,23,81,10,98,'Free_Text','Staff did not follow person’s plan that said the person should not have alone time',1,NULL,NULL,NULL,NULL,NULL),(41446,228,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41447,228,23,81,10,100,'Free_Text','Staff not following the person’s plan that said they should not have alone time was influenced by the unfamiliarity the staff had at the home as they were transferred to cover appropriate shifts as the provider was short staffed. This required the provider to train the staff quickly to become familiar with the home and the people who lived there. When a staff trains at a new home, they have to read multiple plans for each person who lives in the home. The staff present the day of the incident worked at multiple homes to help fill shifts as the provider was short staffed. Low unemployment rates in the region and the state contributed to low unemployment rates, which in turn contributed the provider being short staffed. Adding to the unfamiliarity the staff had with the home, the person who eloped was difficult to understand and was noted to often test boundaries with staff which made it difficult for staff to understand that the person was not supposed to be alone.\r\n\r\nThe staff’s understanding of the difference between alone and community time further influenced the staff not following the person’s plan.  There was also another person in the home that did not have alone time which was contrary to the house norm which implied that each person had some alone time.  Furthermore, the two staff’s roles were not clearly communicated to them and the second staff didn’t counter the support staff’s understanding and may not have been aware.   The person’s plan stated they did have 10 minutes of home time alone but no unsupervised time in the community.  This created confusion for the staff who was new working in the home and had to train fast. \r\n\r\nThe basis for alone time according to the provider can be difficult to manage as staff have to read multiple plans for a person.  There was also pressure due to the staff shortage that is directly tied to regional and statewide staff shortages and overall low unemployment rates.  The CSSP no longer has a line to state whether a person has alone time hence creating confusion and vagueness.  The DWRS further influences the 6790 which connects to provider resources and their need to share a van with multiple locations that support people with disabilities.   \r\n',1,NULL,NULL,NULL,NULL,NULL),(41448,228,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41449,228,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41450,228,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41451,228,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41452,228,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41453,228,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41454,228,23,81,10,101,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41455,228,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41456,228,23,81,10,103,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41457,228,23,81,10,104,'Free_Text','Staff not following the person’s plan that said they should not have alone time was influenced by the unfamiliarity the staff had at the home as they were transferred to cover appropriate shifts as the provider was short staffed. This required the provider to train the staff quickly to become familiar with the home and the people who lived there. When a staff trains at a new home, they have to read multiple plans for each person who lives in the home. The staff present the day of the incident worked at multiple homes to help fill shifts as the provider was short staffed. The basis for alone time according to the provider can be difficult to manage as staff have to read multiple plans for a person.   The CSSP no longer has a line to state whether a person has alone time hence creating confusion and vagueness.  The DWRS further influences the 6790 which connects to provider resources and their need to share a van with multiple locations that support people with disabilities.   ',1,NULL,NULL,NULL,NULL,NULL),(41458,228,23,81,10,105,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41459,228,23,81,10,106,'Free_Text','The CSSP no longer has a line to state whether a person has alone time hence creating confusion and vagueness.  ',1,NULL,NULL,NULL,NULL,NULL),(41460,228,23,81,10,107,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41461,228,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41462,228,23,81,10,109,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41463,228,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41464,228,23,81,10,111,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41465,228,23,81,10,112,'Free_Text','Staff not following the person’s plan that said they should not have alone time was influenced by the unfamiliarity the staff had at the home as they were transferred to cover appropriate shifts as the provider was short staffed. This required the provider to train the staff quickly to become familiar with the home and the people who lived there. When a staff trains at a new home, they have to read multiple plans for each person who lives in the home. The staff present the day of the incident worked at multiple homes to help fill shifts as the provider was short staffed. Low unemployment rates in the region and the state contributed to low unemployment rates, which in turn contributed the provider being short staffed. Adding to the unfamiliarity the staff had with the home, the person who eloped was difficult to understand and was noted to often test boundaries with staff which made it difficult for staff to understand that the person was not supposed to be alone.',1,NULL,NULL,NULL,NULL,NULL),(41466,228,23,81,10,113,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41467,228,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41468,228,23,81,10,115,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41469,228,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41470,228,23,81,10,117,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41471,228,23,81,10,118,'Free_Text','Staff not following the person’s plan that said they should not have alone time was influenced by the unfamiliarity the staff had at the home as they were transferred to cover appropriate shifts as the provider was short staffed. This required the provider to train the staff quickly to become familiar with the home and the people who lived there. ',1,NULL,NULL,NULL,NULL,NULL),(41472,228,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41473,228,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41474,228,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41475,228,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41476,228,23,81,10,123,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41477,228,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41478,228,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41479,228,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41480,228,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41481,229,23,81,10,76,'Short_Answer','SS_Merdian-HC-2021-02',1,NULL,NULL,NULL,NULL,NULL),(41482,229,23,81,10,77,'Date','2021-02-25',1,NULL,NULL,NULL,NULL,NULL),(41483,229,23,81,10,78,'Multiple_Choice','Scott Schifsky',1,NULL,NULL,NULL,NULL,NULL),(41484,229,23,81,10,79,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41485,229,23,81,10,80,'Short_Answer','Meridian Services - Timber Crest',1,NULL,NULL,NULL,NULL,NULL),(41486,229,23,81,10,81,'Short_Answer','Rebecca Hage-Thomley',1,NULL,NULL,NULL,NULL,NULL),(41487,229,23,81,10,82,'Short_Answer','rthomley@orionassoc.net',1,NULL,NULL,NULL,NULL,NULL),(41488,229,23,81,10,83,'Short_Answer','763-450-5045',1,NULL,NULL,NULL,NULL,NULL),(41489,229,23,81,10,84,'Multiple_Choice','Medication Error',1,NULL,NULL,NULL,NULL,NULL),(41490,229,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41491,229,23,81,10,86,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41492,229,23,81,10,87,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41493,229,23,81,10,96,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41494,229,23,81,10,91,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41495,229,23,81,10,94,'True_or_False','',1,NULL,NULL,NULL,NULL,NULL),(41496,229,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41497,229,23,81,10,98,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41498,229,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41499,229,23,81,10,100,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41500,229,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41501,229,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41502,229,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41503,229,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41504,229,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41505,229,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41506,229,23,81,10,101,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41507,229,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41508,229,23,81,10,103,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41509,229,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41510,229,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41511,229,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41512,229,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41513,229,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41514,229,23,81,10,109,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41515,229,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41516,229,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41517,229,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41518,229,23,81,10,113,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41519,229,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41520,229,23,81,10,115,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41521,229,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41522,229,23,81,10,117,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41523,229,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41524,229,23,81,10,119,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41525,229,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41526,229,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41527,229,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41528,229,23,81,10,123,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41529,229,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41530,229,23,81,10,125,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41531,229,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41532,229,23,81,10,432,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41533,230,23,81,10,76,'Short_Answer','201906129',1,NULL,NULL,NULL,NULL,NULL),(41534,230,23,81,10,77,'Date','2019-09-16',1,NULL,NULL,NULL,NULL,NULL),(41535,230,23,81,10,78,'Multiple_Choice','Scott Schifsky',1,NULL,NULL,NULL,NULL,NULL),(41536,230,23,81,10,79,'Multiple_Choice','Aric Gregg',1,NULL,NULL,NULL,NULL,NULL),(41537,230,23,81,10,80,'Short_Answer','Opportunity Partners - Keith\'s Place',1,NULL,NULL,NULL,NULL,NULL),(41538,230,23,81,10,81,'Short_Answer','Jay McKibbins',1,NULL,NULL,NULL,NULL,NULL),(41539,230,23,81,10,82,'Short_Answer','jmckibbins@opportunities.org',1,NULL,NULL,NULL,NULL,NULL),(41540,230,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41541,230,23,81,10,84,'Multiple_Choice','Elopement',1,NULL,NULL,NULL,NULL,NULL),(41542,230,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41543,230,23,81,10,86,'Date','2019-08-24',1,NULL,NULL,NULL,NULL,NULL),(41544,230,23,81,10,87,'Free_Text','VA, Housemate and AP were at food court in Eden Prairie mall. VA needed to go to the bathroom. Bathroom was at sight so AP let VA walk\r\nto the bathroom by himself. AP observed VA walk in to the bathroom but did not observe VA come out. After about 10 minutes, AP went to\r\ncheck the bathroom with Housemate but VA was not there. AP talked to an unknown cleaning lady about contacting the security. AP\r\ncontacted security and also called Nurse and Reporter. Nurse contacted Coordinator.',1,NULL,NULL,NULL,NULL,NULL),(41545,230,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41546,230,23,81,10,91,'Short_Answer','Staff did not continuously monitor a public restroom door a person with dementia was using.',1,NULL,NULL,NULL,NULL,NULL),(41547,230,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41548,230,23,81,10,97,'Date','2020-10-13',1,NULL,NULL,NULL,NULL,NULL),(41549,230,23,81,10,98,'Free_Text','Staff drove two housemates to the Eden Prairie mall. The staff and housemates frequent the mall and are very familiar with the area. They parked in the back of the mall parking lot as they prefer the walk into the mall for some exercise. After shopping in the mall they stopped at the food court for lunch. The person who went missing brought his own lunch and after eating needed to use the restroom. This person had never used the restroom at this mall before. Staff stayed with the other person while he walked to the restroom. The restroom sign was in line of sight for the staff and staff saw the person enter the hallway that led to the restroom. There was only one entrance to the restroom area.  \r\n\r\nWhile the person was using the restroom, the staff reported the other person was experiencing anxiety. Staff is trained in positive behavior approaches and did help the person by talking to them while they used a paper bag to take some deep breaths. After about 10 minutes, staff and the person she was supporting went to the restroom area to check on the person as they did not see him exit. While she was assisting the person, she did have line of sight on the exit to her best knowledge. Staff checked the family and womens restroom, while the other person checked the mens restroom. The person was not present. Staff then spoke with a cleaning attendant and she helped contact the mall security.   \r\n\r\nMall security searched for the person while the staff and other person searched around the food court. Mall security then asked the staff to remain at the food court and that they would contact the police to assist.  Staff then called the Opportunity Partners nurse as the typical program manager was on vacation.  \r\n\r\nAt about 12:45 the mall security found the person standing by the staff’s vehicle. Mall security then reunited the staff with the person.  \r\n',1,NULL,NULL,NULL,NULL,NULL),(41550,230,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41551,230,23,81,10,100,'Free_Text','Staff did not continuously monitor a public restroom door a person with dementia was using. This was influenced by staff’s attention being diverted by both the crowded mall, as it was a busy Saturday at the food court, and assisting another person who was experiencing anxiety. The staff and the two people routinely went to this mall and the one person did not return from the restroom as anticipated.  Staff was within line of sight of the the entrance to the bathroom that only had one exit. The staff did not think using the restroom was a risk and assumed he’d return safely given they frequent the mall and are familiar. Staff knew there was not a back door behind the restrooms. \r\n\r\nThe person had only recently been diagnosed with dementia. While the company nurse trained the staff on supporting people with dementia, the staff was not certain what that meant for the person, but did have familiarity with supporting the person. The person also had been grieving the loss  of a long-time friend/room mate. Person-Centered practices influenced the decision to adhere to the person’s routine and community inclusion activities to have lunch at the mall. This situation was further complicated as the definition of the need of support was not synonimous with the agency’s definition. While the person’s CSSP required 24/7 supervision, it did not require “direct line of sight” supervision in the community. Agencies are given flexibility in determining what level of supervision is required when the CSSP is not specific. Both the provider and case manager noted that “direct line of sight” supervision would require 1:1 staffing, which was not supported in the person’s CSSP or 6790 rate form. \r\n\r\n\r\nThe providers policies allowed for a 1:2 staffing ratio which is influenced by the county via the 6790 rates form and DHS’s DWRS system. The person’s MNCHOICES assessment was not up for renewal for several months which creates more complexity while the person’s dementia as the condition possibly changes or is not understood over time and new symptoms develop. The provider noted that while many times a person with dementia has a higher staffing level in the community, this person did not yet have a higher staffing level as the person’s dementia had just recently developed. The provider had not sought out additional staff or funding for the person yet because they weren’t sure they could add more staff due to the workforce shortage and that the person had not yet had an episode of elopement. The provider noted that staffing levels were typically reactive after incidents rather than proactive to prevent them.\r\n',1,NULL,NULL,NULL,NULL,NULL),(41552,230,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41553,230,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41554,230,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41555,230,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41556,230,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41557,230,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41558,230,23,81,10,101,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41559,230,23,81,10,102,'Free_Text','This was influenced by staff’s attention being diverted by both the crowded mall, as it was a busy Saturday at the food court, and assisting another person who was experiencing anxiety.',1,NULL,NULL,NULL,NULL,NULL),(41560,230,23,81,10,103,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41561,230,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41562,230,23,81,10,105,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41563,230,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41564,230,23,81,10,107,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41565,230,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41566,230,23,81,10,109,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41567,230,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41568,230,23,81,10,111,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41569,230,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41570,230,23,81,10,113,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41571,230,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41572,230,23,81,10,115,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41573,230,23,81,10,116,'Free_Text','This situation was further complicated as the definition of the need of support was not synonymous with the agency’s definition. While the person’s CSSP required 24/7 supervision, it did not require “direct line of sight” supervision in the community. Agencies are given flexibility in determining what level of supervision is required when the CSSP is not specific. Both the provider and case manager noted that “direct line of sight” supervision would require 1:1 staffing, which was not supported in the person’s CSSP or 6790 rate form. ',1,NULL,NULL,NULL,NULL,NULL),(41574,230,23,81,10,117,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41575,230,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41576,230,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41577,230,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41578,230,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41579,230,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41580,230,23,81,10,123,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41581,230,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41582,230,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41583,230,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41584,230,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41585,231,23,81,10,76,'Short_Answer','SS_Success Homes-HC-2021-04',1,NULL,NULL,NULL,NULL,NULL),(41586,231,23,81,10,77,'Date','2021-04-28',1,NULL,NULL,NULL,NULL,NULL),(41587,231,23,81,10,78,'Multiple_Choice','Scott Schifsky',1,NULL,NULL,NULL,NULL,NULL),(41588,231,23,81,10,79,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41589,231,23,81,10,80,'Short_Answer','Success Homes',1,NULL,NULL,NULL,NULL,NULL),(41590,231,23,81,10,81,'Short_Answer','Amy R or P',1,NULL,NULL,NULL,NULL,NULL),(41591,231,23,81,10,82,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41592,231,23,81,10,83,'Short_Answer','763-533-628 (main line)',1,NULL,NULL,NULL,NULL,NULL),(41593,231,23,81,10,84,'Multiple_Choice','Termination of Services',1,NULL,NULL,NULL,NULL,NULL),(41594,231,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41595,231,23,81,10,86,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41596,231,23,81,10,87,'Free_Text','\"Termination is necessary for person\'s welfare and needs can\'t be met; safety of others is endangered and positive support strategies were unsuccessful\r\n\r\nSuccess Homes, Inc. has made attempts to allow person to remain in the home by meeting with the team to find positive support approaches to minimize the behaviors that cause the outbursts that he has displayed. He has become physically aggressive with peers, staff and himself and destroyed property that has resulted in him being transferred to the hospital for assessment. Medication changes have been unsuccessful and attempts to manage these behaviors have been unsuccessful. Success Homes, Inc. feels that the behaviors require a more secure setting and structured placement. He has now displayed behaviors that pose a threat to his peers and staff that cause them to feel endangered and unsafe in their current placement. He has worked with crisis facilities that were unsuccessful in the past. Attempts have been made with medication changes and behavior supports that have been unsuccessful for staff and him. We feel he\'s a threat to his peers and the staff are immanent enough at this point to terminate services.\"',1,NULL,NULL,NULL,NULL,NULL),(41597,231,23,81,10,96,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41598,231,23,81,10,91,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41599,231,23,81,10,94,'True_or_False','',1,NULL,NULL,NULL,NULL,NULL),(41600,231,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41601,231,23,81,10,98,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41602,231,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41603,231,23,81,10,100,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41604,231,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41605,231,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41606,231,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41607,231,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41608,231,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41609,231,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41610,231,23,81,10,101,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41611,231,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41612,231,23,81,10,103,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41613,231,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41614,231,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41615,231,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41616,231,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41617,231,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41618,231,23,81,10,109,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41619,231,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41620,231,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41621,231,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41622,231,23,81,10,113,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41623,231,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41624,231,23,81,10,115,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41625,231,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41626,231,23,81,10,117,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41627,231,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41628,231,23,81,10,119,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41629,231,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41630,231,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41631,231,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41632,231,23,81,10,123,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41633,231,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41634,231,23,81,10,125,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41635,231,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41636,231,23,81,10,432,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41637,232,23,81,10,76,'Short_Answer','201902151',1,NULL,NULL,NULL,NULL,NULL),(41638,232,23,81,10,77,'Date','2019-06-18',1,NULL,NULL,NULL,NULL,NULL),(41639,232,23,81,10,78,'Multiple_Choice','Scott Schifsky',1,NULL,NULL,NULL,NULL,NULL),(41640,232,23,81,10,79,'Multiple_Choice','Sara Romagnoli',1,NULL,NULL,NULL,NULL,NULL),(41641,232,23,81,10,80,'Short_Answer','Taylor SLS',1,NULL,NULL,NULL,NULL,NULL),(41642,232,23,81,10,81,'Short_Answer','Michael Taylor',1,NULL,NULL,NULL,NULL,NULL),(41643,232,23,81,10,82,'Short_Answer','miket.sls@charter.net',1,NULL,NULL,NULL,NULL,NULL),(41644,232,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41645,232,23,81,10,84,'Multiple_Choice','Medication Error',1,NULL,NULL,NULL,NULL,NULL),(41646,232,23,81,10,85,'Multiple_Choice','St. Louis County',1,NULL,NULL,NULL,NULL,NULL),(41647,232,23,81,10,86,'Date','2019-03-22',1,NULL,NULL,NULL,NULL,NULL),(41648,232,23,81,10,87,'Free_Text','Staff 1 administered the person another roommates’ medication at 8:15pm on 3/22/19. Immediately following, Staff 1 notified the facility\'s RN Consultant, the person\'s primary physician, poison control, and the home\'s Associate Director. Poison Control suggested that the person be transported to a local emergency room for treatment. The Staff 1 immediately dialed 9-1-1and activated EMS. EMS arrived and brought the person to St. Mary\'s Medical Center ER in Duluth via Gold Cross Ambulance. VA was brought into an ER room and assessment began. The Associate Director met the person at the hospital. The person was given IV fluids as a precaution. Blood was drawn and x-rays were taken. ER MD planned on transferring person from the ER to a regular room for overnight observation. In the interim, the person had a seizure in the ER and the ER MD\'s plan was changed to have him transferred to an ICU bed for monitoring. The person was moved from the ICU to a regular hospital room on 4 East the next day. The person was discharged from the hospital on 3/24 at 1:30pm as he returned to baseline without any adverse effects per Hospitalist.',1,NULL,NULL,NULL,NULL,NULL),(41649,232,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41650,232,23,81,10,91,'Short_Answer','Agency staff administered incorrect medication to a person living in the home.',1,NULL,NULL,NULL,NULL,NULL),(41651,232,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41652,232,23,81,10,97,'Date','2019-08-01',1,NULL,NULL,NULL,NULL,NULL),(41653,232,23,81,10,98,'Free_Text','Staff 1 arrived at work at 2:00pm and described it as a normal day.  The person 1 who received the incorrect medication was picked up by his Mother around 3:00pm and staff was told they would be back at 6:00pm.   Staff 1 stated that the person receives seizure medications and it is important to administer at specific times per doctors’ orders.   Missing medications or being untimely can trigger seizures.   Evening medication pass is at 7:00pm and as of 7:30pm the person 1 did not arrive home.  Staff 1 stated they felt anxious about not being able to pass medications, however, there is a one hour window on each side of medication passes.   Therefore, medications could be passed between 6:00pm and 8:00pm.   As of 8:30pm, the person 1 did not arrive and staff 2’s shift ended. Staff 2 asked staff 1 if he could administer all medications to the people who lived there.  Staff 1 agreed and continued to feel anxious given the person was not home and was not able to administer medications.     \r\n\r\nStaff 1 began the process of a blood check that is routine for person 2 who lives in the home.   Person 2 receives sleep medication (Trazadone 300mg).   Staff 1 described that person 2 needed a lot of time to prepare for his blood check and taking his medications which required significant attention.  Person 2 was watching TV and required a lot of reminders to eventually transition to the kitchen area to take medications.  Staff 1 was eventually at the kitchen table with person 2 and began the blood check. At about 9pm, person 1 arrived home and staff 1 went to lock the medication cabinet that he had left open.  Staff 1 had already prepared person 1 and 2’s medications.  Staff 1 put both sets of medications on the table in apple sauce and then quickly passed medications to person 1.   Person 1 proceeded to eat a snack while staff 1 was finishing the blood check with person 2.   \r\n\r\nShortly after the medication was passed, staff 1 realized he gave person 1 the incorrect medication and proceeded to contact the house LPN and director.',1,NULL,NULL,NULL,NULL,NULL),(41654,232,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41655,232,23,81,10,100,'Free_Text','Agency staff administering the incorrect medication was influenced by passing medications in apple sauce to two people at the same time. Staff punched out medications for two people from pre-packaged bubble packs at the same time, placed them both in apple sauce but then could not differientiate between the medications in apple sauce.   An additional factor influencing giving the incorrect medication to the person was that the provider had one less staff working than they typically did during medication administration. The provider typically had a 2 staff to 4 person ratio until 8pm, so that two staff would be on during the 6p-8p med administration window. On this day, the person’s mother kept him out past the medication window, so that when he returned the second staff had left, leaving one staff on to administer the person’s meds when he arrived. The provider\'s staff ratio and schedule is influenced by the county’s service agreement with the provider to deliver services. MNCHOICES also influences how the county determines how many staffing hours to include in their service agreement and what medication administration responsibility they assign to the provider.    \r\n\r\nStaff had further constraints on their attention while assisting another person in the home with a blood check. This was further supported by staff worrying about the adverse effects of not passing seizure medications within the window of the medication protocol.  The pressure to pass timely seizure medications is based on the provider’s medication protocol. 245D licensing and nursing protocols further complicated the medication protocol which connects to the person’s physician who established specific times and dosages. Medications for both people were in apple sauce and when the person arrived staff felt pressure to pass medications and did pass the incorrect nighttime medications to the person.  \r\n\r\nThe DWRS, MNCHOICES assessment, and county service agreement also impacted the staff schedule and further complicated the medication protocol.   ',1,NULL,NULL,NULL,NULL,NULL),(41656,232,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41657,232,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41658,232,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41659,232,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41660,232,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41661,232,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41662,232,23,81,10,101,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41663,232,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41664,232,23,81,10,103,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41665,232,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41666,232,23,81,10,105,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41667,232,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41668,232,23,81,10,107,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41669,232,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41670,232,23,81,10,109,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41671,232,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41672,232,23,81,10,111,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41673,232,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41674,232,23,81,10,113,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41675,232,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41676,232,23,81,10,115,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41677,232,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41678,232,23,81,10,117,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41679,232,23,81,10,118,'Free_Text','Staff had further constraints on their attention while assisting another person in the home with a blood check. This was further supported by staff worrying about the adverse effects of not passing seizure medications within the window of the medication protocol.  The pressure to pass timely seizure medications is based on the provider’s medication protocol. 245D licensing and nursing protocols further complicated the medication protocol which connects to the person’s physician who established specific times and dosages. Medications for both people were in apple sauce and when the person arrived staff felt pressure to pass medications and did pass the incorrect nighttime medications to the person.  ',1,NULL,NULL,NULL,NULL,NULL),(41680,232,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41681,232,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41682,232,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41683,232,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41684,232,23,81,10,123,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41685,232,23,81,10,124,'Free_Text','Agency staff administering the incorrect medication was influenced by passing medications in apple sauce to two people at the same time. Staff punched out medications for two people from pre-packaged bubble packs at the same time, placed them both in apple sauce but then could not differentiate between the medications in apple sauce.   ',1,NULL,NULL,NULL,NULL,NULL),(41686,232,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41687,232,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41688,232,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41689,233,23,81,10,76,'Short_Answer','201904741',1,NULL,NULL,NULL,NULL,NULL),(41690,233,23,81,10,77,'Date','2019-07-24',1,NULL,NULL,NULL,NULL,NULL),(41691,233,23,81,10,78,'Multiple_Choice','Scott Schifsky',1,NULL,NULL,NULL,NULL,NULL),(41692,233,23,81,10,79,'Multiple_Choice','Marilee Bengtson',1,NULL,NULL,NULL,NULL,NULL),(41693,233,23,81,10,80,'Short_Answer','Thomas Allen',1,NULL,NULL,NULL,NULL,NULL),(41694,233,23,81,10,81,'Short_Answer','Chet Whitmore',1,NULL,NULL,NULL,NULL,NULL),(41695,233,23,81,10,82,'Short_Answer','chet.whitmore@thomasalleninc.com',1,NULL,NULL,NULL,NULL,NULL),(41696,233,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41697,233,23,81,10,84,'Multiple_Choice','Wheelchair Safety',1,NULL,NULL,NULL,NULL,NULL),(41698,233,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41699,233,23,81,10,86,'Date','2019-06-27',1,NULL,NULL,NULL,NULL,NULL),(41700,233,23,81,10,87,'Free_Text','On 6/27/2019 between 8:00am and 9:30am, Staff 1 was driving person in their electronic wheelchair.  Staff 1 ran into door way, and the person’s leg got caught. The person’s leg looked swollen, so Reporter told Program Manager to bring VA to an Urgent Care (unknown information.) Reporter notified Guardian, Case Manager (unknown information,) and County Licensor. Urgent Care Physician (unknown information) told Program Manager to bring VA to an ER. Program Manager brought VA to an ER (unknown information,) and VA has a hairline fracture in VAs\' foot (unknown information.) VA was admitted to Hospital (unknown information.) Reporter is waiting to hear back to see what plan of action Hospital plans to take. Reporter will train AP on how to drive VAs\' wheelchair.',1,NULL,NULL,NULL,NULL,NULL),(41701,233,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41702,233,23,81,10,91,'Short_Answer','Staff did not have foot pedals on person’s wheelchair while driving the person to the restroom.',1,NULL,NULL,NULL,NULL,NULL),(41703,233,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41704,233,23,81,10,97,'Date','2019-09-05',1,NULL,NULL,NULL,NULL,NULL),(41705,233,23,81,10,98,'Free_Text','Staff arrived at 6:00am and described the morning as a typical shift.  Staff took a Benadryl for allergy relief at 5:00am and described that the medication did not make her sleepy.  Staff then assisted the person with their morning routine by helping them use the restroom, bathing, and then going to the kitchen for breakfast.  The person has difficulty swallowing food and requires assistance eating and reminders to swallow twice.  Staff was doing a variety of household tasks and was helping people get ready between 6:00am and 8:00am.  There were three staff on duty that morning. \r\n\r\nAfter breakfast staff then assisted the person by driving her electric chair from the kitchen to the restroom without foot pedals.  The person does not like their foot pedals on the chair.  The person has a lot of rigidity in her muscles and her legs were sticking out the sides of the chair.  Staff stopped shortly before the doorway to do a task and then proceeded driving the person in their chair.  The person’s leg broke when their foot got caught on a cupboard door jam.    ',1,NULL,NULL,NULL,NULL,NULL),(41706,233,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41707,233,23,81,10,100,'Free_Text','Agency staff not having foot pedals on while driving the person’s wheelchair was influenced by the staffs’ divided attention.  Staff could not recall the specific task that divided her attention while being midway through the kitchen. The person had a preference against using foot pedals and communicates their preference by their rigidity and loud vocalizations.  This was further complicated by typical morning routine that resembles the practice of most busy group homes.  Additionally the staff pushing the wheelchair had a number of years of experience working with the person and felt more comfortable pushing the person without foot pedals. Furthermore, there were policies and plans that were conflicting related to wheel chair. The provider had a policy to always use foot pedals with wheelchairs for safety, but had also been pushing person-centered practices to support people they serve to have more control of daily decisions. \r\n\r\nThe CSSP and risk management plan followed standard wheelchair safety and practice related to the wheelchair manufacturer guidelines.  The general practice for wheel chair use conflicted with the agency’s practice. Team conversations about how this person wanted to live did not have consistency with the person’s plan and guidelines related to wheelchair use. There was a practice of the home not to use foot pedals and given the numerous tasks in the morning, staff could not account for everything.',1,NULL,NULL,NULL,NULL,NULL),(41708,233,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41709,233,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41710,233,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41711,233,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41712,233,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41713,233,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41714,233,23,81,10,101,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41715,233,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41716,233,23,81,10,103,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41717,233,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41718,233,23,81,10,105,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41719,233,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41720,233,23,81,10,107,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41721,233,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41722,233,23,81,10,109,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41723,233,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41724,233,23,81,10,111,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41725,233,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41726,233,23,81,10,113,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41727,233,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41728,233,23,81,10,115,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41729,233,23,81,10,116,'Free_Text','Agency staff not having foot pedals on while driving the person’s wheelchair was influenced by the staffs’ divided attention.  Additionally the staff pushing the wheelchair had a number of years of experience working with the person and felt more comfortable pushing the person without foot pedals. Furthermore, there were policies and plans that were conflicting related to wheel chair. The provider had a policy to always use foot pedals with wheelchairs for safety, but had also been pushing person-centered practices to support people they serve to have more control of daily decisions. \r\n\r\nThe general practice for wheel chair use conflicted with the agency’s practice.',1,NULL,NULL,NULL,NULL,NULL),(41730,233,23,81,10,117,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41731,233,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41732,233,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41733,233,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41734,233,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41735,233,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41736,233,23,81,10,123,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41737,233,23,81,10,124,'Free_Text','Team conversations about how this person wanted to live did not have consistency with the person’s plan and guidelines related to wheelchair use. There was a practice of the home not to use foot pedals and given the numerous tasks in the morning, staff could not account for everything.',1,NULL,NULL,NULL,NULL,NULL),(41738,233,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41739,233,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41740,233,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41741,234,23,81,10,76,'Short_Answer','201906219',1,NULL,NULL,NULL,NULL,NULL),(41742,234,23,81,10,77,'Date','2019-09-16',1,NULL,NULL,NULL,NULL,NULL),(41743,234,23,81,10,78,'Multiple_Choice','Tony Gantenbein',1,NULL,NULL,NULL,NULL,NULL),(41744,234,23,81,10,79,'Multiple_Choice','Jill Tilbury',1,NULL,NULL,NULL,NULL,NULL),(41745,234,23,81,10,80,'Short_Answer','Dungarvin - Brooklyn Park',1,NULL,NULL,NULL,NULL,NULL),(41746,234,23,81,10,81,'Short_Answer','Heather Golden',1,NULL,NULL,NULL,NULL,NULL),(41747,234,23,81,10,82,'Short_Answer','hgolden@dungarvin.com',1,NULL,NULL,NULL,NULL,NULL),(41748,234,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41749,234,23,81,10,84,'Multiple_Choice','Elopement',1,NULL,NULL,NULL,NULL,NULL),(41750,234,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41751,234,23,81,10,86,'Date','2019-08-24',1,NULL,NULL,NULL,NULL,NULL),(41752,234,23,81,10,87,'Free_Text','On 8/24/2019, VA and AP went to the Minnesota State Fair. An unknown event occurred between 12:30 PM and 5:30 PM wile VA was\r\nunsupervised. VA was unsupervised for approximately thirty minutes.\r\n\r\nReporter found out 8/26/2019. VA had appointment with Psychologist at 3:30 PM. Behavior Specialist accompanied VA to appointment. VA\r\ntold Psychologist \"while at the Minnesota State Fair on Saturday, I was alone for about thirty minutes.\" VA said AP walked away from VA. VA\r\ncould not find AP. AP found VA.\r\n\r\nReporter asked AP to explain. AP said VA had a rental scooter while at the Minnesota State Fair. VA told AP she was going to the bathroom\r\non scooter, and took off. AP could not keep up with scooter and soon lost VA. AP continued to search for VA. Approximately thirty minutes\r\nlater AP found VA near a bathroom.\r\n\r\nReporter noted that VA has a previous history of false reporting.',1,NULL,NULL,NULL,NULL,NULL),(41753,234,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41754,234,23,81,10,91,'Short_Answer','Staff lost sight of a person at the State Fair',1,NULL,NULL,NULL,NULL,NULL),(41755,234,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41756,234,23,81,10,97,'Date','2019-10-25',1,NULL,NULL,NULL,NULL,NULL),(41757,234,23,81,10,98,'Free_Text','Collaborative Safety – Systems Mapping \r\nCase Summary\r\nOctober 14, 2019\r\nHennepin County\r\n\r\n\r\nLearning Point #1: Staff lost sight of a person at the State Fair.\r\n\r\nLearning Point #2: Staff brought his son along on this community outing. \r\n\r\nIncident report description\r\n•	Incident date: 8/24/2019, between 12:30 PM and 5:30 PM\r\n•	Report date: 8/27/2019 4:11PM\r\n\r\nStaff and person went to the Minnesota State Fair on a Saturday afternoon. During this outing, the person was unsupervised for approximately thirty minutes. The person had a rental scooter and took off on it to go to use the bathroom. The staff could not keep up with the scooter and lost sight of the person. Approximately 30 minutes later, staff found the person near the bathroom. \r\n\r\nTwo days later, the reporter found out about the incident during an appointment between the person and a Psychologist when the person told the Psychologist \"while at the Minnesota State Fair on Saturday, I was alone for about thirty minutes.\" \r\n\r\nDebriefing information for learning Point #1, October 25, 2019\r\n\r\nStaff participated in a human factors debriefing, led by a Safety Analyst, on October 25, 2019.\r\n\r\nUpon arrival at the State Fair, the person rented an electric mobility scooter for people with disabilities. The staff brought his 10 year old son along to the event. The staff’s attention was influenced by the person’s behavior as they began walking into the Fair, when the person said she wanted to go to the beer garden and drink beer. This action triggered the staff to wonder if this was a good idea. \r\n\r\nShortly after arriving, the staff and his son sat down to eat some food while the person used the scooter to go and browse at a souvenir stand within eyesight. The crowd at the Fair impacted the staff’s focus when he lost sight of the person on the scooter during the outing. Staff reported he was not distracted by his son’s presence. \r\n\r\nDebriefing information for learning Point #2, October 25, 2019\r\n\r\nDuring the debriefing session for Learning Point #1, Staff shared he brought his son along to the outing after the VA told him she thought it was fine. He explained it was a last minute decision because of issues around child care coverage.\r\n\r\nResult of Incident\r\nStaff reported going to the beer garden to search for the person. She was not there, so he called her on her cell phone. She answered his call, but could not tell staff exactly where she was. This phone call went on for about 30 minutes until staff located the person.\r\n\r\n',1,NULL,NULL,NULL,NULL,NULL),(41758,234,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41759,234,23,81,10,100,'Free_Text','The crowd size, unfamiliarity with the State Fair and the person, impacted staff losing sight of the individual. When the staff lost sight of the person, his attention was divided between his 10-year-old son and the person. Staff brought their son along on the outing because the person offered for him to come along. The person likely offered because if staff was unable to work the person would be unable to go to the fair as the person overheard a conversation the staff had about his son not having childcare on the day of the Fair. The provider was experiencing a staff shortage and would not have been able to find another staff to go to the fair with the person. \r\n\r\nAnother contributing factor to losing sight of the person was that staff did not perceive a risk of losing the person because there was no elopement history. Therefore, staff felt comfortable bringing their son. Staff also knew the person’s high level abilities to be independent and capabilities to navigate the scooter, which further supported their decision to have divided attention between the person and their son.  The provider has a policy that allows staff to use judgment/interpretation of the Coordinated Services & Support Plan (CSSP) as long as staff is attentive to the persons needs without direct line of sight. The provider allows this room for staff judgment because it gives staff the space and ability to support each person as they need and choose. \r\n\r\nThe Case Manager approved the decision not to require a line of sight on the person while out in the community. The person’s history of challenging behaviors influenced the Guardian’s directive to the Case Manager not to include any alone time in the CSSP and the Case Manager\'s decision to include a 1:1 staffing ratio on public outings in the CSSP. This requirement was an influence on how the provider selected staff for the outing. An industry wide staffing shortage impacted the providers’ ability to hire and retain part-time, intermittent, 1:1 activities staff. The HCBS Rule on Community Inclusion and Person Centered Planning and Person Centered Thinking influenced the Case Manager and provider roles to meet these standards when staffing for outings in the community.\r\n',1,NULL,NULL,NULL,NULL,NULL),(41760,234,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41761,234,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41762,234,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41763,234,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41764,234,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41765,234,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41766,234,23,81,10,101,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41767,234,23,81,10,102,'Free_Text','The crowd size, unfamiliarity with the State Fair and the person, impacted staff losing sight of the individual. When the staff lost sight of the person, his attention was divided between his 10-year-old son and the person. \r\n\r\nAnother contributing factor to losing sight of the person was that staff did not perceive a risk of losing the person because there was no elopement history. Therefore, staff felt comfortable bringing their son. Staff also knew the person’s high level abilities to be independent and capabilities to navigate the scooter, which further supported their decision to have divided attention between the person and their son.',1,NULL,NULL,NULL,NULL,NULL),(41768,234,23,81,10,103,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41769,234,23,81,10,104,'Free_Text','The provider was experiencing a staff shortage and would not have been able to find another staff to go to the fair with the person.  \r\n\r\nAn industry wide staffing shortage impacted the providers’ ability to hire and retain part-time, intermittent, 1:1 activities staff. The HCBS Rule on Community Inclusion and Person Centered Planning and Person Centered Thinking influenced the Case Manager and provider roles to meet these standards when staffing for outings in the community.',1,NULL,NULL,NULL,NULL,NULL),(41770,234,23,81,10,105,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41771,234,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41772,234,23,81,10,107,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41773,234,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41774,234,23,81,10,109,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41775,234,23,81,10,110,'Free_Text','The Case Manager approved the decision not to require a line of sight on the person while out in the community. The person’s history of challenging behaviors influenced the Guardian’s directive to the Case Manager not to include any alone time in the CSSP and the Case Manager\'s decision to include a 1:1 staffing ratio on public outings in the CSSP. This requirement was an influence on how the provider selected staff for the outing .',1,NULL,NULL,NULL,NULL,NULL),(41776,234,23,81,10,111,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41777,234,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41778,234,23,81,10,113,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41779,234,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41780,234,23,81,10,115,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41781,234,23,81,10,116,'Free_Text','The provider has a policy that allows staff to use judgment/interpretation of the Coordinated Services & Support Plan (CSSP) as long as staff is attentive to the persons needs without direct line of sight. The provider allows this room for staff judgment because it gives staff the space and ability to support each person as they need and choose.  ',1,NULL,NULL,NULL,NULL,NULL),(41782,234,23,81,10,117,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41783,234,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41784,234,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41785,234,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41786,234,23,81,10,121,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41787,234,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41788,234,23,81,10,123,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41789,234,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41790,234,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41791,234,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41792,234,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41793,235,23,81,10,76,'Short_Answer','TG_DungarvinBryant-H-2020-09',1,NULL,NULL,NULL,NULL,NULL),(41794,235,23,81,10,77,'Date','2020-10-12',1,NULL,NULL,NULL,NULL,NULL),(41795,235,23,81,10,78,'Multiple_Choice','Tony Gantenbein',1,NULL,NULL,NULL,NULL,NULL),(41796,235,23,81,10,79,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41797,235,23,81,10,80,'Short_Answer','Dungarvin',1,NULL,NULL,NULL,NULL,NULL),(41798,235,23,81,10,81,'Short_Answer','Caimon Kollie',1,NULL,NULL,NULL,NULL,NULL),(41799,235,23,81,10,82,'Short_Answer','ckollie@dungarvin.com',1,NULL,NULL,NULL,NULL,NULL),(41800,235,23,81,10,83,'Short_Answer','651-699-6050 ext 5761',1,NULL,NULL,NULL,NULL,NULL),(41801,235,23,81,10,84,'Multiple_Choice','Medication Error',1,NULL,NULL,NULL,NULL,NULL),(41802,235,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41803,235,23,81,10,86,'Date','2020-08-09',1,NULL,NULL,NULL,NULL,NULL),(41804,235,23,81,10,87,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41805,235,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41806,235,23,81,10,91,'Short_Answer','Medication was stole from a residential facility without staff knowledge.',1,NULL,NULL,NULL,NULL,NULL),(41807,235,23,81,10,94,'True_or_False','',1,NULL,NULL,NULL,NULL,NULL),(41808,235,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41809,235,23,81,10,98,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41810,235,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41811,235,23,81,10,100,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41812,235,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41813,235,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41814,235,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41815,235,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41816,235,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41817,235,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41818,235,23,81,10,101,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41819,235,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41820,235,23,81,10,103,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41821,235,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41822,235,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41823,235,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41824,235,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41825,235,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41826,235,23,81,10,109,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41827,235,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41828,235,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41829,235,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41830,235,23,81,10,113,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41831,235,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41832,235,23,81,10,115,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41833,235,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41834,235,23,81,10,117,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41835,235,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41836,235,23,81,10,119,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41837,235,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41838,235,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41839,235,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41840,235,23,81,10,123,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41841,235,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41842,235,23,81,10,125,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41843,235,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41844,235,23,81,10,432,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41845,236,23,81,10,76,'Short_Answer','TG_MSOCS-HC-2021-01',1,NULL,NULL,NULL,NULL,NULL),(41846,236,23,81,10,77,'Date','2021-01-29',1,NULL,NULL,NULL,NULL,NULL),(41847,236,23,81,10,78,'Multiple_Choice','Tony Gantenbein',1,NULL,NULL,NULL,NULL,NULL),(41848,236,23,81,10,79,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41849,236,23,81,10,80,'Short_Answer','MSOCS - West Metro Community Resources',1,NULL,NULL,NULL,NULL,NULL),(41850,236,23,81,10,81,'Short_Answer','Donovan Chandler',1,NULL,NULL,NULL,NULL,NULL),(41851,236,23,81,10,82,'Short_Answer','donovan.chandler@state.mn.us',1,NULL,NULL,NULL,NULL,NULL),(41852,236,23,81,10,83,'Short_Answer','218-831-5409',1,NULL,NULL,NULL,NULL,NULL),(41853,236,23,81,10,84,'Multiple_Choice','Elopement',1,NULL,NULL,NULL,NULL,NULL),(41854,236,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41855,236,23,81,10,86,'Date','2020-11-09',1,NULL,NULL,NULL,NULL,NULL),(41856,236,23,81,10,87,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41857,236,23,81,10,96,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41858,236,23,81,10,91,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41859,236,23,81,10,94,'True_or_False','',1,NULL,NULL,NULL,NULL,NULL),(41860,236,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41861,236,23,81,10,98,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41862,236,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41863,236,23,81,10,100,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41864,236,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41865,236,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41866,236,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41867,236,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41868,236,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41869,236,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41870,236,23,81,10,101,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41871,236,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41872,236,23,81,10,103,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41873,236,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41874,236,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41875,236,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41876,236,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41877,236,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41878,236,23,81,10,109,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41879,236,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41880,236,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41881,236,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41882,236,23,81,10,113,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41883,236,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41884,236,23,81,10,115,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41885,236,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41886,236,23,81,10,117,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41887,236,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41888,236,23,81,10,119,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41889,236,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41890,236,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41891,236,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41892,236,23,81,10,123,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41893,236,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41894,236,23,81,10,125,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41895,236,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41896,236,23,81,10,432,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41897,237,23,81,10,76,'Short_Answer','201904039',1,NULL,NULL,NULL,NULL,NULL),(41898,237,23,81,10,77,'Date','2019-07-24',1,NULL,NULL,NULL,NULL,NULL),(41899,237,23,81,10,78,'Multiple_Choice','Tony Gantenbein',1,NULL,NULL,NULL,NULL,NULL),(41900,237,23,81,10,79,'Multiple_Choice','Tim Sullivan',1,NULL,NULL,NULL,NULL,NULL),(41901,237,23,81,10,80,'Short_Answer','Mary T. Inc.',1,NULL,NULL,NULL,NULL,NULL),(41902,237,23,81,10,81,'Short_Answer','Gordon Clark',1,NULL,NULL,NULL,NULL,NULL),(41903,237,23,81,10,82,'Short_Answer','gordonc@marytinc.com',1,NULL,NULL,NULL,NULL,NULL),(41904,237,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41905,237,23,81,10,84,'Multiple_Choice','Elopement',1,NULL,NULL,NULL,NULL,NULL),(41906,237,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(41907,237,23,81,10,86,'Date','2019-06-01',1,NULL,NULL,NULL,NULL,NULL),(41908,237,23,81,10,87,'Free_Text','Staff brought four housemates to the Como Park Zoo on a summer Saturday afternoon. After spending some time walking around the crowed zoo looking at animals, one person wandered away from the group. Staff was not sure what to do so he brought the other guys back to the van, leaving the windows down, to keep them together. He went back to look for the missing person with the help of zoo staff.',1,NULL,NULL,NULL,NULL,NULL),(41909,237,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41910,237,23,81,10,91,'Short_Answer','Staff lost sight of person at Como Zoo',1,NULL,NULL,NULL,NULL,NULL),(41911,237,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41912,237,23,81,10,97,'Date','2019-08-27',1,NULL,NULL,NULL,NULL,NULL),(41913,237,23,81,10,98,'Free_Text','Staff participated in a human factors debriefing, led by a Safety Analyst, on August 27, 2019 at the group home in Richfield where the VA resides.\r\n\r\nThe slow pace of one of the people on the outing impacted the staff persons focus during the outing and he lost sight of one the housemates. The staff placed importance on the safety of the other people in the group when he made the decision to place them in the van while he sought help in locating the missing person. He did not want to lose other people. This decision was further influenced by fact, he was the only staff person on the outing and he had never been to Como Park before so he was not familiar with the park or available resources.\r\n',1,NULL,NULL,NULL,NULL,NULL),(41914,237,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41915,237,23,81,10,100,'Free_Text','Losing sight of a person was influenced by staff being distracted while holding the hand of a slow walker in the group and watching their footing. This was further influenced by the crowded zoo and the varying needs of each of the four people in the group. Also this was the staffs first time at Como Park Zoo and he was unfamiliar with the park and available resources. He wanted to do an activity the group enjoyed and was not afraid to take risks by going to a new place for an outing. It was known that the people living in the home enjoyed seeing animals, and considering that Como Zoo was a free activity, this outing was selected. The staff’s willingness to take risk was likely impacted by the disability advocacy community’s emphasis on allowing people with disabilities the dignity of risk. \r\nAdditional factors that influenced the Como Park outing and staff decision making were the community inclusion goals developed by the provider. These goals are outlined in the CSP/CSSP for each person in the group based on the MN Choices Assessment and the Person Centered/Informed Choice protocols. \r\n\r\nThe staffing pattern on the day of the outing to Como Zoo was impacted by the provider’s budget and the hours allocated to the home during the negotiation process facilitated by DHS Form 6790. This process is impacted by the individual needs of each person in the home, assessed by MnCHOICES and developed into each person’s Coordinated Services and Support Plan. The hours and rate are further impacted by the Disability Waiver Rate System created by the Minnesota Legislature. \r\n\r\nThe staff training established in 245D statute and the Positive Supports Rule influenced the provider required training to prepare staff for community based outings and discretion for decision making. Staff demonstrated competency in this area when he was able to describe the clothing worn by the missing person and share “the book” with details about the person.',1,NULL,NULL,NULL,NULL,NULL),(41916,237,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41917,237,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41918,237,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41919,237,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41920,237,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41921,237,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41922,237,23,81,10,101,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41923,237,23,81,10,102,'Free_Text','Losing sight of a person was influenced by staff being distracted while holding the hand of a slow walker in the group and watching their footing. This was further influenced by the crowded zoo and the varying needs of each of the four people in the group.',1,NULL,NULL,NULL,NULL,NULL),(41924,237,23,81,10,103,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41925,237,23,81,10,104,'Free_Text','The staffing pattern on the day of the outing to Como Zoo was impacted by the provider’s budget and the hours allocated to the home during the negotiation process facilitated by DHS Form 6790. This process is impacted by the individual needs of each person in the home, assessed by MnCHOICES and developed into each person’s Coordinated Services and Support Plan. The hours and rate are further impacted by the Disability Waiver Rate System created by the Minnesota Legislature.',1,NULL,NULL,NULL,NULL,NULL),(41926,237,23,81,10,105,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41927,237,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41928,237,23,81,10,107,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41929,237,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41930,237,23,81,10,109,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41931,237,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41932,237,23,81,10,111,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41933,237,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41934,237,23,81,10,113,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41935,237,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41936,237,23,81,10,115,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41937,237,23,81,10,116,'Free_Text','We may need to edit the narrative and this example to emphasize the conflict between the \"health, safety, and well-being\" and community inclusion\r\n\r\nIt was known that the people living in the home enjoyed seeing animals, and considering that Como Zoo was a free activity, this outing was selected. The staff’s willingness to take risk was likely impacted by the disability advocacy community’s emphasis on allowing people with disabilities the dignity of risk. \r\nAdditional factors that influenced the Como Park outing and staff decision making were the community inclusion goals developed by the provider. \r\n',1,NULL,NULL,NULL,NULL,NULL),(41938,237,23,81,10,117,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41939,237,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41940,237,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41941,237,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41942,237,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41943,237,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41944,237,23,81,10,123,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41945,237,23,81,10,124,'Free_Text','The staff’s willingness to take risk was likely impacted by the disability advocacy community’s emphasis on allowing people with disabilities the dignity of risk.',1,NULL,NULL,NULL,NULL,NULL),(41946,237,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41947,237,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41948,237,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(41949,238,23,81,10,76,'Short_Answer','TG_TBI Residential-SLC-2020-05',1,NULL,NULL,NULL,NULL,NULL),(41950,238,23,81,10,77,'Date','2020-05-28',1,NULL,NULL,NULL,NULL,NULL),(41951,238,23,81,10,78,'Multiple_Choice','Tony Gantenbein',1,NULL,NULL,NULL,NULL,NULL),(41952,238,23,81,10,79,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41953,238,23,81,10,80,'Short_Answer','TBI Residential & Community Services',1,NULL,NULL,NULL,NULL,NULL),(41954,238,23,81,10,81,'Short_Answer','Keith Comstock',1,NULL,NULL,NULL,NULL,NULL),(41955,238,23,81,10,82,'Short_Answer','k.comstock@tbiduluthmn.com',1,NULL,NULL,NULL,NULL,NULL),(41956,238,23,81,10,83,'Short_Answer','218-733-1331',1,NULL,NULL,NULL,NULL,NULL),(41957,238,23,81,10,84,'Multiple_Choice','Elopement',1,NULL,NULL,NULL,NULL,NULL),(41958,238,23,81,10,85,'Multiple_Choice','St. Louis County',1,NULL,NULL,NULL,NULL,NULL),(41959,238,23,81,10,86,'Date','2019-03-20',1,NULL,NULL,NULL,NULL,NULL),(41960,238,23,81,10,87,'Free_Text','TBI Crisis Float was at the Alder home at 5:45pm on Friday, March 20th talking with Dwayne. Crisis Float and\r\nDwayne were outside during the conversation. Dwayne asked if he was able to get his hair done soon and Crisis Float explained that due\r\nto the pandemic the salon was closed until further notice. Dwayne was disappointed that he could not get his hair done. After the\r\nconversation Dwayne walked inside and Crisis Float left the Alder home. At 6:00pm Khun (staff) went to check on Dwayne and he was not\r\nin his bedroom. Khun checked the inside of the house then walked around the outside of the house and could not locate Dwayne. Khun\r\nthen called the Crisis Float to notify them of the situation. Crisis Float began driving around the area looking for Dwayne. At 7:00pm Crisis\r\nFloat notified the Sheriff and completed an Attempt to Locate for Dwayne. Crisis Float continued to search for Dwayne. At 8:30pm the Crisis\r\nFloat asked that the Attempt to Locate be changed to a Missing Persons report. At 4:00am on Saturday, March 21st the TBI Crisis Float\r\nreceived a call from the Duluth Police Department saying that Dwayne had approached them looking for a ride home. Dwayne reported to\r\nthe police and TBI Crisis Float that he eloped from the Alder house and walked to the Kwik Trip where he was able to catch a bus to\r\ndowntown Duluth. Dwayne reported he walked around downtown for several hours before finding a police officer at CVS Pharmacy in\r\ndowntown Duluth. Dwayne returned home at 5:00am and went to bed.',1,NULL,NULL,NULL,NULL,NULL),(41961,238,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41962,238,23,81,10,91,'Short_Answer','Float staff waited four hours to contact their supervisor about an elopement',1,NULL,NULL,NULL,NULL,NULL),(41963,238,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(41964,238,23,81,10,97,'Date','2020-08-27',1,NULL,NULL,NULL,NULL,NULL),(41965,238,23,81,10,98,'Free_Text','Person was talking with (Alder House staff) about going downtown Duluth to get a haircut. The salons were closed due to the Governor’s Executive Order about COVID 19. DSP went to cook food for dinner. The DSP was the only staff working, normally two staff. SP was attending to the other residents who were asking questions while the SP was cooking food. The SP knocked on bedroom door and there was no answer. The room was empty. The SP began to search the house for 10-15 minutes and then called the crisis float for direction and next steps. The SP immediately began to write up report, Incident Report Internal Review (IRIR). The Alder House DSP worked alone most of March. Quote: “If two staff were working this elopement could have been avoided because the other staff could drive person downtown Duluth”.\r\nCrisis float takes over the elopement incident and the decision to call 911. Arrives at home and begins the attempt to locate. Drives and searches streets and downtown Duluth for 4 hours. It is protocol to search for 1-2 hours before contacting a supervisor. The Program manager makes the decision to call 911 and report a missing person. The call 911 was to report a non-emergency and provide a description of the person. The role of the crisis float is to fill in gaps as needed in the residential setting. The Crisis float needs to be available to respond to other crisis. The night of the incident the crisis float was moving from a crisis, de-escalating attention seeking behaviors, and then came to Alder House. Priority goes to situations that require hospitalization. During the attempt to locate the Crisis float communicates with the Alder house DSP with updates as needed, about every 15-20 minutes.\r\n',1,NULL,NULL,NULL,NULL,NULL),(41966,238,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41967,238,23,81,10,100,'Free_Text','The float staff waiting 4 hours (instead of the policy of 1 hour) to contact their supervisor about an individual eloping, was impacted by the staff not seeing it as an emergency . Staff had ideas of where the person would go and that they’d be able to find them. The float staff’s ideas were impacted by their familiarity with the person, they knew their favorite places to go, that they had no previous elopements, and the person mentioned wanting to get a haircut. The staff feeling like they could find the person was also influenced by the empty streets in Duluth due to the Governor’s Stay at Home order. The Governor’s Stay At Home Order was issued due to COVID-19 in an attempt to slow the curve of the virus spreading. The Order required people to stay in their home unless they were conducting essential business. This influenced the streets of Duluth to be empty, businesses to be closed and the staff feeling as though the person should have been easier to spot. Other contributing factors to not seeing this elopement as an emergency and waiting to call the supervisor was that the staff maintained constant communication with the house staff about search strategies and updates and they knew the person had the ability to navigate the community independently .  \r\nAdditional influences to waiting 4 hours to call the supervisor may have been the staff’s desire to avoid the 245D/Positive Support Rule reporting requirements because the process can be very time consuming . Additionally, staff waited to call the supervisor because it is provider practice is not to contact supervisors if the elopement is supervised or the person’s whereabouts are known and they were confident they would be able to find the person .  St. Louis County had a recent history of attempting to decrease 911 calls, and had brought together HCBS providers, Law Enforcement Officers, County staff and Healthcare staff to work on this issue and created a Person Centered Incident Matrix to help provider’s parse out when 911 should be called and how to avoid overusing the 911 relay. The staff noted they were aware of the Person-Centered Matrix and this influenced the staff to exhaust all known places the person might go before contacting the supervisor about the elopement . \r\n\r\n',1,NULL,NULL,NULL,NULL,NULL),(41968,238,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(41969,238,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(41970,238,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(41971,238,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41972,238,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(41973,238,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41974,238,23,81,10,101,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(41975,238,23,81,10,102,'Free_Text','The float staff waiting 4 hours (instead of the policy of 1 hour) to contact their supervisor about an individual eloping, was impacted by the staff not seeing it as an emergency.\r\n\r\nOther contributing factors to not seeing this elopement as an emergency and waiting to call the supervisor was that the staff maintained constant communication with the house staff about search strategies and updates and they knew the person had the ability to navigate the community independently . \r\n\r\n  St. Louis County had a recent history of attempting to decrease 911 calls, and had brought together HCBS providers, Law Enforcement Officers, County staff and Healthcare staff to work on this issue and created a Person Centered Incident Matrix to help provider’s parse out when 911 should be called and how to avoid overusing the 911 relay. The staff noted they were aware of the Person-Centered Matrix and this influenced the staff to exhaust all known places the person might go before contacting the supervisor about the elopement . \r\n\r\n',1,NULL,NULL,NULL,NULL,NULL),(41976,238,23,81,10,103,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41977,238,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41978,238,23,81,10,105,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41979,238,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41980,238,23,81,10,107,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41981,238,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41982,238,23,81,10,109,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41983,238,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41984,238,23,81,10,111,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41985,238,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41986,238,23,81,10,113,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41987,238,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41988,238,23,81,10,115,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(41989,238,23,81,10,116,'Free_Text','Other contributing factors to not seeing this elopement as an emergency and waiting to call the supervisor was that the staff maintained constant communication with the house staff about search strategies and updates and they knew the person had the ability to navigate the community independently .  ',1,NULL,NULL,NULL,NULL,NULL),(41990,238,23,81,10,117,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41991,238,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41992,238,23,81,10,119,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41993,238,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41994,238,23,81,10,121,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41995,238,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41996,238,23,81,10,123,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(41997,238,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(41998,238,23,81,10,125,'Multiple_Choice','0',1,NULL,NULL,NULL,NULL,NULL),(41999,238,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42000,238,23,81,10,432,'Yes_or_No','Yes',1,NULL,NULL,NULL,NULL,NULL),(42001,239,23,81,10,76,'Short_Answer','201900069',1,NULL,NULL,NULL,NULL,NULL),(42002,239,23,81,10,77,'Date','2019-05-15',1,NULL,NULL,NULL,NULL,NULL),(42003,239,23,81,10,78,'Multiple_Choice','Tim Sullivan',1,NULL,NULL,NULL,NULL,NULL),(42004,239,23,81,10,79,'Multiple_Choice','Tony Gantenbein',1,NULL,NULL,NULL,NULL,NULL),(42005,239,23,81,10,80,'Short_Answer','Howry Southside',1,NULL,NULL,NULL,NULL,NULL),(42006,239,23,81,10,81,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(42007,239,23,81,10,82,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(42008,239,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(42009,239,23,81,10,84,'Multiple_Choice','Staff Sleeping on Duty',1,NULL,NULL,NULL,NULL,NULL),(42010,239,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(42011,239,23,81,10,86,'Date','2019-01-02',1,NULL,NULL,NULL,NULL,NULL),(42012,239,23,81,10,87,'Free_Text','VA is describing increasing frustration and low mood as a result of these incidents. He does not feel comfortable with staff assistance and therefore isolates himself in his room. ',1,NULL,NULL,NULL,NULL,NULL),(42013,239,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(42014,239,23,81,10,91,'Short_Answer','Staff did not hear person call for assistance after falling',1,NULL,NULL,NULL,NULL,NULL),(42015,239,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(42016,239,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(42017,239,23,81,10,98,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42018,239,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42019,239,23,81,10,100,'Free_Text','The overnight asleep direct service provider’s ability to hear the vulnerable adult’s calls for assistance was impacted by the VA being a soft spoken individual and the existence of routine overnight “white” noise in the home from roommates (TV, radio, electronics, etc.).  \r\nThe direct service provider’s ability to hear the vulnerable adult’s call for assistance was impacted by the fact that the provider only provides overnight asleep staff at this site.  This decision was made by the provider based on the support needs of the other three residents in the home which reflected the information provided in their assessments and service plans and the information provided by the vulnerable adult’s CM before admission\r\nThe pre-admission information the case manager provides to the provider varies by person and may have been impacted by a lack of resources and options due to the current moratorium on new adult foster (CRS) beds.  Based on the information provided the case manager and provider discussed these needs prior to the VA moving into the home and all agreed that the provider could meet the needs of the VA with an asleep overnight staff person.\r\n',1,NULL,NULL,NULL,NULL,NULL),(42020,239,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(42021,239,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(42022,239,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(42023,239,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42024,239,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42025,239,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42026,239,23,81,10,101,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42027,239,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42028,239,23,81,10,103,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42029,239,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42030,239,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42031,239,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42032,239,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42033,239,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42034,239,23,81,10,109,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42035,239,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42036,239,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42037,239,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42038,239,23,81,10,113,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42039,239,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42040,239,23,81,10,115,'Multiple_Choice','3',1,NULL,NULL,NULL,NULL,NULL),(42041,239,23,81,10,116,'Free_Text','The direct service provider’s ability to hear the vulnerable adult’s call for assistance was impacted by the fact that the provider only provides overnight asleep staff at this site.  This decision was made by the provider based on the support needs of the other three residents in the home which reflected the information provided in their assessments and service plans and the information provided by the vulnerable adult’s CM before admission.\r\n',1,NULL,NULL,NULL,NULL,NULL),(42042,239,23,81,10,117,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42043,239,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42044,239,23,81,10,119,'Multiple_Choice','2',1,NULL,NULL,NULL,NULL,NULL),(42045,239,23,81,10,120,'Free_Text','The pre-admission information the case manager provides to the provider varies by person and may have been impacted by a lack of resources and options due to the current moratorium on new adult foster (CRS) beds. Based on the information provided the case manager and provider discussed these needs prior to the VA moving into the home and all agreed that the provider could meet the needs of the VA with an asleep overnight staff person.',1,NULL,NULL,NULL,NULL,NULL),(42046,239,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42047,239,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42048,239,23,81,10,123,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42049,239,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42050,239,23,81,10,125,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42051,239,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42052,239,23,81,10,432,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(42053,240,23,81,10,76,'Short_Answer','201904508',1,NULL,NULL,NULL,NULL,NULL),(42054,240,23,81,10,77,'Date','2019-07-15',1,NULL,NULL,NULL,NULL,NULL),(42055,240,23,81,10,78,'Multiple_Choice','Tim Sullivan',1,NULL,NULL,NULL,NULL,NULL),(42056,240,23,81,10,79,'Multiple_Choice','Tony Gantenbein',1,NULL,NULL,NULL,NULL,NULL),(42057,240,23,81,10,80,'Short_Answer','Meridian Services, Inc - Logan',1,NULL,NULL,NULL,NULL,NULL),(42058,240,23,81,10,81,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(42059,240,23,81,10,82,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(42060,240,23,81,10,83,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(42061,240,23,81,10,84,'Multiple_Choice','Medication Error',1,NULL,NULL,NULL,NULL,NULL),(42062,240,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(42063,240,23,81,10,86,'Date','2019-06-19',1,NULL,NULL,NULL,NULL,NULL),(42064,240,23,81,10,87,'Free_Text','On 6/19/19 at 7:00PM, AP was getting pills ready and accidently gave VA the other client\'s (unknown) medication.\r\n\r\nPills Given-\r\nRistidome 4mg\r\nBaclofen 20mg\r\nDivalporex 500mg\r\nMelatonin 3mg\r\nAtenolol 50mg\r\nCyproheptad 4mg\r\n\r\nReporter contacted Facility Nurse and Facility Nurse said to contact poison control. Poison control said to monitor VA and call 911 if VA had\r\nany labored breathing or any issues. Reporter did not feel comfortable with the information Poison Control provided so Reporter brought\r\nVA to Nicollet Park Brookdale Urgent Care. Urgent Care said to keep VA home from VA\'s day program and to monitor VA\'s blood pressure\r\nto make sure it doesn\'t get elevated and to contact Primary Doctor. No affects at this time; however, VA appears drowsier than usual.\r\n\r\nVA attends a day program called Workabilities Monday-Friday from 9am to 4PM or 5PM.\r\nAP gave VA another resident\'s medications (Resperidone 4 mg, Basisen 20 mg, Divalproep 500mg, Melatonin 3 mg., Attenolol 6 mg and\r\nCyproheptadine 4mg,\r\nAP had set up 2 medications at 1 time. Reporter contacted the facility Nurse and Poison Control.\r\nVA was taken to last night to be checked out.\r\nVA stayed home from day program today so staff could monitor VA.\r\nReporter stated she was going to ask Manager what hospital VA was taken to. Call was disconnected. Agent attempted to reach Reporter\r\n3 times but message came on to leave message. Agent unable to finish report.',1,NULL,NULL,NULL,NULL,NULL),(42065,240,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(42066,240,23,81,10,91,'Short_Answer','Staff administered wrong medication to the person',1,NULL,NULL,NULL,NULL,NULL),(42067,240,23,81,10,94,'True_or_False','',1,NULL,NULL,NULL,NULL,NULL),(42068,240,23,81,10,97,'Date','',1,NULL,NULL,NULL,NULL,NULL),(42069,240,23,81,10,98,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42070,240,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42071,240,23,81,10,100,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42072,240,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(42073,240,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(42074,240,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(42075,240,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42076,240,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42077,240,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42078,240,23,81,10,101,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42079,240,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42080,240,23,81,10,103,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42081,240,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42082,240,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42083,240,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42084,240,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42085,240,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42086,240,23,81,10,109,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42087,240,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42088,240,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42089,240,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42090,240,23,81,10,113,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42091,240,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42092,240,23,81,10,115,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42093,240,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42094,240,23,81,10,117,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42095,240,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42096,240,23,81,10,119,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42097,240,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42098,240,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42099,240,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42100,240,23,81,10,123,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42101,240,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42102,240,23,81,10,125,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42103,240,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42104,240,23,81,10,432,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(42105,241,23,81,10,76,'Short_Answer','201907105',1,NULL,NULL,NULL,NULL,NULL),(42106,241,23,81,10,77,'Date','2019-10-15',1,NULL,NULL,NULL,NULL,NULL),(42107,241,23,81,10,78,'Multiple_Choice','Tim Sullivan',1,NULL,NULL,NULL,NULL,NULL),(42108,241,23,81,10,79,'Multiple_Choice','Scott Schifsky',1,NULL,NULL,NULL,NULL,NULL),(42109,241,23,81,10,80,'Short_Answer','REM Hennepin - Columbus',1,NULL,NULL,NULL,NULL,NULL),(42110,241,23,81,10,81,'Short_Answer','Kris Wainwright-Tadych',1,NULL,NULL,NULL,NULL,NULL),(42111,241,23,81,10,82,'Short_Answer','kris.wainwright-tadych@thementornetwork.com',1,NULL,NULL,NULL,NULL,NULL),(42112,241,23,81,10,83,'Short_Answer','(952) 945-4947',1,NULL,NULL,NULL,NULL,NULL),(42113,241,23,81,10,84,'Multiple_Choice','Medication Error',1,NULL,NULL,NULL,NULL,NULL),(42114,241,23,81,10,85,'Multiple_Choice','Hennepin County',1,NULL,NULL,NULL,NULL,NULL),(42115,241,23,81,10,86,'Date','2019-08-23',1,NULL,NULL,NULL,NULL,NULL),(42116,241,23,81,10,87,'Free_Text','On 8/16/19 the house nurse, Terri Abrahamson requested a refill of Carbamazepine 200 mg ER twice a day. The\r\nclinic sent Geritom Pharmacy a prescription for 200mg and 300mg which was then denied by insurance. On 8/16/19 Geritom reported that\r\nthey contacted REM-Hennepin Inc/Columbus and said that the medication was no able to be refilled. The medication supply ran out on\r\n8/23/19 and was not administered from 8/23/19-9/27/19. Currently-contacting the doctor and asking for directives.',1,NULL,NULL,NULL,NULL,NULL),(42117,241,23,81,10,96,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(42118,241,23,81,10,91,'Short_Answer','The DSP initialed the med log but did not administer the med.',1,NULL,NULL,NULL,NULL,NULL),(42119,241,23,81,10,94,'True_or_False','Yes',1,NULL,NULL,NULL,NULL,NULL),(42120,241,23,81,10,97,'Date','2020-01-30',1,NULL,NULL,NULL,NULL,NULL),(42121,241,23,81,10,98,'Free_Text','The DSP has worked in this capacity for approximately 5 years and reports this is her first med error.  She describes the day of the incident (8/16/19) as “busy”, with 1 of the four residents on an outing with the other staff person on duty.  The DSP volunteered that she was preparing meds for one resident at a time.  After signing the medication log for the resident in question, she noticed that one of the medications was different in color and realized the dosage was different (300 mg vs. his usual dosage of 200 mg) and notified the supervisor.  The supervisor instructed the DSP to look in the “overflow” medications and see if there were meds there until the meds could be re-ordered.  The DSP was able to administer the correct medication dosage from the resident’s “overflow” meds. However, the DSP had already initialed the med log when she pulled the incorrect dosage.  The supervisor notified the nurse and the correct dosage was ordered because there were not enough meds in overflow for more than one more day.  During her next shift, two days later, the DSP again signed the med log and then noticed the new medication bubble packs were still the wrong dosage. She again notified the house supervisor who worked with the nurse and the pharmacist to make the correction and get the correct dosage.  The DSP reports that the time lapse between the time she first noticed the incorrect dosage and when it finally arrived was no more than 4-5 days.  Because there were meds in the overflow, the resident only went without the medication a 2-3 day (not the 30+ days indicated on the CEP Report) and never received more than prescribed dosage.  ',1,NULL,NULL,NULL,NULL,NULL),(42122,241,23,81,10,99,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42123,241,23,81,10,100,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42124,241,23,81,10,127,'Short_Answer','',1,NULL,NULL,NULL,NULL,NULL),(42125,241,23,81,10,128,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(42126,241,23,81,10,129,'Date','',1,NULL,NULL,NULL,NULL,NULL),(42127,241,23,81,10,130,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42128,241,23,81,10,131,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42129,241,23,81,10,132,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42130,241,23,81,10,101,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42131,241,23,81,10,102,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42132,241,23,81,10,103,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42133,241,23,81,10,104,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42134,241,23,81,10,105,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42135,241,23,81,10,106,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42136,241,23,81,10,107,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42137,241,23,81,10,108,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42138,241,23,81,10,109,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(42139,241,23,81,10,110,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42140,241,23,81,10,111,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42141,241,23,81,10,112,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42142,241,23,81,10,113,'Multiple_Choice','1',1,NULL,NULL,NULL,NULL,NULL),(42143,241,23,81,10,114,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42144,241,23,81,10,115,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42145,241,23,81,10,116,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42146,241,23,81,10,117,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42147,241,23,81,10,118,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42148,241,23,81,10,119,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42149,241,23,81,10,120,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42150,241,23,81,10,121,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42151,241,23,81,10,122,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42152,241,23,81,10,123,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42153,241,23,81,10,124,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42154,241,23,81,10,125,'Multiple_Choice','',1,NULL,NULL,NULL,NULL,NULL),(42155,241,23,81,10,126,'Free_Text','',1,NULL,NULL,NULL,NULL,NULL),(42156,241,23,81,10,432,'Yes_or_No','',1,NULL,NULL,NULL,NULL,NULL),(42157,243,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42158,244,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42159,245,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42160,246,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42161,247,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42164,250,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42165,251,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42166,252,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42167,253,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42168,254,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42169,255,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42170,256,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42171,257,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42172,258,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42173,259,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42174,260,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42175,261,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42176,262,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42177,263,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42178,264,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42179,266,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42180,267,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42181,268,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42182,269,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42183,270,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42184,271,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42185,272,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42186,273,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42187,274,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42188,275,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42189,276,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42190,277,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42191,278,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42192,279,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42193,280,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42194,281,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42195,282,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42197,284,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42199,286,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42200,287,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42201,288,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42202,289,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42203,290,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42205,292,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42206,293,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42207,294,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42208,295,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42209,296,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42210,297,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42211,298,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42212,299,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42213,301,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42214,302,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42215,303,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42217,305,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42218,306,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42219,307,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42220,308,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42221,309,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42223,311,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42224,312,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42225,313,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42226,314,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42227,315,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42228,316,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42229,317,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42230,318,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42231,319,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42232,320,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42233,321,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42234,322,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42235,323,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42236,324,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42239,327,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42240,328,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42241,329,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42242,330,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42243,331,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42245,333,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42246,334,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42248,336,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42249,337,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42250,338,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42251,339,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42252,340,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42253,341,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42254,342,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42257,345,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42258,346,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42260,348,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42261,349,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42263,351,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42264,352,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42265,353,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42266,354,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42267,355,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42268,356,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42269,357,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42270,358,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42271,360,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42272,361,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42273,362,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42275,364,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42276,365,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42278,367,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42279,368,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42281,370,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42282,371,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42284,373,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42285,374,22,91,13,298,'Yes_or_No','No',1,91,91,'2021-05-26 02:33:44','2021-05-26 02:33:44',NULL),(42287,249,22,71,13,291,'Multiple_Choice','Kelly Knutson',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42288,249,22,71,13,292,'Short_Answer','Paul Lennander',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42289,249,22,71,13,293,'Date','04/24/2018',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42290,249,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42291,249,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42292,249,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42293,249,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42294,249,22,71,13,297,'Short_Answer','Licensed',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42295,249,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42296,249,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42297,249,22,71,13,300,'Multiple_Choice','8',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42298,249,22,71,13,301,'Multiple_Choice','Hennepin',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42299,249,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42300,249,22,71,13,303,'Short_Answer','Arianna',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42301,249,22,71,13,304,'Short_Answer','Hunziker',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42302,249,22,71,13,305,'Date','07/09/2014',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42303,249,22,71,13,306,'Date','11/06/2017',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42304,249,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42305,249,22,71,13,308,'Multiple_Choice','3 Years',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42306,249,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42307,249,22,71,13,310,'Short_Answer','Relative caregiver',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42308,249,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42309,249,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42310,249,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42311,249,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42312,249,22,71,13,316,'Multiple_Choice','1',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42313,249,22,71,13,317,'Short_Answer','Change of Placement and Communication between workers',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42314,249,22,71,13,318,'Free_Text','Debrief information was not documented at the agency\'s request due to pending litigation.  Local rationality gathered in the debrief has been incorporated into the narrative.',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42315,249,22,71,13,319,'Free_Text','The decision to change placement was influenced by the need to find permanency for the identified child and her sibling.  Her current placement had indicated that they were not a permanency option for the subject child and her sibling.  Due to this and the fact that there are both state and federal pressures with statue and guidance to achieve timely permanency, staff were placed in a position in which they needed to locate and move the subject child and her sibling to a placement option that would be permanent for her and her brother.  Further contributing to this pressure that staff felt was that the Judge granted a TPR in this case without having an identified permanency option and the county attorney did not want the case to go to trial.  Further impacting this change of placement and in order for it to occur quickly was that the current relative provider indicated to staff that they were going to be moving out of state in the near future and that they would not be able to take the children with them.  \r\nIn cases such as this, the staff are likely to use the emergency placements process/paperwork for a change of placement when it\'s not an emergency.  It was staff\'s perception that this could more quickly get a relative licensed as the formal licensing process at the local agency is impacted by the amount of time the licensing  process can take at DHS.  This is also influenced by not having enough foster care homes for children.  The non-emergency route to get a relative licensed can also feel daunting to a relative provider.  \r\nIn cases such as this one, there is often a kinship worker, ongoing case worker, and an adoption worker.  As a result of the need to achieve timely (within 12 months) permanency, things were happening very quickly in this case This efficiency pressure impacted communication between all of the staff and left staff feeling like important information was not communicated amongst one another about the case.  Additionally impacting staff\'s ability to communicate effectively and thoroughly about this case was having staff located so far away from one another and staff not having a space where they are readily available to communicate on cases such as this one that involved multiple workers. This, in addition to the pressure felt to make decisions quickly in this case, the case transfer process was impacted and staff where not able to sit down all together as a team and talk through placement decisions together.   \r\nLastly, the older sibling in this case had many identified mental and behavioral health needs.  As a result this became staff\'s focus of attention and believed that a placement that could meet his complex mental and behavioral needs was critically important.   It was important for staff to keep both children together, and place with them with a relative that could be a permanency option for both of them.  Staff noted that the 10 best interest factors influenced this, in addition to identifying placements in which can support the children\'s needs.',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42316,249,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42317,249,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42318,249,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42319,249,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42320,249,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42321,249,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42322,249,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42323,249,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42324,249,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42325,249,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42326,249,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42327,249,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42328,249,22,71,13,346,'Multiple_Choice','3',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42329,249,22,71,13,347,'Free_Text','.  It was staff\'s perception that this could more quickly get a relative licensed as the formal licensing process at the local agency is impacted by the amount of time the licensing  process can take at DHS. \r\n\r\nLastly, the older sibling in this case had many identified mental and behavioral health needs.  As a result this became staff\'s focus of attention and believed that a placement that could meet his complex mental and behavioral needs was critically important.',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42330,249,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42331,249,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42332,249,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42333,249,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42334,249,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42335,249,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42336,249,22,71,13,354,'Multiple_Choice','2',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42337,249,22,71,13,355,'Free_Text','This efficiency pressure impacted communication between all of the staff and left staff feeling like important information was not communicated amongst one another about the case.  Additionally impacting staff\'s ability to communicate effectively and thoroughly about this case was having staff located so far away from one another and staff not having a space where they are readily available to communicate on cases such as this one that involved multiple workers. This, in addition to the pressure felt to make decisions quickly in this case, the case transfer process was impacted and staff where not able to sit down all together as a team and talk through placement decisions together.   \r\nLastly, the older sibling in this case had many identified mental and behavioral health needs.  As a result this became staff\'s focus of attention and believed that a placement that could meet his complex mental and behavioral needs was critically important.   It was important for staff to keep both children together, and place with them with a relative that could be a permanency option for both of them.  Staff noted that the 10 best interest factors influenced this, in addition to identifying placements in which can support the children\'s needs.',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42338,249,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42339,249,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42340,249,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42341,249,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42342,249,22,71,13,358,'Multiple_Choice','2',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42343,249,22,71,13,359,'Free_Text','The decision to change placement was influenced by the need to find permanency for the identified child and her sibling.  Her current placement had indicated that they were not a permanency option for the subject child and her sibling.  Due to this and the fact that there are both state and federal pressures with statue and guidance to achieve timely permanency, staff were placed in a position in which they needed to locate and move the subject child and her sibling to a placement option that would be permanent for her and her brother.  Further contributing to this pressure that staff felt was that the Judge granted a TPR in this case without having an identified permanency option and the county attorney did not want the case to go to trial.  Further impacting this change of placement and in order for it to occur quickly was that the current relative provider indicated to staff that they were going to be moving out of state in the near future and that they would not be able to take the children with them.  \r\n\r\nLastly, the older sibling in this case had many identified mental and behavioral health needs.  As a result this became staff\'s focus of attention and believed that a placement that could meet his complex mental and behavioral needs was critically important.   It was important for staff to keep both children together, and place with them with a relative that could be a permanency option for both of them.  Staff noted that the 10 best interest factors influenced this, in addition to identifying placements in which can support the children\'s needs.',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42344,249,22,71,13,360,'Multiple_Choice','2',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42345,249,22,71,13,361,'Free_Text','The decision to change placement was influenced by the need to find permanency for the identified child and her sibling.  Her current placement had indicated that they were not a permanency option for the subject child and her sibling.  Due to this and the fact that there are both state and federal pressures with statue and guidance to achieve timely permanency, staff were placed in a position in which they needed to locate and move the subject child and her sibling to a placement option that would be permanent for her and her brother.  Further contributing to this pressure that staff felt was that the Judge granted a TPR in this case without having an identified permanency option and the county attorney did not want the case to go to trial.  Further impacting this change of placement and in order for it to occur quickly was that the current relative provider indicated to staff that they were going to be moving out of state in the near future and that they would not be able to take the children with them.  \r\n\r\nIn cases such as this one, there is often a kinship worker, ongoing case worker, and an adoption worker.  As a result of the need to achieve timely (within 12 months) permanency, things were happening very quickly in this case This efficiency pressure impacted communication between all of the staff and left staff feeling like important information was not communicated amongst one another about the case.  Additionally impacting staff\'s ability to communicate effectively and thoroughly about this case was having staff located so far away from one another and staff not having a space where they are readily available to communicate on cases such as this one that involved multiple workers. \r\n\r\nThis efficiency pressure impacted communication between all of the staff and left staff feeling like important information was not communicated amongst one another about the case.  Additionally impacting staff\'s ability to communicate effectively and thoroughly about this case was having staff located so far away from one another and staff not having a space where they are readily available to communicate on cases such as this one that involved multiple workers. This, in addition to the pressure felt to make decisions quickly in this case, the case transfer process was impacted and staff where not able to sit down all together as a team and talk through placement decisions together.',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42346,249,22,71,13,362,'Multiple_Choice','2',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42347,249,22,71,13,363,'Free_Text','This is also influenced by not having enough foster care homes for children.  The non-emergency route to get a relative licensed can also feel daunting to a relative provider.',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42348,249,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42349,249,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42350,249,22,71,13,366,'Multiple_Choice','2',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42351,249,22,71,13,367,'Free_Text','In cases such as this, the staff are likely to use the emergency placements process/paperwork for a change of placement when it\'s not an emergency.  It was staff\'s perception that this could more quickly get a relative licensed as the formal licensing process at the local agency is impacted by the amount of time the licensing  process can take at DHS.',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42352,249,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 18:58:07','2021-06-01 18:58:07',NULL),(42354,283,22,71,13,291,'Multiple_Choice','Ryan Hartneck',1,71,71,'2021-06-01 18:59:05','2021-06-01 18:59:05',NULL),(42355,283,22,71,13,292,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:05','2021-06-01 18:59:05',NULL),(42356,283,22,71,13,293,'Date','08/09/2017',1,71,71,'2021-06-01 18:59:05','2021-06-01 18:59:05',NULL),(42357,283,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 18:59:05','2021-06-01 18:59:05',NULL),(42358,283,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 18:59:05','2021-06-01 18:59:05',NULL),(42359,283,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 18:59:05','2021-06-01 18:59:05',NULL),(42360,283,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 18:59:05','2021-06-01 18:59:05',NULL),(42361,283,22,71,13,297,'Short_Answer','Licensed',1,71,71,'2021-06-01 18:59:05','2021-06-01 18:59:05',NULL),(42362,283,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42363,283,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42364,283,22,71,13,300,'Multiple_Choice','8',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42365,283,22,71,13,301,'Multiple_Choice','Hennepin',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42366,283,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42367,283,22,71,13,303,'Short_Answer','Gabriel',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42368,283,22,71,13,304,'Short_Answer','Cooper',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42369,283,22,71,13,305,'Date','07/14/2016',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42370,283,22,71,13,306,'Date','07/13/2017',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42371,283,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42372,283,22,71,13,308,'Multiple_Choice','1 Year',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42373,283,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42374,283,22,71,13,310,'Short_Answer','Daycare provider',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42375,283,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42376,283,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42377,283,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42378,283,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42379,283,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42380,283,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42381,283,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42382,283,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42383,283,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42384,283,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42385,283,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42386,283,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42387,283,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42388,283,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42389,283,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42390,283,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42391,283,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42392,283,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42393,283,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42394,283,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42395,283,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42396,283,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42397,283,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42398,283,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42399,283,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42400,283,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42401,283,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42402,283,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42403,283,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42404,283,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42405,283,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42406,283,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42407,283,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42408,283,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42409,283,22,71,13,358,'Multiple_Choice','2',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42410,283,22,71,13,359,'Free_Text','After receiving and screening in an intake after a critical incident, subsequent intakes regarding the critical incident (duplicates)  were screened out.',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42411,283,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42412,283,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42413,283,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42414,283,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42415,283,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42416,283,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42417,283,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42418,283,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42419,283,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 18:59:06','2021-06-01 18:59:06',NULL),(42421,285,22,71,13,291,'Multiple_Choice','Kristine Frick',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42422,285,22,71,13,292,'Short_Answer','Tiffany Kacir',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42423,285,22,71,13,293,'Date','09/05/2019',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42424,285,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42425,285,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42426,285,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42427,285,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42428,285,22,71,13,297,'Short_Answer','Licensed',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42429,285,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42430,285,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42431,285,22,71,13,300,'Multiple_Choice','7',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42432,285,22,71,13,301,'Multiple_Choice','Washington',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42433,285,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42434,285,22,71,13,303,'Short_Answer','Gus',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42435,285,22,71,13,304,'Short_Answer','Hoisser',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42436,285,22,71,13,305,'Date','11/27/2018',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42437,285,22,71,13,306,'Date','04/30/2019',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42438,285,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42439,285,22,71,13,308,'Multiple_Choice','5 Months',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42440,285,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42441,285,22,71,13,310,'Short_Answer','Father',1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42442,285,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42443,285,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:43','2021-06-01 18:59:43',NULL),(42444,285,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42445,285,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42446,285,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42447,285,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42448,285,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42449,285,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42450,285,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42451,285,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42452,285,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42453,285,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42454,285,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42455,285,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42456,285,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42457,285,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42458,285,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42459,285,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42460,285,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42461,285,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42462,285,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42463,285,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42464,285,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42465,285,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42466,285,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42467,285,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42468,285,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42469,285,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42470,285,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42471,285,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42472,285,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42473,285,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42474,285,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42475,285,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42476,285,22,71,13,358,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42477,285,22,71,13,359,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42478,285,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42479,285,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42480,285,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42481,285,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42482,285,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42483,285,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42484,285,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42485,285,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42486,285,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 18:59:44','2021-06-01 18:59:44',NULL),(42488,291,22,71,13,291,'Multiple_Choice','Kristine Frick',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42489,291,22,71,13,292,'Short_Answer','Triage Team',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42490,291,22,71,13,293,'Date','02/10/2017',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42491,291,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42492,291,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42493,291,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42494,291,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42495,291,22,71,13,297,'Short_Answer','Legally Unlicensed',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42496,291,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42497,291,22,71,13,299,'Multiple_Choice','Legally Unlicensed',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42498,291,22,71,13,300,'Multiple_Choice','8',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42499,291,22,71,13,301,'Multiple_Choice','Hennepin',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42500,291,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42501,291,22,71,13,303,'Short_Answer','Ja\'Mir',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42502,291,22,71,13,304,'Short_Answer','Dunagan',1,71,71,'2021-06-01 19:00:21','2021-06-01 19:00:21',NULL),(42503,291,22,71,13,305,'Date','08/20/2016',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42504,291,22,71,13,306,'Date','01/28/2017',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42505,291,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42506,291,22,71,13,308,'Multiple_Choice','5 Months',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42507,291,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42508,291,22,71,13,310,'Short_Answer','Unlicensed child daycare provider',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42509,291,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42510,291,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42511,291,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42512,291,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42513,291,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42514,291,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42515,291,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42516,291,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42517,291,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42518,291,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42519,291,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42520,291,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42521,291,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42522,291,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42523,291,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42524,291,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42525,291,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42526,291,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42527,291,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42528,291,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42529,291,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42530,291,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42531,291,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42532,291,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42533,291,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42534,291,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42535,291,22,71,13,352,'Multiple_Choice','1',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42536,291,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42537,291,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42538,291,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42539,291,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42540,291,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42541,291,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42542,291,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42543,291,22,71,13,358,'Multiple_Choice','1',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42544,291,22,71,13,359,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42545,291,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42546,291,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42547,291,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42548,291,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42549,291,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42550,291,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42551,291,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42552,291,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42553,291,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:00:22','2021-06-01 19:00:22',NULL),(42556,300,22,71,13,291,'Multiple_Choice','Kelly Knutson',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42557,300,22,71,13,292,'Short_Answer','Paul Lennander',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42558,300,22,71,13,293,'Date',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42559,300,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42560,300,22,71,13,294,'Multiple_Choice','Other',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42561,300,22,71,13,295,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42562,300,22,71,13,296,'Multiple_Choice','Other Tribe',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42563,300,22,71,13,297,'Short_Answer','Sisseton-Wahpeton',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42564,300,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42565,300,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42566,300,22,71,13,300,'Multiple_Choice','8',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42567,300,22,71,13,301,'Multiple_Choice','Hennepin',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42568,300,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42569,300,22,71,13,303,'Short_Answer','Jenecio',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42570,300,22,71,13,304,'Short_Answer','Prentice',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42571,300,22,71,13,305,'Date',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42572,300,22,71,13,306,'Date',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42573,300,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42574,300,22,71,13,308,'Multiple_Choice','<1 Month',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42575,300,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42576,300,22,71,13,310,'Short_Answer','Grandfather',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42577,300,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42578,300,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42579,300,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42580,300,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42581,300,22,71,13,316,'Multiple_Choice','3',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42582,300,22,71,13,317,'Short_Answer','Placement occurred when licensing concerns were noted',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42583,300,22,71,13,318,'Free_Text','The human factors debriefing information was not documented at the request of the local agency due to pending litigation.  All of the local rationality information is captured in the narrative.',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42584,300,22,71,13,319,'Free_Text','The decision to place the child in a home when licensing concerns were noted was influenced by federal, state, and local agency policies that prioritize the placement of children with relative caregivers and siblings whenever possible.  Minnesota State Statues 260C.212; 260C.221 and Stat. Â§ 260C.212, subd. 2 requires additional due diligence beyond the federal requirements with regards to locating and placing children with relatives as well as placing children with their siblings whenever possible.  Further placing pressure on staff to place children with relatives in cases like this is the metric of relative placement in which is set at 35.7% for agencies to achieve. This placement was not only a relative provider but also had the child\'s siblings in his care as well.  Additionally, there were no other relatives available to take the subject child and this relative care provider was excited to take the child when he was born and wanted the child in his care.  \r\nFurther supporting the agency\'s decision to place the child in this home was that this child was Native American and the child\'s Tribe was recommending placement with this relative. Deferring to the child\'s Tribe and following their recommendation as well as placement preferences is shaped by both the Federal Indian Child Welfare Act as well as the Minnesota Indian Family Preservation Act.  As a result of this, the local agency\'s normative practice is to defer to the Tribe for placement options.  It was also staff\'s perception that placing with this relative would further preserve the relationship between the Tribe and the worker.  An additional influence into this placement occurring with this relative was that there was limited availability of Native American foster care homes for children qualifying under the ICWA.',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42585,300,22,71,13,320,'Short_Answer','Placement with the relative provider occurred beyond capacity',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42586,300,22,71,13,321,'Free_Text','The human factors debriefing information was not documented at the request of the local agency due to pending litigation.  All of the local rationality information is captured in the narrative',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42587,300,22,71,13,322,'Free_Text','Influencing placing the subject child with the relative provider beyond the providers licensed capacity was the fact that this provider was both a relative placement and all of the child\'s siblings were placed with this relative.  Additionally, multiple workers were assigned to this case within the placing agency. The multiple workers assigned to cases such as this has resulted in the agency\'s need to have specialized workers on a case that better support the agency being more child focused.  Having multiple workers on this case contributed to role confusion in providing services to this child and family.  This role confusion impacted communication between the placing worker and the licensing worker at the agency that was responsible for licensing the home.  As a result, communication barriers between the two agencies occurred around the licensing process; including notification of the child being placed in the home.  This further contributed to the placing agency not being aware that the home was only licensed for 3 children, not 4.  Staff within this local agency also do not have offices and as a result, often work remotely and separate from one another.  The location of the multiple staff on the case within the agency also created communication barriers between staff. Further supporting this placement decision was staff\'s limited knowledge of all of the licensing requirements as child protection workers are not typically responsible for the licensing process with families.',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42588,300,22,71,13,323,'Short_Answer','Services were not provided to the relative caregiver',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42589,300,22,71,13,324,'Free_Text','The human factors debriefing information was not documented at the request of the local agency due to pending litigation.  All of the local rationality information is captured in the narrative',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42590,300,22,71,13,325,'Free_Text','Services not being provided to the relative caregiver was influenced by the multiple workers and agencies involved with this case.  Having this many workers on one case impacted communication and consultation between the two agencies involved with regards to which agency was assessing and providing services to the relative caregiver. Furthermore, in relative foster care placements such as this, agencies are less likely to provide services to relative placements.  This was often supported by relative placement providers having and utilizing informal supports. It is also common in cases such as this that a history of mistrust exists between the family and the local agency, impacting the relative placement provider requesting services for support.  Furthermore, there are a lack of culturally appropriate services available for relative placement providers.  Lastly, staff perceived that this provider was getting all of the services he needed as it was common that he would reach out for basic need items and allowances for the children he was caring for.',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42591,300,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42592,300,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42593,300,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42594,300,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42595,300,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42596,300,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42597,300,22,71,13,346,'Multiple_Choice','2',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42598,300,22,71,13,347,'Free_Text','LP 1- It was also staff\'s perception that placing with this relative would further preserve the relationship between the Tribe and the worker.  \r\n\r\nLP 3-Lastly, staff perceived that this provider was getting all of the services he needed as it was common that he would reach out for basic need items and allowances for the children he was caring for.',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42599,300,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42600,300,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42601,300,22,71,13,350,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42602,300,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42603,300,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42604,300,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42605,300,22,71,13,354,'Multiple_Choice','3',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42606,300,22,71,13,355,'Free_Text','LP 2-Additionally, multiple workers were assigned to this case within the placing agency. The multiple workers assigned to cases such as this has resulted in the agency\'s need to have specialized workers on a case that better support the agency being more child focused.  Having multiple workers on this case contributed to role confusion in providing services to this child and family.  This role confusion impacted communication between the placing worker and the licensing worker at the agency that was responsible for licensing the home.  As a result, communication barriers between the two agencies occurred around the licensing process; including notification of the child being placed in the home.  This further contributed to the placing agency not being aware that the home was only licensed for 3 children, not 4.  Staff within this local agency also do not have offices and as a result, often work remotely and separate from one another.  The location of the multiple staff on the case within the agency also created communication barriers between staff. Further supporting this placement decision was staff\'s limited knowledge of all of the licensing requirements as child protection workers are not typically responsible for the licensing process with families.  \r\n\r\nLP 3-\r\nServices not being provided to the relative caregiver was influenced by the multiple workers and agencies involved with this case.  Having this many workers on one case impacted communication and consultation between the two agencies involved with regards to which agency was assessing and providing services to the relative caregiver.',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42607,300,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42608,300,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42609,300,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42610,300,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42611,300,22,71,13,358,'Multiple_Choice','3',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42612,300,22,71,13,359,'Free_Text','LP 1-The decision to place the child in a home when licensing concerns were noted was influenced by federal, state, and local agency policies that prioritize the placement of children with relative caregivers and siblings \r\nwhenever possible.  Minnesota State Statues 260C.212; 260C.221 and Stat. Â§ 260C.212, subd. 2 requires additional due diligence beyond the federal requirements with regards to locating and placing children with relatives as well as placing children with their siblings whenever possible.  Further placing pressure on staff to place children with relatives in cases like this is the metric of relative placement in which is set at 35.7% for agencies to achieve. This placement was not only a relative provider but also had the child\'s siblings in his care as well.  Additionally, there were no other relatives available to take the subject child and this relative care provider was excited to take the child when he was born and wanted the child in his care. \r\n\r\nFurther supporting the agency\'s decision to place the child in this home was that this child was Native American and the child\'s Tribe was recommending placement with this relative. Deferring to the child\'s Tribe and following their recommendation as well as placement preferences is shaped by both the Federal Indian Child Welfare Act as well as the Minnesota Indian Family Preservation Act.  As a result of this, the local agency\'s normative practice is to defer to the Tribe for placement options.  \r\n\r\nLP2-Influencing placing the subject child with the relative provider beyond the providers licensed capacity was the fact that this provider was both a relative placement and all of the child\'s siblings were placed with this relative.',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42613,300,22,71,13,360,'Multiple_Choice','2',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42614,300,22,71,13,361,'Free_Text','LP 2-Additionally, multiple workers were assigned to this case within the placing agency. The multiple workers assigned to cases such as this has resulted in the agency\'s need to have specialized workers on a case that better support the agency being more child focused.  Having multiple workers on this case contributed to role confusion in providing services to this child and family.  This role confusion impacted communication between the placing worker and the licensing worker at the agency that was responsible for licensing the home.  As a result, communication barriers between the two agencies occurred around the licensing process; including notification of the child being placed in the home.  This further contributed to the placing agency not being aware that the home was only licensed for 3 children, not 4.  Staff within this local agency also do not have offices and as a result, often work remotely and separate from one another.  The location of the multiple staff on the case within the agency also created communication barriers between staff. Further supporting this placement decision was staff\'s limited knowledge of all of the licensing requirements as child protection workers are not typically responsible for the licensing process with families.',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42615,300,22,71,13,362,'Multiple_Choice','2',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42616,300,22,71,13,363,'Free_Text','An additional influence into this placement occurring with this relative was that there was limited availability of Native American foster care homes for children qualifying under the ICWA.\r\n\r\nLP 3-Furthermore, there are a lack of culturally appropriate services available for relative placement providers.',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42617,300,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42618,300,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42619,300,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42620,300,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42621,300,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:01:47','2021-06-01 19:01:47',NULL),(42623,304,22,71,13,291,'Multiple_Choice','Kristine Frick',1,71,71,'2021-06-01 19:02:19','2021-06-01 19:02:19',NULL),(42624,304,22,71,13,292,'Short_Answer','Tiffany Kacir',1,71,71,'2021-06-01 19:02:19','2021-06-01 19:02:19',NULL),(42625,304,22,71,13,293,'Date','02/15/2018',1,71,71,'2021-06-01 19:02:19','2021-06-01 19:02:19',NULL),(42626,304,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:02:19','2021-06-01 19:02:19',NULL),(42627,304,22,71,13,294,'Multiple_Choice','Near Fatality',1,71,71,'2021-06-01 19:02:19','2021-06-01 19:02:19',NULL),(42628,304,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:02:19','2021-06-01 19:02:19',NULL),(42629,304,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42630,304,22,71,13,297,'Short_Answer','Legally Unlicensed',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42631,304,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42632,304,22,71,13,299,'Multiple_Choice','Legally Unlicensed',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42633,304,22,71,13,300,'Multiple_Choice','7',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42634,304,22,71,13,301,'Multiple_Choice','Dakota',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42635,304,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42636,304,22,71,13,303,'Short_Answer','Justin',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42637,304,22,71,13,304,'Short_Answer','Lin',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42638,304,22,71,13,305,'Date','05/10/2017',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42639,304,22,71,13,306,'Date',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42640,304,22,71,13,307,'Date','02/05/2018',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42641,304,22,71,13,308,'Multiple_Choice','9 Months',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42642,304,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42643,304,22,71,13,310,'Short_Answer','Legally unlicensed care provider',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42644,304,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42645,304,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42646,304,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42647,304,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42648,304,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42649,304,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42650,304,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42651,304,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42652,304,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42653,304,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42654,304,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42655,304,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42656,304,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42657,304,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42658,304,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42659,304,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42660,304,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42661,304,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42662,304,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42663,304,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42664,304,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42665,304,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42666,304,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42667,304,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42668,304,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42669,304,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42670,304,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42671,304,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42672,304,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42673,304,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42674,304,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42675,304,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42676,304,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42677,304,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42678,304,22,71,13,358,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42679,304,22,71,13,359,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42680,304,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42681,304,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42682,304,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42683,304,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42684,304,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42685,304,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42686,304,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42687,304,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42688,304,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:02:20','2021-06-01 19:02:20',NULL),(42690,310,22,71,13,291,'Multiple_Choice','Kristine Frick',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42691,310,22,71,13,292,'Short_Answer','Tracy Nielsen',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42692,310,22,71,13,293,'Date','02/09/2018',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42693,310,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42694,310,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42695,310,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42696,310,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42697,310,22,71,13,297,'Short_Answer','Licensed',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42698,310,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42699,310,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42700,310,22,71,13,300,'Multiple_Choice','9',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42701,310,22,71,13,301,'Multiple_Choice','Ramsey',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42702,310,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42703,310,22,71,13,303,'Short_Answer','Kristin',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42704,310,22,71,13,304,'Short_Answer','Nelson',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42705,310,22,71,13,305,'Date','07/29/2016',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42706,310,22,71,13,306,'Date','11/13/2017',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42707,310,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42708,310,22,71,13,308,'Multiple_Choice','1 Year',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42709,310,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42710,310,22,71,13,310,'Short_Answer','Licensed relative - Maternal Grandmother',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42711,310,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42712,310,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42713,310,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42714,310,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42715,310,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42716,310,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42717,310,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42718,310,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42719,310,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42720,310,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42721,310,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42722,310,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42723,310,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42724,310,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42725,310,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42726,310,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42727,310,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42728,310,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42729,310,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42730,310,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42731,310,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42732,310,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42733,310,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42734,310,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42735,310,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42736,310,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42737,310,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42738,310,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42739,310,22,71,13,354,'Multiple_Choice','3',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42740,310,22,71,13,355,'Free_Text','Maltreatment determination for natural sleep related death impacted work relationships between the local agency\'s licensing, adoptions, adn child protection units. \r\n\r\nAdoptions worker had trouble getting a hold of GAL. GAL did not attend meetings.',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42741,310,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42742,310,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42743,310,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42744,310,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42745,310,22,71,13,358,'Multiple_Choice','3',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42746,310,22,71,13,359,'Free_Text','SUID - Maltreatment determined, natural death that occurred in relative licensed family foster care provider\'s home. Child had been sick with a cold. Relative caregiver placed child down for rest; she was later found deceased. Cause of death possible croup laryngotracheobronchitis.\r\n\r\nLocal agency practice to remove all children from caregiver prior to assessing safety, and with DHS Licensing direction to the local agency\'s licensing unit, to issue a temporary immediate suspension when a child death occurred did not support the permanency pre-adoptive placement option for the surviving children.',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42747,310,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42748,310,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42749,310,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42750,310,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42751,310,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42752,310,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42753,310,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42754,310,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42755,310,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:03:11','2021-06-01 19:03:11',NULL),(42757,325,22,71,13,291,'Multiple_Choice','Brittany Lochner',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42758,325,22,71,13,292,'Short_Answer','Colette Roesler',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42759,325,22,71,13,293,'Date','12/05/2016',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42760,325,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42761,325,22,71,13,294,'Multiple_Choice','Near Fatality',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42762,325,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42763,325,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42764,325,22,71,13,297,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42765,325,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42766,325,22,71,13,299,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42767,325,22,71,13,300,'Multiple_Choice','7',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42768,325,22,71,13,301,'Multiple_Choice','Washington',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42769,325,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42770,325,22,71,13,303,'Short_Answer','Mackenzie',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42771,325,22,71,13,304,'Short_Answer','Wynne',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42772,325,22,71,13,305,'Date','05/24/2016',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42773,325,22,71,13,306,'Date',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42774,325,22,71,13,307,'Date','11/14/2016',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42775,325,22,71,13,308,'Multiple_Choice','5 Months',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42776,325,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42777,325,22,71,13,310,'Short_Answer','Unknown Offender',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42778,325,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42779,325,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42780,325,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42781,325,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42782,325,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42783,325,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42784,325,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42785,325,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42786,325,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42787,325,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42788,325,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42789,325,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42790,325,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42791,325,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42792,325,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42793,325,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42794,325,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42795,325,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42796,325,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42797,325,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42798,325,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42799,325,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42800,325,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42801,325,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42802,325,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42803,325,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42804,325,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42805,325,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42806,325,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42807,325,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42808,325,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42809,325,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42810,325,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42811,325,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42812,325,22,71,13,358,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42813,325,22,71,13,359,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42814,325,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42815,325,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42816,325,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42817,325,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42818,325,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42819,325,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42820,325,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42821,325,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42822,325,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:04:27','2021-06-01 19:04:27',NULL),(42825,326,22,71,13,291,'Multiple_Choice','Kelly Knutson',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42826,326,22,71,13,292,'Short_Answer','Ann Many Birds, Reanna Jacobs, and Yvonne Barett',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42827,326,22,71,13,293,'Date',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42828,326,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42829,326,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42830,326,22,71,13,295,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42831,326,22,71,13,296,'Multiple_Choice','Other Tribe',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42832,326,22,71,13,297,'Short_Answer','Sisseton Wahpeton Oyate',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42833,326,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42834,326,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42835,326,22,71,13,300,'Multiple_Choice','3',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42836,326,22,71,13,301,'Multiple_Choice','Stearns',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42837,326,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42838,326,22,71,13,303,'Short_Answer','Maliyah',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42839,326,22,71,13,304,'Short_Answer','Provancial',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42840,326,22,71,13,305,'Date','09/04/2002',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42841,326,22,71,13,306,'Date','03/29/2019',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42842,326,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42843,326,22,71,13,308,'Multiple_Choice','16 Years',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42844,326,22,71,13,309,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42845,326,22,71,13,310,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42846,326,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42847,326,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42848,326,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42849,326,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42850,326,22,71,13,316,'Multiple_Choice','3',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42851,326,22,71,13,317,'Short_Answer','Permanency has not been achieved for subject child\'s sibling',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42852,326,22,71,13,318,'Free_Text','Debrief with Child Protection Staff related to this case:\r\nStaff debriefed noted that this case was difficult as the subject child\'s mother was only in this county for a short time once the case opened and quickly left the county.  This created challenges in engaging the mother in her case planning for reunification and identifying relative placement options that would support alternate permanency planning.  Limited relatives were provided to the agency by the mother as possible relative placement options. When relatives were given as placement options it was difficult for the agency staff to get a hold of them to explore if they would be a permanency options for the subject child\'s sibling.  This agency worked to coordinate case work with the family\'s out of state Tribe in addition to the other counties in which were serving the mother and subject child\'s sibling.  Staff noted difficulties in coordinating case work including the achievement of permanency for the subject child\'s sibling with both the Tribe and other counties.  This included transferring the case to other counties so the family could be better served and getting consultation from the Tribe on other options.  Further creating barriers for staff to provide case management services to the best of their ability was mom\'s absence and inability to locate and work with mom.  \r\nStaff felt that the system created barriers to best serve this family together as the family was working with three counties and her sibling (the subject child) was placed somewhere else across the state.  This created challenges to maintain and preserve this sibling relationship when two counties were involved, and the siblings were placed so far away from one another.  \r\nFurther impacting staff\'s ability to move to permanency with the subject child\'s sibling was that the Tribal worker was very difficult to get a hold of to provide both consultation on the case and a QEW.  It was staff\'s perception that a QEW needed to attend a hearing in order for the agency to move to permanency and the Tribe would not respond and assist with a QEW, impacting movement towards permanency.  \r\nFurthermore, not having access to the Tribes records or knowing if South Dakota had been involved with the family impacted staff\'s ability to explore other relatives and/or kin options for the subject child\'s sibling as permanency options.  \r\nAdditionally, the subject child\'s sibling had significant needs that included mental health, trauma, and chemical dependency.  It was difficult to find a placement facility that could meet this child\'s needs.  Her high level of needs impacted her being in a lesser restrictive setting including being able to reunifying with her mother and residing with relatives.\r\nFurther contributing to not achieving permanency in this case are the timelines.  They are not realistic when you have a mother like this with a long history of chemical dependency problems.  It can take 30 days to obtain a rule 25 assessment and then the waitlist for treatment can be 3-4 months.  Once in treatment, it can be another 3-6 months putting you almost at the 12 month permanency timelines.  Staff indicated that they are simply not realistic with the needs of families such as this one.  \r\nStaff indicated challenges occurred in communicating and coordinating with the Tribe regarding if this family were Tribal members, further impacting movement towards permanency in this case.  Communication challenges continued throughout the case influencing the agency\'s ability to move towards permanency.  \r\nThe tribal worker indicated to agency staff that she was not able to be directly involved due to capacity and the children being off the reservation.  When agency asked about other family members as permanency options for the subject child\'s sibling, the Tribal worker further indicated to staff that the family was not good  Staff noted that it was difficult to obtain other Tribal members names as a result of the limited communication with the Tribal worker.  Staff noted that they would call, email, and fax, and the Tribal worker was very difficult to get a hold of, often not responding, and not appearing at hearings.  This impacted the agency\'s ability to plan and coordinate permanency planning options for the subject child\'s sibling.	\r\nAdditional barriers noted in this case by staff included being able to share information with other counties and with the Tribe.  Due to the number of case load tasks and documentation requirements staff noted limitations in being able to dig up additional history elsewhere that may have identified other permanency options for the subject child\'s sibling.  \r\nTrying to support reunification, the agency attempted to transfer jurisdiction to a county where mom was located, however, that county denied the transfer further contributing to delays in reunification and identifying others that may be able to take the child.  The agency also tried to transfer the case to the county where the subject child was placed so that the siblings could be closer, however, this did not occur and further impacted the agency achieving permanency for the subject child\'s sibling\r\nStaff indicated that when it is difficult to engage with families it can be can create barriers to achieving permanency for children such as in this case.   Contributing to staff feeling like they cannot engage meaningfully is their high caseloads, the requirement to time report at 100% of their time in addition to all of the documentation requirements within SSIS.  \r\nFurther supporting permanency not being achieved was that the subject child\'s sibling did not want to be reunified with her mother and did not want to live with her family as she did not think they would be healthy for her.  When she was 16, staff engaged her in what she wanted for permanency.   She also told staff that she felt supported in her group home and wanted to age out from there.  \r\n\r\nDebrief with CMH worker related to this case:\r\nStaff noted that her primary focus as a CMH worker was to provide support for subject child\'s sibling\'s mental health.  Staff reported that the subject child\'s sibling has a lot of needs including her mental health, chemical dependency and was also a victim of sex trafficking. Due to her age the main focus was on Independent Living.  Staff also indicated that they were following the recommendations of the doctor who recommended long term residential placement to best meet the subject child\'s needs.  This staff noted that in her role she has worked with very few Native American children.  Staff debriefed indicated that finding placements for children like the subject child\'s sibling was very difficult due to her needs-particularly around self-harm.  It was staff\'s perception that she would do well for a while and then sabotage her recovery.  Staff further indicated that she believed that the sibling child did not have a lot of family support but felt supported by the group home staff.  The subject child\'s sibling has also indicated to staff that she would like to age out of that group home and go on to Job Corps.  It was also noted that there are Native American workers at the group home where the child is and that they reportedly connect the sibling child to some of her cultural practices.  \r\nWhen relatives were explored such as the aunt and grandma, they both turned out to not be permanency options for the subject child\'s sibling.  The CMH worker noted that this was managed by the CP worker.  It was also staff\'s perception that the requirements for ICWA and relative placements was new for them as CMH staff.  \r\nFurther supporting the decision for the subject child\'s sibling to age out of foster care was that the child was asked what she wanted to do-what she thought was best for her and that those working with her would support that.   Initially, the child indicated (at age 17) that she wanted to try and live with her grandma.  As a result the agency began planning for this, however, shortly after the child decided that she changed her mind and indicated she would like to attend Job Corps.',1,71,71,'2021-06-01 19:05:29','2021-06-01 19:05:29',NULL),(42853,326,22,71,13,319,'Free_Text','Permanency not being achieved for the subject child\'s sibling before turning 18 was influenced by the challenges that existed for local agency staff to locate and find relatives that were able to care for the child.  Not being able to locate relatives for the child was impacted by the mother\'s location from the agency as mom lived several hours away from the county in which the child had been placed creating difficulties for the agency to engage mom in case planning and permanency planning for this child.  Furthermore, it was staff\'s perception based upon knowledge shard with them that the child\'s father had passed away.  As a result the agency did not believe that there were any possible paternal relative placement options for this child either.  Additionally, this child had complex needs that included significant trauma related to sexual exploitation, mental health, and chemical dependency needs.  It was difficult to find a placement that could meet this child\'s unique needs and this impacted the agency\'s ability to place her in a lesser restrictive setting including being able to reunifying with her mother and residing with relatives. This coupled with being unable to identify viable maternal and paternal relative placement options impacted the agency\'s ability to achieve permanency for this youth.\r\nFurther contributing to not achieving permanency in this case is the incongruence that occurs between federal permanency timelines and the time it takes to provide services that will support reunification.  Staff noted that timelines ae not realistic when you have a mother with a long history of chemical dependency problems.  It can take 30 days to obtain a chemical dependency assessment and once this is completed, it can take another 3-4 months then before someone can start inpatient treatment.  Once in treatment, it can be another 3-6 months putting you almost at the 12 month permanency timeline.  Staff indicated that they (permanency timelines) are simply not realistic with the needs of families that struggle with chemical dependency and are not conducive to supporting reunification within federally mandated timelines.  \r\nFurthermore, such timeframes and the time required to achieve of ICWA and MIFPA requirements for active efforts can impact court proceedings which can further influence planning for permanency and therefore permanency being achieved within state and federal timelines.  This can be further compounded by staff\'s perception that in order to proceed on an ICWA case they must wait for the BIA to respond with Tribal affiliation before proceeding with permanency planning and case proceedings.   \r\nAdditionally impacting permanency not being achieved in this case were communication and consultation barriers that occurred between the county and the tribe on permanency planning for this child. Communication and coordination barriers were influenced by staff turnover both at the county and tribal agency.  Specifically, there is only one tribal child welfare worker at the Tribe that covers both Tribal Child Protection cases within the reservation and off the reservation.  The additional ICWA/MIFPA related tasks places pressure on Tribal staff that already have limited resources to do the work and have not received additional resources/funding to ensure they can manage the tasks associated with responding to the ICWA.    \r\nIn cases such as this, court proceedings including the number of court proceedings, the timing of them, and the Judges knowledge of when both ICWA and MIFPA requirements have been met can lengthen the time it takes local agencies and tribal staff to plan for permanency further creating barriers to both achieving permanency and achieving permanency in accordance with state a federal performance measures.  This can be further impacted by the Judges knowledge of ICWA and MIFP, and if ICWA/MIFPA active efforts have been achieved in a case.  \r\nLastly, it was the local agencies perception in addition to their county attorney\'s perception that a Qualified Expert Witness (QEW) for the Tribe needed to be present at court in order to move toward permanency.  As a result, the agency believed that they were unable to move towards permanency for the child and continued to delay permanency court proceedings as a result.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42854,326,22,71,13,320,'Short_Answer','Active Efforts in accordance with MIFPA-specific to',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42855,326,22,71,13,321,'Free_Text','Debrief with CMH Staff related to this case:\r\nStaff indicated that she was working with the subject child through a voluntary placement agreement to support the child\'s mental health needs.  This was the staff\'s focus of attention, which is normative practice in children\'s mental health cases. Staff reported that distance between the child\'s residential treatment and her mother was significant, creating barriers for visitation and connection.  When the subject child\'s mother lived closer to the placement she would ride with staff to the residential treatment center to visit with the subject child.  Staff indicated that typical practice within children\'s mental health cases is that the focus in on the child and that it isn\'t typical to transport family members or arrange for or provide transportation for visitation of family members when the child is in treatment.  \r\nFurther influencing staff not transporting family members is that it is agency policy to not transport family members of clients.  Further impacting connection to the subject child\'s Tribe and community and cultural connections was that the staff did not perceive this to be her role in both supporting mom and other relatives in both visitation and connection with the subject child as well as engaging the Tribe in the subject child\'s treatment.  While they (CMH staff) will provide support if needed to parents, they won\'t hold their hand.  Staff noted that this was what child protection does, however, they were not involved since it was a voluntary placement.  \r\nStaff noted that it wasn\'t really a thought to engage other relatives and they did not think mom\'s brother could support visits due to his drinking and that grandma was not able to support mom with visits. \r\nFurther supporting the decision to not actively engage other known family members was the perception that all relatives known to the agency had engaged in some type of abusive or neglectful behaviors towards the subject child.  Staff\'s mental model of traditional funeral practices and conditions created by poverty (moving from house to house, eating gas station food, etc.) may have been perceived as neglectful when the child was home with relatives. This may have further impacted the engagement of relatives and other tribal members as supports or placement options for the subject child.  \r\nStaff reported trying to recommend the subject child attending a Pow Wow while in placement as the subject child expressed interested in this, however, reported there did not seem to be followed through with. Staff also noted that the community falls short of cultural activities for Native American children.  \r\nEngagement with relatives in these cases is typically done for respite purposes, however, this child was in residential placement so respite was not an option and therefore relatives were not engaged.  \r\nFurther impacting visits with family was that the subject child was early in her residential programming and that the subject child wasn\'t ready for a visit.  Additionally, it was staff\'s perception that mom was not ready for a visit due to her drug use.  \r\nStaff also reported that her focus was ensuring that the subject child\'s mental health needs were met, including disability services, day treatment programming, and mental health services.  Staff noted and that she was also working to get her set up with a CADI waiver as a result of her disability as it is difficult finding group home placements and services for children like this.  Staff also indicated that within the mental health placements that they were following the recommendations from the residential treatment center and the subject child\'s doctor and that traditional cultural healing practices and engagement with the Tribe were not considered or recommended during those times.  \r\nDebrief with CP Staff related to this case:\r\nDifficulties occurred engaging the Tribal worker throughout this case and it was difficult to directly connect with the Tribal worker, despite multiple attempts and modes of communication by staff.  As a result the tribal worker did not provide any additional names of relative tribal members that may be able to care for the subject child or keep her connected to her Tribe.  \r\n\r\nFurther impacting connection with relatives and culture was that the father\'s side of the family was not considered for connection or placement.  This resulted from family not providing dad\'s side of the family\'s information to the agency.  If the family cannot or won\'t provide this information, it is normative agency practice that they would not seek out any additional information about the father and this side of the family. It was reported that the subject\'s child\'s father had also committed suicide.  As a result of it being difficult to engage the Tribe with the case, it was also difficult to seek out additional guidance regarding consultation around cultural practices and Tribal connections for the subject child.  \r\n\r\nIn addition to the above, the subject child reported that she was not connected to the Tribe and her mother reported being somewhat connected to the Tribe.  Normative practice is to defer to the family regarding their involvement with the Tribe and the connection that they have to their culture.  This can make it challenging to try and engage the Tribe and support the family in connecting with their culture and Tribe if they indicate they are not connected. Staff noted that it can be difficult to engage families with their culture when not connected before they are involved with child protection. Staff also indicated that this was first child protection case ever worked and her first ICWA case.  When this case was assigned to her in 2015 there was not a lot of guidance on what to do in these cases.  \r\n\r\nFurther contributing to barriers in connecting the subject child to her culture is the lack of Native American foster care homes.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42856,326,22,71,13,322,'Free_Text','Active Efforts, in accordance with ICWA/MIFPA, not being made; specifically to preserving connections to the child\'s culture and Tribe, as well as active efforts to engage the Tribe and family members as support and as permanency options were influenced by the perception that active efforts requirements are not the responsibility of children\'s mental health staff.  In cases such as this when it is a voluntary children\'s mental health case and a contracted children\'s mental health worker is assigned to the case, it is normative practice that staff\'s primary focus of attention is to support the mental health needs of the identified child.  This perception is supported by the coordination of guidance around active efforts requirements between DHS\'s Children\'s Mental Health Division and DHS\'s Child Safety and Permanency Division.  Until recently, coordination between Divisions has been minimal with regards to guidance around active efforts requirements.  This has contributed to ambiguity in guidance and staff not wanting to overstep boundaries and roles that can exist between child protection and children\'s mental health case management within local social service agencies in cases such as this one.  The coordination of guidance around role responsibilities of child protection workers and children\'s mental health staff has been further impacted by the resources (staff) available at DHS within the Child Safety and Permanency Division and other areas to provide guidance and training around active efforts. \r\nFurthermore, it isn\'t typical practice for contracted children\'s mental health staff to transport family members or arrange for or provide transportation for visitation of family members when a child is in treatment which constitutes active efforts. Impacting staff not transporting family members is that it can be a contracted provider agency\'s policy such as in this case to not allow workers to transport family members of clients.  Further impacting connection to the subject child\'s Tribe, community, and culture was that the staff did not perceive supporting mom and other relatives in both visitation and connection with the subject child, as well as engaging the Tribe in the subject child\'s treatment to be within their scope of work with Children\'s Mental Health cases.  Often, Children\'s Mental Health staff operate with the belief that this is child protection\'s responsibility.  \r\nAn additional influence to active efforts not being made can be staff\'s comfort level to learn about, explore, and expose themselves to others\' cultural frameworks such as in Native American cultures.  This can impact keeping Native American children connected and engaged with cultural activities such as Pow Wows and other cultural practices.  This comfort level is influenced by several factors.  There are often agency/union policies that don\'t allow attending such activities with clients on the weekends and after traditional business hours as this can pose risks and liabilities to the agency. This can be further supported by not having the space (emotional) to engage in these activities with clients and not having the knowledge of where to locate such activities.  Self-preservation with regards to both personal and professional boundaries can also impact staff engaging in cultural activities with clients that support active efforts.  Staff also noted that their own lack of understanding and not wanting to offend Native American clients further impacts the comfort level to explore cultural differences.  Lastly, staff\'s own cultural differences and broader sense of culture can further impact exploration of other cultures influencing how Native American children are being supported to stay connected with their Tribe and culture.\r\nAlso, there was a perception among staff that all relatives known to the agency had engaged in some type of abusive or neglectful behaviors toward the subject child supporting staff\'s decision to not actively engage other known family members. Staff\'s mental model of traditional funeral practices and conditions created by poverty (moving from house to house, eating gas station food, etc.) may have been perceived as neglectful when the child was home with relatives. This may have further impacted the engagement of relatives and other tribal members as supports or placement options for the subject child.\r\nAn additional factor that influences when active efforts are not made is that staff have the perception that they are meeting ICWA/MIFPA requirements when the Judge rules that active efforts have been achieved.  Varying levels of understanding and knowledge regarding fulfillment of ICWA/MIFPA requirements by Judges further supports active efforts not being met when the court rules that active efforts have been made when they may not have not been in accordance with ICWA/MIFPA.  Communication gaps between DHS and local agencies has resulted in changes being made that were not fully communicated around active effort requirements have further impacted the implementation and interpretation of active efforts requirements by local agencies.  Funding also influences active efforts not being achieved as additional resources have not been allocated to both the local agencies and Tribes to ensure additional active effort requirements are fulfilled.  For example, there has not been any additional funding provided to Tribes to support Tribal Child Welfare infrastructure in being able to meet the demands of the county agencies state and federal requirements. The additional requirements have placed demands on both the local agencies and Tribes in which both agencies struggle to have the resources to ensure active efforts are met on all cases.  \r\n\r\nAn additional factor contributing to active efforts not being fulfilled is that staff have less time to complete active effort activities due to needing to prioritize and complete the significant amount documentation for all cases, including the documentation of active efforts.  Redundancies in documentation requirements increase the amount of time needed to document active efforts.  \r\n\r\nFurther impacting active efforts not being made in this case was that the subject child reported that she was not connected to the Tribe and her mother reported being somewhat connected to the Tribe.  Normative practice for local agencies is to defer to the family regarding their involvement with the Tribe and the connection that they have to their culture.  Different interpretations around active efforts in such circumstances supports why staff perceive once someone says they are not connected to his/her Tribe that staff stop pursing this with the client.    This can make it challenging to try and engage the Tribe and support the family in connecting with their culture and Tribe if they indicate they are not connected. Staff noted that it can be difficult to engage families with their culture when not connected before they are involved with child protection. \r\nFurthermore, barriers also occurred in this case in communicating with the Tribe as the Tribal worker is very hard to reach as her availability is limited due to the scope of responsibility placed on her.  She is responsible for the Tribes Child Protection Services as well as the out of state ICWA cases and is therefore in high demand.  As a result, the local agency was unable to obtain any additional names of relative tribal members that may be able to care for the subject child or keep her connected to her Tribe.  \r\n\r\nAn additional influence into not being able to achieve active efforts is knowing who to go to at the Tribe and what constitutes active efforts.  This is impacted by local agencies knowledge of ICWA/MIFPA and who the Tribal contacts are for ICWA/MIPFPA cases.  The communication gap from DHS around revisions regarding implementation of state changes has impacted local agencies knowledge of requirements which can create further create challenges on what to do to ensure active efforts are met.  \r\n\r\nLastly, when this case was assigned to staff in 2015 a knowledge gap existed as this was staff\'s first child protection case and first ICWA case.  There was limited guidance on ICWA cases during this time, further impacting the achievement of active efforts not being made.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42857,326,22,71,13,323,'Short_Answer','Permanent custody to the agency occurred as permanency for the subject child',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42858,326,22,71,13,324,'Free_Text','Debrief with CP Staff related to this case:\r\nStaff noted that she had good rapport with the mother and the mother also struggled with mental health issues.  The case was open for almost a year before and as a result the agency was automatically at permanency timelines due to the time that the child was out of home prior to this case opening.   This influenced the agency\'s decision to move towards permanent custody to the agency as there were not any other options as mom wasn\'t not fulfilling her case plan requirements and there were not any relatives that could care for the subject child.  Additionally, the Tribe and the mother of the subject child were supportive of this plan, however, they were not in support of a TPR. \r\n\r\nThe agency, Tribe, and mother believed that this was the best option for the subject child to ensure that she could get her mental and developmental needs met as the subject child would need ongoing assistance in her day to day functioning. This combination (dual diagnoses) made it challenging to locate placements for the subject child\r\n\r\nIt was also difficult to engage the Tribe throughout the life of the case, despite multiple efforts.  This made it difficult to obtain guidance and consultation from the Tribe throughout the case.  It was difficult to get a response back from the Tribal worker. In order to move towards permanency they ended up sending an affidavit to the Tribe for a QEW as they were never able to get one and needed one to move forward with permanency for the subject child.  Staff also noted that the staff at the Tribe did not seem to care for the mother.  The mother reported to the county worker that she did not feel supported by the tribal worker and tried to request a new worker through the Tribe.  It was reported that the tribal worker did not have anything positive to say about the family and did not provide staff at the county any other relatives or tribal options for permanency.  This further contributed to the difficulty in finding other relatives or tribal members to take the subject child given her complex needs.  \r\n\r\nFurther impacting the decision to not place with known relatives was that all relatives known to the agency had at some point been abusive or neglectful towards the subject child.    \r\n\r\nDebrief with CMH Staff related to this case:\r\nStaff noted that the subject child had such significant needs and that a relative would not be able to care for her and mom was not able to care for her. They tried a foster care home, however, that was unsuccessful due to the subject child\'s multiple needs, especially given her history of aggression. \r\n\r\n\r\n\r\n\r\nAdditional Information:\r\n\r\nReviewers were unable to talk with the Tribal worker or have her or others from the Tribe participate in the mapping.  However, the Tribal Liaison for the Tribe through the Minneapolis American Indian Center indicated that the Tribal worker is very hard to catch because she does the Tribes Child Protection Services as well as the out of state ICWA cases.   She\'s in high demand and kind of a one woman operation.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42859,326,22,71,13,325,'Free_Text','Permanent custody to the agency as permanency for the subject child was influenced by the subject child\'s overall complex needs. This influenced the agency\'s decision to move towards permanent custody to the agency as there were not any other options as mom wasn\'t fulfilling her case plan requirements and had identified that she was not able to care for the subject child.  There were also not any relatives that could care for the subject child due to her emotional, behavior, and developmental needs.  In addition to this, the agency tried a foster care home, however, this placement was not successful due to the subject child\'s complex and unique needs, especially given her history of aggression.   \r\nFurthermore, the agency, the Tribe, the subject child\'s mother, her GAL and her attorney believed that this was the best permanency option for the subject child to ensure that she could get her emotional, behavioral, and developmental needs met as the subject child would need ongoing assistance for her day to day functioning. This combination (dual diagnoses) made it challenging to locate placements for the subject child.  Further impacting the ability to find a foster care home was that there are very few foster care homes that can take a child with such complex and unique needs.  Lastly, the subject child had identified to staff that she wanted to remain in her current placement.  \r\n\r\nAs a result of the pressures associated with state and federal statutory permanency timelines, there was a need to move to permanency quickly in this case since statuary timelines had been met in the previous case in which the subject child had been placed out of the home prior to this case opening, automatically placing the agency near the 12 month permanency timeline. Furthermore, while county agencies are bound by the state and federal permanency definitions, Tribal agencies have a different definition of permanency which can also influence the final permanency decision.  \r\n\r\nLastly, communication and coordination barriers occurred between the Tribe and the local agency. It was difficult to communicate and coordinate with the Tribe throughout the life of the case.  When this happens, it is difficult to obtain guidance and consultation from the Tribe throughout the case on permanency options and planning.  It was difficult to get a response back from the Tribal worker as her availability is limited due to the scope of responsibility placed on her.  She is responsible for the Tribes Child Protection Services as well as the out of state ICWA cases and is therefore in high demand.  Staff also noted that the staff at the Tribe did not seem to have a positive relationship with the mother and did not provide staff at the county any other relatives or tribal options for permanency.  This further contributed to the difficulty in finding other relatives or tribal members for placement of the subject child given her complex needs.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42860,326,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42861,326,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42862,326,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42863,326,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42864,326,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42865,326,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42866,326,22,71,13,346,'Multiple_Choice','2',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42867,326,22,71,13,347,'Free_Text','LP #1:\r\nFurthermore, it was staff\'s perception based upon knowledge shared with them that the child\'s father had passed away.  As a result the agency did not believe that there were any possible paternal relative placement options for this child either.\r\n\r\nThis can be further compounded by staff\'s perception that in order to proceed on an ICWA case they must wait for the BIA to respond with Tribal affiliation before proceeding with permanency planning and case proceedings.\r\n\r\nLastly, it was the local agencies perception in addition to their county attorney\'s perception that a Qualified Expert Witness (QEW) for the Tribe needed to be present at court in order to move toward permanency.  As a result, the agency believed that they were unable to move towards permanency for the child and continued to delay permanency court proceedings as a result.\r\n\r\nLP #2:\r\nActive Efforts, in accordance with ICWA/MIFPA, not being made; specifically to preserving connections to the child\'s culture and Tribe, as well as active efforts to engage the Tribe and family members as support and as permanency options were influenced by the perception that active efforts requirements are not the responsibility of children\'s mental health staff.  In cases such as this when it is a voluntary children\'s mental health case and a contracted children\'s mental health worker is assigned to the case, it is normative practice that staff\'s primary focus of attention is to support the mental health needs of the identified child.  This perception is supported by the coordination of guidance around active efforts requirements between DHS\'s Children\'s Mental Health Division and DHS\'s Child Safety and Permanency Division.\r\n\r\nFurther impacting connection to the subject child\'s Tribe, community, and culture was that the staff did not perceive supporting mom and other relatives in both visitation and connection with the subject child, as well as engaging the Tribe in the subject child\'s treatment to be within their scope of work with Children\'s Mental Health cases.  Often, Children\'s Mental Health staff operate with the belief that this is child protection\'s responsibility. \r\n\r\nAn additional influence to active efforts not being made can be staff\'s comfort level to learn about, explore, and expose themselves to others\' cultural frameworks such as in Native American cultures.  This can impact keeping Native American children connected and engaged with cultural activities such as Pow Wows and other cultural practices.  This comfort level is influenced by several factors.\r\n\r\nStaff also noted that their own lack of understanding and not wanting to offend Native American clients further impacts the comfort level to explore cultural differences.  Lastly, staff\'s own cultural differences and broader sense of culture can further impact exploration of other cultures influencing how Native American children are being supported to stay connected with their Tribe and culture.\r\nAlso, there was a perception among staff that all relatives known to the agency had engaged in some type of abusive or neglectful behaviors toward the subject child supporting staff\'s decision to not actively engage other known family members. Staff\'s mental model of traditional funeral practices and conditions created by poverty (moving from house to house, eating gas station food, etc.) may have been perceived as neglectful when the child was home with relatives. This may have further impacted the engagement of relatives and other tribal members as supports or placement options for the subject child.\r\nAn additional factor that influences when active efforts are not made is that staff have the perception that they are meeting ICWA/MIFPA requirements when the Judge rules that active efforts have been achieved.  Varying levels of understanding and knowledge regarding fulfillment of ICWA/MIFPA requirements by Judges further supports active efforts not being met when the court rules that active efforts have been made when they may not have not been in accordance with ICWA/MIFPA.\r\n\r\nDifferent interpretations around active efforts in such circumstances supports why staff perceive once someone says they are not connected to his/her Tribe that staff stop pursing this with the client.    This can make it challenging to try and engage the Tribe and support the family in connecting with their culture and Tribe if they indicate they are not connected. Staff noted that it can be difficult to engage families with their culture when not connected before they are involved with child protection. \r\n\r\nLP #3:\r\nFurthermore, the agency, the Tribe, the subject child\'s mother, her GAL and her attorney believed that this was the best permanency option for the subject child to ensure that she could get her emotional, behavioral, and developmental needs met as the subject child would need ongoing assistance for her day to day functioning.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42868,326,22,71,13,348,'Multiple_Choice','2',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42869,326,22,71,13,349,'Free_Text','LP #1:\r\nIt was difficult to find a placement that could meet this child\'s unique needs and this impacted the agency\'s ability to place her in a lesser restrictive setting including being able to reunifying with her mother and residing with relatives. This coupled with being unable to identify viable maternal and paternal relative placement options impacted the agency\'s ability to achieve permanency for this youth.\r\n\r\nLP #2:\r\nThe coordination of guidance around role responsibilities of child protection workers and children\'s mental health staff has been further impacted by the resources (staff) available at DHS within the Child Safety and Permanency Division and other areas to provide guidance and training around active efforts.\r\n\r\nFunding also influences active efforts not being achieved as additional resources have not been allocated to both the local agencies and Tribes to ensure additional active effort requirements are fulfilled.  For example, there has not been any additional funding provided to Tribes to support Tribal Child Welfare infrastructure in being able to meet the demands of the county agencies state and federal requirements. The additional requirements have placed demands on both the local agencies and Tribes in which both agencies struggle to have the resources to ensure active efforts are met on all cases.\r\n\r\nLP #3:\r\nPermanent custody to the agency as permanency for the subject child was influenced by the subject child\'s overall complex needs. This influenced the agency\'s decision to move towards permanent custody to the agency as there were not any other options as mom wasn\'t fulfilling her case plan requirements and had identified that she was not able to care for the subject child.  There were also not any relatives that could care for the subject child due to her emotional, behavior, and developmental needs.  In addition to this, the agency tried a foster care home, however, this placement was not successful due to the subject child\'s complex and unique needs, especially given her history of aggression.\r\n\r\nThis combination (dual diagnoses) made it challenging to locate placements for the subject child.  Further impacting the ability to find a foster care home was that there are very few foster care homes that can take a child with such complex and unique needs.  Lastly, the subject child had identified to staff that she wanted to remain in her current placement.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42870,326,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42871,326,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42872,326,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42873,326,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42874,326,22,71,13,354,'Multiple_Choice','3',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42875,326,22,71,13,355,'Free_Text','LP #1:\r\nAdditionally impacting permanency not being achieved in this case were communication and consultation barriers that occurred between the county and the tribe on permanency planning for this child. \r\n\r\nLP #2:\r\nCommunication gaps between DHS and local agencies has resulted in changes being made that were not fully communicated around active effort requirements have further impacted the implementation and interpretation of active efforts requirements by local agencies.\r\n\r\nFurthermore, barriers also occurred in this case in communicating with the Tribe as the Tribal worker is very hard to reach as her availability is limited due to the scope of responsibility placed on her.  She is responsible for the Tribes Child Protection Services as well as the out of state ICWA cases and is therefore in high demand.  As a result, the local agency was unable to obtain any additional names of relative tribal members that may be able to care for the subject child or keep her connected to her Tribe.  \r\n\r\nAn additional influence into not being able to achieve active efforts is knowing who to go to at the Tribe and what constitutes active efforts.  This is impacted by local agencies knowledge of ICWA/MIFPA and who the Tribal contacts are for ICWA/MIPFPA cases.  The communication gap from DHS around revisions regarding implementation of state changes has impacted local agencies knowledge of requirements which can create further create challenges on what to do to ensure active efforts are met.\r\n\r\nLP #3:\r\nLastly, communication and coordination barriers occurred between the Tribe and the local agency. It was difficult to communicate and coordinate with the Tribe throughout the life of the case.  When this happens, it is difficult to obtain guidance and consultation from the Tribe throughout the case on permanency options and planning.  It was difficult to get a response back from the Tribal worker as her availability is limited due to the scope of responsibility placed on her.  She is responsible for the Tribes Child Protection Services as well as the out of state ICWA cases and is therefore in high demand.  Staff also noted that the staff at the Tribe did not seem to have a positive relationship with the mother and did not provide staff at the county any other relatives or tribal options for permanency.  This further contributed to the difficulty in finding other relatives or tribal members for placement of the subject child given her complex needs.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42876,326,22,71,13,356,'Multiple_Choice','2',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42877,326,22,71,13,357,'Free_Text','LP #2:\r\nFurther impacting active efforts not being made in this case was that the subject child reported that she was not connected to the Tribe and her mother reported being somewhat connected to the Tribe.  \r\n\r\nLastly, when this case was assigned to staff in 2015 a knowledge gap existed as this was staff\'s first child protection case and first ICWA case.  There was limited guidance on ICWA cases during this time, further impacting the achievement of active efforts not being made',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42878,326,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42879,326,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42880,326,22,71,13,358,'Multiple_Choice','3',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42881,326,22,71,13,359,'Free_Text','LP #1:\r\nFurther contributing to not achieving permanency in this case is the incongruence that occurs between federal permanency timelines and the time it takes to provide services that will support reunification.  Staff noted that timelines are not realistic when you have a mother with a long history of chemical dependency problems.  It can take 30 days to obtain a chemical dependency assessment and once this is completed, it can take another 3-4 months then before someone can start inpatient treatment.  Once in treatment, it can be another 3-6 months putting you almost at the 12 month permanency timeline.  Staff indicated that they (permanency timelines) are simply not realistic with the needs of families that struggle with chemical dependency and are not conducive to supporting reunification within federally mandated timelines.  \r\nFurthermore, such timeframes and the time required to achieve ICWA and MIFPA requirements for active efforts can impact court proceedings which can further influence planning for permanency and therefore permanency being achieved within state and federal timelines.\r\n\r\nLP #2:\r\nActive Efforts, in accordance with ICWA/MIFPA, not being made; specifically to preserving connections to the child\'s culture and Tribe, as well as active efforts to engage the Tribe and family members as support and as permanency options were influenced by the perception that active efforts requirements are not the responsibility of children\'s mental health staff.  In cases such as this when it is a voluntary children\'s mental health case and a contracted children\'s mental health worker is assigned to the case, it is normative practice that staff\'s primary focus of attention is to support the mental health needs of the identified child.  This perception is supported by the coordination of guidance around active efforts requirements between DHS\'s Children\'s Mental Health Division and DHS\'s Child Safety and Permanency Division.  Until recently, coordination between Divisions has been minimal with regards to guidance around active efforts requirements.  This has contributed to ambiguity in guidance and staff not wanting to overstep boundaries and roles that can exist between child protection and children\'s mental health case management within local social service agencies in cases such as this one.\r\n\r\nFurthermore, it isn\'t typical practice for contracted children\'s mental health staff to transport family members or arrange for or provide transportation for visitation of family members when a child is in treatment which constitutes active efforts. Impacting staff not transporting family members is that it can be a contracted provider agency\'s policy such as in this case to not allow workers to transport family members of clients.\r\n\r\nAn additional influence to active efforts not being made can be staff\'s comfort level to learn about, explore, and expose themselves to others\' cultural frameworks such as in Native American cultures.  This can impact keeping Native American children connected and engaged with cultural activities such as Pow Wows and other cultural practices.  This comfort level is influenced by several factors.    \r\n\r\nFurther impacting active efforts not being made in this case was that the subject child reported that she was not connected to the Tribe and her mother reported being somewhat connected to the Tribe.  Normative practice for local agencies is to defer to the family regarding their involvement with the Tribe and the connection that they have to their culture. \r\n\r\nLP #3:\r\nAs a result of the pressures associated with state and federal statutory permanency timelines, there was a need to move to permanency quickly in this case since statuary timelines had been met in the previous case in which the subject child had been placed out of the home prior to this case opening, automatically placing the agency near the 12 month permanency timeline. Furthermore, while county agencies are bound by the state and federal permanency definitions, Tribal agencies have a different definition of permanency which can also influence the final permanency decision.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42882,326,22,71,13,360,'Multiple_Choice','3',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42883,326,22,71,13,361,'Free_Text','LP #1:\r\nFurther contributing to not achieving permanency in this case is the incongruence that occurs between federal permanency timelines and the time it takes to provide services that will support reunification.  Staff noted that timelines are not realistic when you have a mother with a long history of chemical dependency problems.  It can take 30 days to obtain a chemical dependency assessment and once this is completed, it can take another 3-4 months then before someone can start inpatient treatment.  Once in treatment, it can be another 3-6 months putting you almost at the 12 month permanency timeline.  Staff indicated that they (permanency timelines) are simply not realistic with the needs of families that struggle with chemical dependency and are not conducive to supporting reunification within federally mandated timelines.  \r\nFurthermore, such timeframes and the time required to achieve ICWA and MIFPA requirements for active efforts can impact court proceedings which can further influence planning for permanency and therefore permanency being achieved within state and federal timelines. \r\n\r\nCommunication and coordination barriers were influenced by staff turnover both at the county and tribal agency.  Specifically, there is only one tribal child welfare worker at the Tribe that covers both Tribal Child Protection cases within the reservation and off the reservation.  The additional ICWA/MIFPA related tasks places pressure on Tribal staff that already have limited resources to do the work and have not received additional resources/funding to ensure they can manage the tasks associated with responding to the ICWA.    \r\nIn cases such as this, court proceedings including the number of court proceedings, the timing of them, and the Judges knowledge of when both ICWA and MIFPA requirements have been met can lengthen the time it takes local agencies and tribal staff to plan for permanency further creating barriers to both achieving permanency and achieving permanency in accordance with state a federal performance measures.\r\n\r\nLP #2:\r\nAn additional factor contributing to active efforts not being fulfilled is that staff have less time to complete active effort activities due to needing to prioritize and complete the significant amount documentation for all cases, including the documentation of active efforts.  Redundancies in documentation requirements increase the amount of time needed to document active efforts.\r\n\r\nLP #3:\r\nAs a result of the pressures associated with state and federal statutory permanency timelines, there was a need to move to permanency quickly in this case since statuary timelines had been met in the previous case in which the subject child had been placed out of the home prior to this case opening, automatically placing the agency near the 12 month permanency timeline. Furthermore, while county agencies are bound by the state and federal permanency definitions, Tribal agencies have a different definition of permanency which can also influence the final permanency decision.',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42884,326,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42885,326,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42886,326,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42887,326,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42888,326,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42889,326,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42890,326,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:05:30','2021-06-01 19:05:30',NULL),(42892,332,22,71,13,291,'Multiple_Choice','Kelly Knutson',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42893,332,22,71,13,292,'Short_Answer','Paul Lennander',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42894,332,22,71,13,293,'Date','11/13/2017',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42895,332,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42896,332,22,71,13,294,'Multiple_Choice','Other',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42897,332,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42898,332,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42899,332,22,71,13,297,'Short_Answer','Licensed',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42900,332,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42901,332,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42902,332,22,71,13,300,'Multiple_Choice','8',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42903,332,22,71,13,301,'Multiple_Choice','Hennepin',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42904,332,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42905,332,22,71,13,303,'Short_Answer','McKinley',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42906,332,22,71,13,304,'Short_Answer','Askenette',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42907,332,22,71,13,305,'Date','08/06/2017',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42908,332,22,71,13,306,'Date',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42909,332,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42910,332,22,71,13,308,'Multiple_Choice','2 Months',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42911,332,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42912,332,22,71,13,310,'Short_Answer','Foster care parent',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42913,332,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42914,332,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42915,332,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42916,332,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42917,332,22,71,13,316,'Multiple_Choice','2',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42918,332,22,71,13,317,'Short_Answer','Placement capacity of shelter home',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42919,332,22,71,13,318,'Free_Text','The human factors debriefing information was not documented at the request of the local agency due to pending litigation.  All of the local rationality information is captured in the narrative.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42920,332,22,71,13,319,'Free_Text','The decision to place a child in a shelter care home that was nearing capacity was influenced by no relatives being identified as immediate placement options.  While an extensive relative search was completed, many licensing barriers existed in licensing any of the relatives who were identified.  It is common in relative placement cases that the time it can take and the bureaucratic system created by both the local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative.  While a few of them may have been a viable options, the Judge ordered that the subject child be placed immediately into shelter care.  \r\nFurthermore, at this time, the placing process within the agency was for children to be immediately placed in shelter and that the shelter center locates the placement for the child/children based upon needs to the child and who can care for the child.  Normative practice is to defer to shelter for these decisions. Staff also noted that in placement cases they are often balancing multiple competing goals.  Such as the location and placement with a relative often takes more time, which can be difficult when operating under tight permanency timelines.  While working to accomplish concurrent planning, staff also need to make reasonable and active efforts to reunify whenever possible.  Further impacting this pressure is the best practice of placement stability.  Best practice is to ensure children are placed in stable placement as soon as possible and such practices are also measured through state and federal placement stability performance measures creating additional pressure on staff to ensure placements are stable.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42921,332,22,71,13,320,'Short_Answer','Placement occurred in shelter versus a relative home.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42922,332,22,71,13,321,'Free_Text','The human factors debriefing information was not documented at the request of the local agency due to pending litigation.  All of the local rationality information is captured in the narrative.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42923,332,22,71,13,322,'Free_Text','The decision to place a child in a shelter care home versus a relative home was influenced by the fact that an extensive relative search was completed, and many licensing barriers occurred for many of the relatives identified as placement resources.  It is common in relative placement cases that the time it can take and the bureaucratic system for a relative to become licensed created by both local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative. Additionally, normative practice for this local agency is to place children in shelter care until a relative can be identified as a placement option.  This placing process further impacted the subject child being placed in shelter care versus a relative.  While a few relatives may have been viable options, when the critical incident occurred, the Judge ordered that the subject child be placed immediately into shelter care.  Further impacting this decision was that a relative was set to take the subject child but then decided at the last minute that they could not take the child.   \r\nAn additional influence into the subject child being placed in shelter care versus a relative care home was the difficulty in communicating with the state of Massachusetts.  The subject child\'s mother also had an open case and other children in placement in Massachusetts.  Staff noted significant barriers in obtaining any information at all from their CPS system/staff related to the subject child\'s mother, siblings, their placements, and any other potential relative placement options for the subject child.  \r\nFurthermore, when this case came into the agency, it was assigned an initial kinship worker whom had been working to secure a relative placement for the subject child.  This initial kinship work went out on leave and the case at the time of the critical incident was transferred to another kinship worker.  This created challenges in communication around potential relative options that had been and were explored for the subject child further impacting the ability to identify and place with a viable relative option.  Furthermore, both kinship workers had made multiple attempts with relatives and all of the relatives contacted took a substantial amount of time to respond to both kinship workers.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42924,332,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42925,332,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42926,332,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42927,332,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42928,332,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42929,332,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42930,332,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42931,332,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42932,332,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42933,332,22,71,13,346,'Multiple_Choice','2',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42934,332,22,71,13,347,'Free_Text','LP 1-Additionally, licensing staff conduct regular check-ins with relative placements to understand how they are feeling about taking other children and how things are going overall. This process supports a perception of trust that everything is going okay in the foster care home.  In this case, the provider was self-reporting that things were going well and that she could take an additional child and that she did not need additional support.  \r\n\r\nFurthermore, this provider had taken care of a number if infants such as the subject child that were high needs and drug exposed.  As a result, staff were confident in her ability to take another child.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42935,332,22,71,13,348,'Multiple_Choice','2',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42936,332,22,71,13,349,'Free_Text','LP 1- In this case, the provider was self-reporting that things were going well and that she could take an additional child and that she did not need additional support.  However, at the time that the subject child was in placement, there were only two licensing workers carrying shelter caseloads (leaving them with 30-40 cases a piece).  As a result quarterly face-to-face check-ins with providers went to every other quarter face-to-face check-ins with phone calls during the other two quarters.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42937,332,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42938,332,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42939,332,22,71,13,352,'Multiple_Choice','3',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42940,332,22,71,13,353,'Free_Text','LP 2-An additional influence into the subject child being placed in shelter care versus a relative care home was the difficulty in communicating with the state of Massachusetts.  The subject child\'s mother also had an open case and other children in placement in Massachusetts.  Staff noted significant barriers in obtaining any information at all from their CPS system/staff related to the subject child\'s mother, siblings, their placements, and any other potential relative placement options for the subject child.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42941,332,22,71,13,354,'Multiple_Choice','3',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42942,332,22,71,13,355,'Free_Text','LP 3-\r\nAn additional influence into the subject child being placed in shelter care versus a relative care home was the difficulty in communicating with the state of Massachusetts.  The subject child\'s mother also had an open case and other children in placement in Massachusetts.  Staff noted significant barriers in obtaining any information at all from their CPS system/staff related to the subject child\'s mother, siblings, their placements, and any other potential relative placement options for the subject child.  \r\n\r\nFurthermore, when this case came into the agency, it was assigned an initial kinship worker whom had been working to secure a relative placement for the subject child.  This initial kinship work went out on leave and the case at the time of the critical incident was transferred to another kinship worker.  This created challenges in communication around potential relative options that had been and were explored for the subject child further impacting the ability to identify and place with a viable relative option.  Furthermore, both kinship workers had made multiple attempts with relatives and all of the relatives contacted took a substantial amount of time to respond to both kinship workers.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42943,332,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42944,332,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42945,332,22,71,13,368,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42946,332,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42947,332,22,71,13,358,'Multiple_Choice','2',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42948,332,22,71,13,359,'Free_Text','LP 1-While an extensive relative search was completed, many licensing barriers existed in licensing any of the relatives who were identified.  It is common in relative placement cases that the time it can take and the bureaucratic system created by both the local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative.\r\n\r\nFurthermore, at this time, the placing process within the agency was for children to be immediately placed in shelter and that the shelter center locates the placement for the child/children based upon needs to the child and who can care for the child.  Normative practice is to defer to shelter for these decisions. \r\n\r\nLP 2-The decision to place a child in a shelter care home versus a relative home was influenced by the fact that an extensive relative search was completed, and many licensing barriers occurred for many of the relatives identified as placement resources.  It is common in relative placement cases that the time it can take and the bureaucratic system for a relative to become licensed created by both local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative. Additionally, normative practice for this local agency is to place children in shelter care until a relative can be identified as a placement option.  This placing process further impacted the subject child being placed in shelter care versus a relative.  \r\n\r\nLP 2-Additionally, normative practice for this local agency is to place children in shelter care until a relative can be identified as a placement option.  This placing process further impacted the subject child being placed in shelter care versus a relative.  While a few relatives may have been viable options, when the critical incident occurred, the Judge ordered that the subject child be placed immediately into shelter care.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42949,332,22,71,13,360,'Multiple_Choice','2',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42950,332,22,71,13,361,'Free_Text','LP 1- Staff also noted that in placement cases they are often balancing multiple competing goals.  Such as the location and placement with a relative often takes more time, which can be difficult when operating under tight permanency timelines.  While working to accomplish concurrent planning, staff also need to make reasonable and active efforts to reunify whenever possible.  Further impacting this pressure is the best practice of placement stability.  Best practice is to ensure children are placed in stable placement as soon as possible and such practices are also measured through state and federal placement stability performance measures creating additional pressure on staff to ensure placements are stable.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42951,332,22,71,13,362,'Multiple_Choice','2',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42952,332,22,71,13,363,'Free_Text','Further impacting placement with this particular home was that there are never enough homes to take drug exposed infants.  \r\n\r\nLP 2-The decision to place a child in a shelter care home versus a relative home was influenced by the fact that an extensive relative search was completed, and many licensing barriers occurred for many of the relatives identified as placement resources.  It is common in relative placement cases that the time it can take and the bureaucratic system for a relative to become licensed created by both local agency and DHS standards can influence placing children in an already licensed shelter care home versus one of a relative. Additionally, normative practice for this local agency is to place children in shelter care until a relative can be identified as a placement option.  This placing process further impacted the subject child being placed in shelter care versus a relative.',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42953,332,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42954,332,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42955,332,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42956,332,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42957,332,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:05:54','2021-06-01 19:05:54',NULL),(42959,335,22,71,13,291,'Multiple_Choice','Kristine Frick',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42960,335,22,71,13,292,'Short_Answer','JoLynn Sundstrom',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42961,335,22,71,13,293,'Date','01/05/2018',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42962,335,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42963,335,22,71,13,294,'Multiple_Choice','Near Fatality',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42964,335,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42965,335,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42966,335,22,71,13,297,'Short_Answer','Legally Unlicensed',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42967,335,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42968,335,22,71,13,299,'Multiple_Choice','Legally Unlicensed',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42969,335,22,71,13,300,'Multiple_Choice','5',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42970,335,22,71,13,301,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42971,335,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42972,335,22,71,13,303,'Short_Answer','Miles',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42973,335,22,71,13,304,'Short_Answer','Tyson',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42974,335,22,71,13,305,'Date','07/20/2017',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42975,335,22,71,13,306,'Date',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42976,335,22,71,13,307,'Date','01/04/2018',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42977,335,22,71,13,308,'Multiple_Choice','6 Months',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42978,335,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42979,335,22,71,13,310,'Short_Answer','Legally unlicensed childcare provider',1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42980,335,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42981,335,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42982,335,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42983,335,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42984,335,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42985,335,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42986,335,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42987,335,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42988,335,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42989,335,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42990,335,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42991,335,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42992,335,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42993,335,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42994,335,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:11','2021-06-01 19:06:11',NULL),(42995,335,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(42996,335,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(42997,335,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(42998,335,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(42999,335,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43000,335,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43001,335,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43002,335,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43003,335,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43004,335,22,71,13,350,'Multiple_Choice','2',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43005,335,22,71,13,351,'Free_Text','SSIS feature to change response paths from Facility to Family Investigation took place, however the victim children were not added within the SSIS system.',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43006,335,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43007,335,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43008,335,22,71,13,354,'Multiple_Choice','1',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43009,335,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43010,335,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43011,335,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43012,335,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43013,335,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43014,335,22,71,13,358,'Multiple_Choice','2',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43015,335,22,71,13,359,'Free_Text','Intake, Screening, and response path guidelines, directs local agencies to make a new CP intake report, screen it, and refer to current workgroup or open new workgroup when new child victims are added to an investigation, however in this case that did not occur for the children of the offender.',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43016,335,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43017,335,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43018,335,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43019,335,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43020,335,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43021,335,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43022,335,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43023,335,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43024,335,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:06:12','2021-06-01 19:06:12',NULL),(43026,343,22,71,13,291,'Multiple_Choice','Kristine Frick',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43027,343,22,71,13,292,'Short_Answer','Sarah Storm',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43028,343,22,71,13,293,'Date','09/27/2016',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43029,343,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43030,343,22,71,13,294,'Multiple_Choice','Near Fatality',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43031,343,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43032,343,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43033,343,22,71,13,297,'Short_Answer','Licensed',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43034,343,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43035,343,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43036,343,22,71,13,300,'Multiple_Choice','7',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43037,343,22,71,13,301,'Multiple_Choice','Washington',1,71,71,'2021-06-01 19:06:27','2021-06-01 19:06:27',NULL),(43038,343,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43039,343,22,71,13,303,'Short_Answer','Noah',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43040,343,22,71,13,304,'Short_Answer','Spiess',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43041,343,22,71,13,305,'Date','08/23/2015',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43042,343,22,71,13,306,'Date',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43043,343,22,71,13,307,'Date','07/01/2016',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43044,343,22,71,13,308,'Multiple_Choice','11 Months',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43045,343,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43046,343,22,71,13,310,'Short_Answer','Licensed Daycare Provider',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43047,343,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43048,343,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43049,343,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43050,343,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43051,343,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43052,343,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43053,343,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43054,343,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43055,343,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43056,343,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43057,343,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43058,343,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43059,343,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43060,343,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43061,343,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43062,343,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43063,343,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43064,343,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43065,343,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43066,343,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43067,343,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43068,343,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43069,343,22,71,13,348,'Multiple_Choice','1',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43070,343,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43071,343,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43072,343,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43073,343,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43074,343,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43075,343,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43076,343,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43077,343,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43078,343,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43079,343,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43080,343,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43081,343,22,71,13,358,'Multiple_Choice','2',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43082,343,22,71,13,359,'Free_Text','Area of Learning:  Temporary immediate suspension.\r\nLocal Review Recommendation: The local mortality review team recommended legislation to give agencies more authority to enforce temporary immediate suspensions of unlicensed foster homes (monetary penalties, criminal charge, etc.).\r\n\r\nThe following people participated in the Ramsey County Local review:\r\nTami Baker\r\nKristen Jackelen\r\nBecky Knighton\r\nChris Murphy\r\nNissa Knutson\r\nJohn Hanna\r\nGeorge Joyer\r\nAlice Swenson\r\nLaura Miles\r\nLauren Otanez\r\nJake Peterson\r\nSarah Cory\r\nAaron Strong',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43083,343,22,71,13,360,'Multiple_Choice','1',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43084,343,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43085,343,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43086,343,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43087,343,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43088,343,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43089,343,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43090,343,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43091,343,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:06:28','2021-06-01 19:06:28',NULL),(43093,344,22,71,13,291,'Multiple_Choice','Brittany Lochner',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43094,344,22,71,13,292,'Short_Answer','Triage Review',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43095,344,22,71,13,293,'Date','10/20/2017',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43096,344,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43097,344,22,71,13,294,'Multiple_Choice','Near Fatality',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43098,344,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43099,344,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43100,344,22,71,13,297,'Short_Answer','Licensed',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43101,344,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43102,344,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43103,344,22,71,13,300,'Multiple_Choice','7',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43104,344,22,71,13,301,'Multiple_Choice','Scott',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43105,344,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43106,344,22,71,13,303,'Short_Answer','Nolan',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43107,344,22,71,13,304,'Short_Answer','McNally',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43108,344,22,71,13,305,'Date','03/09/2017',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43109,344,22,71,13,306,'Date',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43110,344,22,71,13,307,'Date','09/14/2017',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43111,344,22,71,13,308,'Multiple_Choice','6 Months',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43112,344,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43113,344,22,71,13,310,'Short_Answer','Daycare provider',1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43114,344,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43115,344,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43116,344,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43117,344,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43118,344,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43119,344,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43120,344,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:52','2021-06-01 19:06:52',NULL),(43121,344,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43122,344,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43123,344,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43124,344,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43125,344,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43126,344,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43127,344,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43128,344,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43129,344,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43130,344,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43131,344,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43132,344,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43133,344,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43134,344,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43135,344,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43136,344,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43137,344,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43138,344,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43139,344,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43140,344,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43141,344,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43142,344,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43143,344,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43144,344,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43145,344,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43146,344,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43147,344,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43148,344,22,71,13,358,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43149,344,22,71,13,359,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43150,344,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43151,344,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43152,344,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43153,344,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43154,344,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43155,344,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43156,344,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43157,344,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43158,344,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:06:53','2021-06-01 19:06:53',NULL),(43160,248,22,92,13,291,'Multiple_Choice','Kristine Frick',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43161,248,22,92,13,292,'Short_Answer','KariLee Pietz',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43162,248,22,92,13,293,'Date','09/27/2018',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43163,248,22,92,13,342,'Date',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43164,248,22,92,13,294,'Multiple_Choice','Fatality',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43165,248,22,92,13,295,'Yes_or_No','No',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43166,248,22,92,13,296,'Multiple_Choice',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43167,248,22,92,13,297,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43168,248,22,92,13,298,'Yes_or_No','No',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43169,248,22,92,13,299,'Multiple_Choice',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43170,248,22,92,13,300,'Multiple_Choice','7',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43171,248,22,92,13,301,'Multiple_Choice','Dakota',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43172,248,22,92,13,302,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43173,248,22,92,13,303,'Short_Answer','Anthony',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43174,248,22,92,13,304,'Short_Answer','Herkal',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43175,248,22,92,13,305,'Date','07/31/2018',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43176,248,22,92,13,306,'Date','08/14/2018',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43177,248,22,92,13,307,'Date',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43178,248,22,92,13,308,'Multiple_Choice','<1 Month',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43179,248,22,92,13,309,'Multiple_Choice','1',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43180,248,22,92,13,310,'Short_Answer','Father',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43181,248,22,92,13,311,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43182,248,22,92,13,312,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43183,248,22,92,13,313,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43184,248,22,92,13,314,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43185,248,22,92,13,316,'Multiple_Choice','1',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43186,248,22,92,13,317,'Short_Answer','At close of CP Investigation, result of the risk assessment was â€˜high\', and ongoing CP services were marked needed, however ongoing CP case management was not opened.',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43187,248,22,92,13,318,'Free_Text','â€¢	In 2016, SSIS did not have an override/underride feature incorporated within the safety and risk assessments. Currently this is an available option. \r\nâ€¢	Worker had 20+ years of experience working CP investigations\r\nâ€¢	The mother\'s reaction was cooperative and protective. Mother is able and willing to keep her kids safe. Mother is a safe caregiver. \r\nâ€¢	She followed recommendations of no contact/Domestic Abuse No Contact Order (DANCO)\r\nâ€¢	Half-sister did not report witnessing violence; had heard yelling between the adults\r\nâ€¢	Mother had family support network in the area\r\nâ€¢	Previous maltreatment determination was made against the half-sister\'s biological father, not the subject child\'s father. \r\nâ€¢	Father compliant with Probation Officer and was making impressive strides at completing required programming. He was doing well. \r\no	Father comply with no contact, was not living at the home\r\no	Father was engaged in DBT therapy and domestic violence programming \r\no	Father was sober/ clear UA\'s\r\no	County Attorney would likely not accept CHIPS petition due to all the services family receiving and completing successfully \r\nâ€¢	Judge made decision to lift the DANCO\r\nâ€¢	Consult with Supervisor and support decision to close without opening ongoing CP case management\r\no	SDM Tool is used more for discussion during supervisory consult at CP Inv. closing for worker with more experience. Safety Assessment results were either safe/conditionally safe \r\no	Tools are prescriptive/ black and white, but child protection practice is very gray',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43188,248,22,92,13,319,'Free_Text','When determining if CP services were needed, the SDM tool\'s result of â€˜high\' for the risk assessment was considered, however, it was not the only factor used to determine if CP services would be provided at the time the CP investigation closed. There was a domestic abuse no contact order (DANCO) (MN Statute 629.750), issued by the court, which was being complied with by the mother and the offender. In addition, the mother\'s protective capacities and safety assessment result of â€œsafeâ€ was considered following DHS FA/FI guidance. \r\nThe fact that the probable cause standard was not met for a child in need of protection and/or services defined by juvenile court law (MN statute 260C.007 Subd. 6 and 260C.141 Subd. 1), and/or the prescriptive legislation provided in MN Statute 626.556 Subd. 10e. (g), \r\nâ€œa determination that child protective services are needed means that the local welfare agency has documented conditions during the investigation sufficient to cause a child protection worker, to conclude that a child is at significant risk of maltreatment if protective intervention is not provided and that the individuals responsible for the child\'s care have not taken or are not likely to take actions to protect the child from maltreatment or risk of maltreatment,â€\r\nwhich supported the agency to close the investigation and not open ongoing CP CM workgroup, in spite of the high risk assessment result. Protective iintervention was not in the best interests of the children (MN statute 518.17), as the mother was not an offending caregiver, she was a safe parent/caregiver. She actively displayed protective capacities to keep the children safe.  She was engaged with the staff and followed the recommendations within the safety plan, she complied with having no contact with the offender after issuance of a Domestic Abuse No Contact Order (DANCO), and the mother was also utilizing her family for support. \r\nIn 2016, the agency employed professionals with a wealth of practice experience and longevity, many with 20+ years in child welfare and assessing child safety and risk. The knowledge possessed by the staff, coupled by a functional working relationship with the local agency\'s county attorney office, supported the decision to not open ongoing child protection case management services. The local agency\'s mental model was a presumption that the County Attorney would not accept a petition for CHIPS (Child in Need of Protection or Services) as the local agency had collaborated with many service providers to address safety concerns and provide the family resources, which the caregivers were compliant and completed successfully throughout the CP investigation. The circumstances did not present a need to consult with the County Attorney to file a CHIPS petition, and staff consulted with their supervisor to resolve this goal conflict.\r\nAlthough it is suggested in the SDM manual to consult with the county attorney when the result of a risk assessment is â€œhighâ€, this case did not have unresolved safety threats efforts, and the efforts made to provide for child safety were successful, indicating the legal threshold for court intervention was not met, as there were no other conditions known at the time to indicate child safety was at risk. The staff\'s supervisor supported the decision to close the investigation without opening an ongoing CP case management workgroup. \r\nProfessionals believe the SDM tools are prescriptive (black and white), but child protection practice is subjective (gray), where staff are required to use their professional ethics and judgement to assess child safety and risk based on wide array of variable circumstances.  Staff considered the Probation Officer reported positive feedback regarding the offending caregiver, that he had been compliant with the DANCO and was not residing in the home, was providing clean UA\'s, and was successfully engaging and completing other programming (DBT therapy and domestic violence program). Additionally, the Judge lifted the DANCO, further influencing staff\'s perception of strengthened caregiver capacities, and lessened risk to child safety. In this case the risk to child safety was actively being controlled for using safety planning, which both caregivers engaged and followed local agency recommendations. The perception is that the risk assessment result does not speak directly to when ongoing services are necessarily needed, and the risk assessment result is used as a functional starting point during supervisor and county attorney consultation, as well as during conversations with the family. Staff believe the risk assessment is used to establish a baseline, considering many other factors when deciding if ongoing CP services need to be provided. Other factors considered is if the risk to child safety continues to exist. Although, contrary to State guidance and local practice norms, (that staff seek a consult with their supervisor and the county attorney to inquire CHIPS and the need for ongoing case management services when there is a â€˜high\' result on the risk assessment at the close of a CP investigation), the staff had Supervisor support to close the CP investigation and not open a workgroup for ongoing CP case management services in this case. When the result of the risk assessment is â€˜high\' in combination with a safety assessment result of â€˜safe\', a discrepancy surfaces. The discrepancy highlights a double bind/goal conflict for staff to navigate and resolve when children are â€˜presumed safe\' as the presenting reality of conditions do not suspect substantial child endangerment (Minn. Stat. 626.556, subd. 2(o )) and/or services are not needed to ameliorate immediate risk to child safety.\r\nIn 2016, when SSIS did not yet have an override/underride feature incorporated within the safety and decision making tools for supervisors and/or staff, the potential influence of training available to professionals about the purpose of the risk assessment, and how the SDM tools were developed in order to understand functional use for frontline staff was a systemic feature existing across the state and local levels. Applicability and interpretation of the results of the safety and risk assessments, and using the results to inform decision making in real time practice with children and families, in order to capture all risks, were contributing variables when staff use the SDM decision making tools. Additionally the staff\'s interpretation of the training and knowledge retained from training contributes to how knowledge is accessed when staff complete the child safety and risk assessments with the family in real time.',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43189,248,22,92,13,320,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43190,248,22,92,13,321,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43191,248,22,92,13,322,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43192,248,22,92,13,323,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43193,248,22,92,13,324,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43194,248,22,92,13,325,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43195,248,22,92,13,326,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43196,248,22,92,13,327,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43197,248,22,92,13,328,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43198,248,22,92,13,343,'Short_Answer',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43199,248,22,92,13,344,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43200,248,22,92,13,345,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43201,248,22,92,13,346,'Multiple_Choice','3',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43202,248,22,92,13,347,'Free_Text','In 2016, the agency employed professionals with a wealth of practice experience and longevity, many with 20+ years in child welfare and assessing child safety and risk. The knowledge possessed by the staff, coupled by a functional working relationship with the local agency\'s county attorney office, supported the decision to not open ongoing child protection case management services. The local agency\'s mental model was a presumption that the County Attorney would not accept a petition for CHIPS (Child in Need of Protection or Services) as the local agency had collaborated with many service providers to address safety concerns and provide the family resources, which the caregivers were compliant and completed successfully throughout the CP investigation. The circumstances did not present a need to consult with the County Attorney to file a CHIPS petition, and staff consulted with their supervisor to resolve this goal conflict. Although it is suggested in the SDM manual to consult with the county attorney when the result of a risk assessment is â€œhighâ€, this case did not have unresolved safety threats efforts, and the efforts made to provide for child safety were successful, indicating the legal threshold for court intervention was not met, as there were no other conditions known at the time to indicate child safety was at risk. The staff\'s supervisor supported the decision to close the investigation without opening an ongoing CP case management workgroup. \r\n2.) Professionals believe the SDM tools are prescriptive (black and white), but child protection practice is subjective (gray), where staff are required to use their professional ethics and judgement to assess child safety and risk based on wide array of variable circumstances.  Staff considered the Probation Officer reported positive feedback regarding the offending caregiver, that he had been compliant with the DANCO and was not residing in the home, was providing clean UA\'s, and was successfully engaging and completing other programming (DBT therapy and domestic violence program). Additionally, the Judge lifted the DANCO, further influencing staff\'s perception of strengthened caregiver capacities, and lessened risk to child safety. In this case the risk to child safety was actively being controlled for using safety planning, which both caregivers engaged and followed local agency recommendations. The perception is that the risk assessment result does not speak directly to when ongoing services are necessarily needed, and the risk assessment result is used as a functional starting point during supervisor and county attorney consultation, as well as during conversations with the family. Staff believe the risk assessment is used to establish a baseline, considering many other factors when deciding if ongoing CP services need to be provided. Other factors considered is if the risk to child safety continues to exist.\r\n3.)In 2016, when SSIS did not yet have an override/underride feature incorporated within the safety and decision making tools for supervisors and/or staff, the potential influence of training available to professionals about the purpose of the risk assessment, and how the SDM tools were developed in order to understand functional use for frontline staff was a systemic feature existing across the state and local levels. Applicability and interpretation of the results of the safety and risk assessments, and using the results to inform decision making in real time practice with children and families, in order to capture all risks, were contributing variables when staff use the SDM decision making tools. Additionally the staff\'s interpretation of the training and knowledge retained from training contributes to how knowledge is accessed when staff complete the child safety and risk assessments with the family in real time.',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43203,248,22,92,13,348,'Multiple_Choice','0',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43204,248,22,92,13,349,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43205,248,22,92,13,350,'Multiple_Choice','0',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43206,248,22,92,13,351,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43207,248,22,92,13,352,'Multiple_Choice','2',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43208,248,22,92,13,353,'Free_Text','In 2016, when SSIS did not yet have an override/underride feature incorporated within the safety and decision making tools for supervisors and/or staff, the potential influence of training available to professionals about the purpose of the risk assessment, and how the SDM tools were developed in order to understand functional use for frontline staff was a systemic feature existing across the state and local levels. Applicability and interpretation of the results of the safety and risk assessments, and using the results to inform decision making in real time practice with children and families, in order to capture all risks, were contributing variables when staff use the SDM decision making tools. Additionally the staff\'s interpretation of the training and knowledge retained from training contributes to how knowledge is accessed when staff complete the child safety and risk assessments with the family in real time.',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43209,248,22,92,13,354,'Multiple_Choice','3',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43210,248,22,92,13,355,'Free_Text','Staff considered the Probation Officer reported positive feedback regarding the offending caregiver, that he had been compliant with the DANCO and was not residing in the home, was providing clean UA\'s, and was successfully engaging and completing other programming (DBT therapy and domestic violence program). Additionally, the Judge lifted the DANCO, further influencing staff\'s perception of strengthened caregiver capacities, and lessened risk to child safety. In this case the risk to child safety was actively being controlled for using safety planning, which both caregivers engaged and followed local agency recommendations.',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43211,248,22,92,13,356,'Multiple_Choice','0',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43212,248,22,92,13,357,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43213,248,22,92,13,368,'Multiple_Choice','0',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43214,248,22,92,13,369,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43215,248,22,92,13,358,'Multiple_Choice','2',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43216,248,22,92,13,359,'Free_Text','1.) When determining if CP services were needed, the SDM tool\'s result of â€˜high\' for the risk assessment was considered, however, it was not the only factor used to determine if CP services would be provided at the time the CP investigation closed. There was a domestic abuse no contact order (DANCO) (MN Statute 629.750), issued by the court, which was being complied with by the mother and the offender. In addition, the mother\'s protective capacities and safety assessment result of â€œsafeâ€ was considered following DHS FA/FI guidance. \r\nThe fact that the probable cause standard was not met for a child in need of protection and/or services defined by juvenile court law (MN statute 260C.007 Subd. 6 and 260C.141 Subd. 1), and/or the prescriptive legislation provided in MN Statute 626.556 Subd. 10e. (g), \r\nâ€œa determination that child protective services are needed means that the local welfare agency has documented conditions during the investigation sufficient to cause a child protection worker, to conclude that a child is at significant risk of maltreatment if protective intervention is not provided and that the individuals responsible for the child\'s care have not taken or are not likely to take actions to protect the child from maltreatment or risk of maltreatment,â€\r\nwhich supported the agency to close the investigation and not open ongoing CP CM workgroup, in spite of the high risk assessment result. Protective iintervention was not in the best interests of the children (MN statute 518.17), as the mother was not an offending caregiver, she was a safe parent/caregiver. She actively displayed protective capacities to keep the children safe.  She was engaged with the staff and followed the recommendations within the safety plan, she complied with having no contact with the offender after issuance of a Domestic Abuse No Contact Order (DANCO), and the mother was also utilizing her family for support. \r\n2.) In this case the risk to child safety was actively being controlled for using safety planning, which both caregivers engaged and followed local agency recommendations. The perception is that the risk assessment result does not speak directly to when ongoing services are necessarily needed, and the risk assessment result is used as a functional starting point during supervisor and county attorney consultation, as well as during conversations with the family. Staff believe the risk assessment is used to establish a baseline, considering many other factors when deciding if ongoing CP services need to be provided. Other factors considered is if the risk to child safety continues to exist. Although, contrary to State guidance and local practice norms, (that staff seek a consult with their supervisor and the county attorney to inquire CHIPS and the need for ongoing case management services when there is a â€˜high\' result on the risk assessment at the close of a CP investigation), the staff had Supervisor support to close the CP investigation and not open a workgroup for ongoing CP case management services in this case. When the result of the risk assessment is â€˜high\' in combination with a safety assessment result of â€˜safe\', a discrepancy surfaces. The discrepancy highlights a double bind/goal conflict for staff to navigate and resolve when children are â€˜presumed safe\' as the presenting reality of conditions do not suspect substantial child endangerment (Minn. Stat. 626.556, subd. 2(o )) and/or services are not needed to ameliorate immediate risk to child safety.',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43217,248,22,92,13,360,'Multiple_Choice','1',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43218,248,22,92,13,361,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43219,248,22,92,13,362,'Multiple_Choice','2',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43220,248,22,92,13,363,'Free_Text','The potential influence of training available to professionals about the purpose of the risk assessment, and how the SDM tools were developed along with the staff\'s interpretation of the training and knowledge retained from training contributes to how knowledge is accessed when staff complete the child safety and risk assessments with the family in real time.',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43221,248,22,92,13,364,'Multiple_Choice','1',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43222,248,22,92,13,365,'Free_Text',NULL,1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43223,248,22,92,13,366,'Multiple_Choice','3',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43224,248,22,92,13,367,'Free_Text','In 2016, the agency employed professionals with a wealth of practice experience and longevity, many with 20+ years in child welfare and assessing child safety and risk. The knowledge possessed by the staff, coupled by a functional working relationship with the local agency\'s county attorney office, supported the decision to not open ongoing child protection case management services. The local agency\'s mental model was a presumption that the County Attorney would not accept a petition for CHIPS (Child in Need of Protection or Services) as the local agency had collaborated with many service providers to address safety concerns and provide the family resources, which the caregivers were compliant and completed successfully throughout the CP investigation.\r\nThe circumstances did not present a need to consult with the County Attorney to file a CHIPS petition, and staff consulted with their supervisor to resolve this goal conflict.\r\nAlthough it is suggested in the SDM manual to consult with the county attorney when the result of a risk assessment is â€œhighâ€, this case did not have unresolved safety threats efforts, and the efforts made to provide for child safety were successful, indicating the legal threshold for court intervention was not met, as there were no other conditions known at the time to indicate child safety was at risk. The staff\'s supervisor supported the decision to close the investigation without opening an ongoing CP case management workgroup. \r\nProfessionals believe the SDM tools are prescriptive (black and white), but child protection practice is subjective (gray), where staff are required to use their professional ethics and judgement to assess child safety and risk based on wide array of variable circumstances.  Staff considered the Probation Officer reported positive feedback regarding the offending caregiver, that he had been compliant with the DANCO and was not residing in the home, was providing clean UA\'s, and was successfully engaging and completing other programming (DBT therapy and domestic violence program). Additionally, the Judge lifted the DANCO, further influencing staff\'s perception of strengthened caregiver capacities, and lessened risk to child safety. In this case the risk to child safety was actively being controlled for using safety planning, which both caregivers engaged and followed local agency recommendations. The perception is that the risk assessment result does not speak directly to when ongoing services are necessarily needed, and the risk assessment result is used as a functional starting point during supervisor and county attorney consultation, as well as during conversations with the family. Staff believe the risk assessment is used to establish a baseline, considering many other factors when deciding if ongoing CP services need to be provided. Other factors considered is if the risk to child safety continues to exist. Although, contrary to State guidance and local practice norms, (that staff seek a consult with their supervisor and the county attorney to inquire CHIPS and the need for ongoing case management services when there is a â€˜high\' result on the risk assessment at the close of a CP investigation), the staff had Supervisor support to close the CP investigation and not open a workgroup for ongoing CP case management services in this case. \r\n2.) Additionally the staff\'s interpretation of the training and knowledge retained from training contributes to how knowledge is accessed when staff complete the child safety and risk assessments with the family in real time.',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43225,248,22,92,13,370,'Yes_or_No','Yes',1,92,92,'2021-06-01 19:07:29','2021-06-01 19:07:29',NULL),(43226,347,22,71,13,291,'Multiple_Choice','Ryan Hartneck',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43227,347,22,71,13,292,'Short_Answer','Triage Team',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43228,347,22,71,13,293,'Date','04/15/2018',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43229,347,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43230,347,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43231,347,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43232,347,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43233,347,22,71,13,297,'Short_Answer','Unlicensed',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43234,347,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43235,347,22,71,13,299,'Multiple_Choice','Unlicensed',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43236,347,22,71,13,300,'Multiple_Choice','7',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43237,347,22,71,13,301,'Multiple_Choice','Anoka',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43238,347,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43239,347,22,71,13,303,'Short_Answer','Phoenix',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43240,347,22,71,13,304,'Short_Answer','Lincoln',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43241,347,22,71,13,305,'Date','11/06/2017',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43242,347,22,71,13,306,'Date','02/04/2018',1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43243,347,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 19:07:44','2021-06-01 19:07:44',NULL),(43244,347,22,71,13,308,'Multiple_Choice','2 Months',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43245,347,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43246,347,22,71,13,310,'Short_Answer','Daycare Provider',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43247,347,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43248,347,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43249,347,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43250,347,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43251,347,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43252,347,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43253,347,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43254,347,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43255,347,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43256,347,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43257,347,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43258,347,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43259,347,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43260,347,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43261,347,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43262,347,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43263,347,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43264,347,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43265,347,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43266,347,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43267,347,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43268,347,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43269,347,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43270,347,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43271,347,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43272,347,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43273,347,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43274,347,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43275,347,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43276,347,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43277,347,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43278,347,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43279,347,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43280,347,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43281,347,22,71,13,358,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43282,347,22,71,13,359,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43283,347,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43284,347,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43285,347,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43286,347,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43287,347,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43288,347,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43289,347,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43290,347,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43291,347,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:07:45','2021-06-01 19:07:45',NULL),(43293,363,22,71,13,291,'Multiple_Choice','Ryan Hartneck',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43294,363,22,71,13,292,'Short_Answer','Jennifer Carlson',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43295,363,22,71,13,293,'Date','09/08/2016',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43296,363,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43297,363,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43298,363,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43299,363,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43300,363,22,71,13,297,'Short_Answer','Unlicensed',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43301,363,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43302,363,22,71,13,299,'Multiple_Choice','Unlicensed',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43303,363,22,71,13,300,'Multiple_Choice','9',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43304,363,22,71,13,301,'Multiple_Choice','Ramsey',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43305,363,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43306,363,22,71,13,303,'Short_Answer','Susannah',1,71,71,'2021-06-01 19:08:02','2021-06-01 19:08:02',NULL),(43307,363,22,71,13,304,'Short_Answer','Crider',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43308,363,22,71,13,305,'Date','01/22/2016',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43309,363,22,71,13,306,'Date','08/08/2016',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43310,363,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43311,363,22,71,13,308,'Multiple_Choice','7 Months',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43312,363,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43313,363,22,71,13,310,'Short_Answer','Caregiver',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43314,363,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43315,363,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43316,363,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43317,363,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43318,363,22,71,13,316,'Multiple_Choice','1',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43319,363,22,71,13,317,'Short_Answer','Cross report of incident from Law Enforcement (LE) to Child Protective Services (CPS) did not occur',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43320,363,22,71,13,318,'Free_Text','No debrief occurred on this LP due to the LP being outside the CW system',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43321,363,22,71,13,319,'Free_Text','Law Enforcement (LE) not cross reporting to CPS after the critical incident was influenced by the unique processes and role of LE, access to mandated reporter training and circumstances regarding the incident. LE shared that child\'s condition was initially called out as a medical concern and after being notified by hospital staff that they were unsuccessful in life-saving efforts, the case became a child death investigation. When this occurs, this becomes the priority for the LE agency and the focus becomes finding justice, not the more nuanced job duties such as cross-reporting that are much lower priority. Additionally, there are organizational processes within LE regarding cross-reports being made. The process typically goes through several staff (i.e., officer to sergeant to administrative support staff) in order to get the cross-report made. The LE agency\'s administration makes the final determination on whether to cross-report to CPS. Since this reporting process starts with the responding officer(s), the officer\'s perception of the situation also influences whether a cross-report is made. In this case, the officer was unsure of the origin of the child\'s injuries (appeared to be an accident), the child was not being cared for by a parent at the time of the incident and the officer did not want to cause additional trauma to the family by potentially initiating a CPS response by cross-reporting in error. All circumstances that impacted a CP report being made. Also, it was believed by LE that they had mitigated risk to other children by informing the families not to bring their kids back to the unlicensed daycare. Furthermore, unlicensed daycare homes such as this one receive less oversight and direction by the state for when incidents like this one occur. For example, there is not a requirement to notify CPS or licensing of the critical incident. As a result, this limited oversight further impacts reports not being made when incidents occur in unlicensed daycare homes.  \r\n\r\nFurther impacting cross-reporting not occurring are the complexities of how/when to report suspected child abuse and neglect as well as general access to that mandated reporter training to accurately understand reporting requirements. Also, nuances in the mandated reporter statute (MN statute 626.556) results in a lack of clarity in mandated reporting rules creating inconsistent reporting practices. This, coupled with accessibility to training, impacts cross-reporting to CPS. Additionally, local CPS agencies provide the mandated reporter training to local partners when it is requested. Due to the need to complete daily CPS duties, the added requirement to provide mandated reporter training creates additional demands on local agencies. Since agencies do not have the resources to provide the mandated reporter training it is difficult to provide any type of ongoing training for those local partners. \r\n\r\nAdditionally in these cases, the demographics of families, and biases associated with those demographics, may result in cross-reports not being made. In this case, other mandated reporters, such as hospital and medical examiner\'s office, also did not cross-report the child\'s condition to CPS.',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43322,363,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43323,363,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43324,363,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43325,363,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43326,363,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43327,363,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43328,363,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43329,363,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43330,363,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43331,363,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43332,363,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43333,363,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43334,363,22,71,13,346,'Multiple_Choice','3',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43335,363,22,71,13,347,'Free_Text','Since this reporting process starts with the responding officer(s), the officer\'s perception of the situation also influences whether a cross-report is made. In this case, the officer was unsure of the origin of the child\'s injuries (appeared to be an accident), the child was not being cared for by a parent at the time of the incident and the officer did not want to cause additional trauma to the family by potentially initiating a CPS response by cross-reporting in error.',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43336,363,22,71,13,348,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43337,363,22,71,13,349,'Free_Text','local CPS agencies provide the mandated reporter training to local partners when it is requested. Due to the need to complete daily CPS duties, the added requirement to provide mandated reporter training creates additional demands on local agencies. Since agencies do not have the resources to provide the mandated reporter training it is difficult to provide any type of ongoing training for those local partners.',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43338,363,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43339,363,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43340,363,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43341,363,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43342,363,22,71,13,354,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43343,363,22,71,13,355,'Free_Text','there are organizational processes within LE regarding cross-reports being made. The process typically goes through several staff (i.e., officer to sergeant to administrative support staff) in order to get the cross-report made. The LE agency\'s administration makes the final determination on whether to cross-report to CPS',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43344,363,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43345,363,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43346,363,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43347,363,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43348,363,22,71,13,358,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43349,363,22,71,13,359,'Free_Text','unlicensed daycare homes such as this one receive less oversight and direction by the state for when incidents like this one occur. For example, there is not a requirement to notify CPS or licensing of the critical incident. \r\n\r\nnuances in the mandated reporter statute (MN statute 626.556) results in a lack of clarity in mandated reporting rules creating inconsistent reporting practices.',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43350,363,22,71,13,360,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43351,363,22,71,13,361,'Free_Text','Law Enforcement (LE) not cross reporting to CPS after the critical incident was influenced by the unique processes and role of LE, access to mandated reporter training and circumstances regarding the incident. LE shared that child\'s condition was initially called out as a medical concern and after being notified by hospital staff that they were unsuccessful in life-saving efforts, the case became a child death investigation. When this occurs, this becomes the priority for the LE agency and the focus becomes finding justice, not the more nuanced job duties such as cross-reporting that are much lower priority.',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43352,363,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43353,363,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43354,363,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43355,363,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43356,363,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43357,363,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43358,363,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:08:03','2021-06-01 19:08:03',NULL),(43360,366,22,71,13,291,'Multiple_Choice','Kristine Frick',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43361,366,22,71,13,292,'Short_Answer','Colette Roesler',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43362,366,22,71,13,293,'Date','07/05/2017',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43363,366,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43364,366,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43365,366,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43366,366,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43367,366,22,71,13,297,'Short_Answer','Licensed',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43368,366,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43369,366,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43370,366,22,71,13,300,'Multiple_Choice','9',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43371,366,22,71,13,301,'Multiple_Choice','Ramsey',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43372,366,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43373,366,22,71,13,303,'Short_Answer','Talayia',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43374,366,22,71,13,304,'Short_Answer','Sabillon-Suazo',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43375,366,22,71,13,305,'Date','02/01/2017',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43376,366,22,71,13,306,'Date','06/06/2017',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43377,366,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43378,366,22,71,13,308,'Multiple_Choice','4 Months',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43379,366,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43380,366,22,71,13,310,'Short_Answer','Non-relative foster care provider',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43381,366,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43382,366,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43383,366,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43384,366,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43385,366,22,71,13,316,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43386,366,22,71,13,317,'Short_Answer','Screening of 2/3/2017 CP intake occurred beyond 24-hour timelines.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43387,366,22,71,13,318,'Free_Text','â€¢	Too many unknowns at the time the report was made \r\no	Limited knowledge at first, go off information had at the time, it was difficult to know because the mother used a false identity, and claimed to live in Wisconsin.\r\nâ€¢	Mother and Father were not honest about identity and home address at time the report was made, and attempted to mislead and confuse the CP Systems in WI and MN. \r\nâ€¢	Previous report was made on 2/1 that was screened out and referred to the jurisdiction the parents alleged as their home address in Wisconsin. \r\nâ€¢	Getting the information back on 2/3 in a new CP Intake increased the suspicion of suspected child abuse and neglect; report was screened in. Worker believed it was timely screened, but also stated she gave to her supervisor who she had been consulting with about the intake information. \r\nâ€¢	The worker reported she would not have authority to make changes to information documented in the CP intake.\r\nâ€¢	Wisconsin do things differently than MN, no police holds. Ramsey County Intake requested to place infant on a hold, but WI Law enforcement does not place holds on children. \r\nâ€¢	Once the Child Maltreatment Report was screened in the investigator learned the mother\'s real identity and that information was used to make changes to the Child Maltreatment report; Mother\'s identity and previous TLC\'s/TPR was not known until after the CP investigation was opened\r\nâ€¢	TPR look up in SSIS is not reliable\r\nâ€¢	Identifying people is not reliable in SSIS\r\nâ€¢	In Feb. 2017, there was pressure to complete screening within the allotted 24 hour timeframe, which the team of screeners prioritized. \r\nâ€¢	Worker was not certain why SSIS shows 3 days in between the open and close date on the intake. It is not uncommon to gather information to see if the information meets criteria before closing the intake; but if the timeline is near the 24 hour mark, the report is screened with what information could be gathered.\r\nâ€¢	Meeting the 24 hour screening timeline is priority, however it is one the worker does not believe increases safety, and can sometimes feel like it is in place to hold staff accountable versus trust the professionals doing the work; understandable to have checks and balances enmeshed in guidance though.  \r\nâ€¢	The worker did not know how the technical change of the mother\'s name was corrected in the SSIS system  \r\nâ€¢	It was presumed that the SSIS Helpdesk would have likely had to be involved because the SSIS CP Intakes would not be merged for an circumstance like this\r\nâ€¢	Possible a new CP intake would have been created?\r\nâ€¢	The worker is one of 6 screeners who document all the intakes coming into Ramsey County and screen them as a team or with supervisor; they are also responsible for all calls that come in not related to child protection; The screeners do not have a support staff or receptionist to field calls.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43388,366,22,71,13,319,'Free_Text','The CP intake being screened beyond the 24-hour timelines was influenced by multiple states and jurisdictions being involved with the family.  The last known address for the family was in the State of Wisconsin; consequently, a CP report that came into the local agency in MN two days prior to the 2/3/2017 report was screened out and referred to Wisconsin\'s CP system.  When the 2/3/2017 report came in, the worker believed the report was screened in within the 24-hour timeline as she had consulted with her supervisor and gave the report to her.  Additionally, the parents did not provide current or correct information regarding their identity and home address, further contributing to the confusion as to who had jurisdiction over the CP intake.\r\n\r\nFurther influencing the screening of the CP intake occurring beyond the 24-hour timelines was the fact that the report came in on a Friday and the local agency does not have the ability to screen reports after regular business hours.  In addition to the report coming in on Friday, the worker\'s high caseload, coupled with the need to verify participants in the case and determine jurisdiction, added complexity to screening the report within the 24-hour timelines. Complicating factors included two states being involved, as well as the ambiguity of the family\'s home address, which further support the report not being screened timely.\r\n\r\nScreeners felt an added pressure to prioritize screening reports within 24-hour timelines in order to meet this metric.  Due to this added pressure, the worker was unclear as to why SSIS showed the report being screened outside of the 24-hour timelines.  Additionally, it is not uncommon for the screener to gather more information to see if the information meets criteria before closing the intake; however, if it is near the 24-hour timeline, normative practice is to screen the report with the information the screener has at the time.  Screeners are responsible for all calls that come into the agency, which include those that are not specific to child protection, placing additional responsibilities on the screeners.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43389,366,22,71,13,320,'Short_Answer','CP Intake made on June 7. 2017 for suspected neglect (inadequate supervision) regarding a licensing violation incident that occurred on May 2, 2017.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43390,366,22,71,13,321,'Free_Text','â€¢	It was a chaotic environment that day, the 2 year old being outside unnoticed by the foster mother was circumstantial, isolated, and atypical.  \r\nâ€¢	The front door was observed to be left open for the delivery of a freezer multiple times after the foster mother had repeatedly closed it. The door had a chime alarm which was dismissed as the delivery professionals coming in and out of the door.\r\nâ€¢	The 2 year old was somewhat higher need; very active and impulsive with his behavior.\r\nâ€¢	The foster home had been licensed since 1999; Foster mother was reliable and resourceful. Had adopted children, had taken in many children as a Traditional placement option and as a Substitute shelter care placement option\r\nâ€¢	Never had a violation in the past\r\nâ€¢	Foster mother was an active in Ramsey County Training initiatives; Helping teach parents/supervising visitation for children and parents in her home\r\nâ€¢	The foster home was described as â€œone of Ramsey County\'s bestâ€ providers.  \r\nâ€¢	May 2 â€“ Worker consulted with supervisor and colleagues about the child not being supervised at the moment when she approached the home.  A correction order was decided to be appropriate at that time; A CP intake/Child Maltreatment report was not made on May 2.  \r\nâ€¢	Typical normative process would be for CP Program worker to collaborate with Lic Social Worker prior to the placement about the number of children and needs of all the children placed in the foster home at the time. \r\nâ€¢	A shortage of foster home placement options places pressure on CP Program workers to find placement option for children, and would contact the foster provider directly asking if there was space for substitute shelter care. \r\nâ€¢	The pressure behind the needed placement would make the provider feel guilty, especially if mention of a â€œvarianceâ€ was stated, she didn\'t like to say no.\r\nâ€¢	Placements for children with higher behavioral needs aren\'t meeting criteria of residential, or if they are there are wait lists; so many foster homes are managing high needs children with added supports \r\nâ€¢	After hours placements would sometimes occur before the licensing worker was made aware. \r\nâ€¢	Lic worker believed the foster mother would\'ve felt obligated to keep trying to help the overwhelmed system with shortage of placement options, because she was committed to raising the foster kids.\r\nâ€¢	Foster home\'s only violation/corrective action order was the May 2 corrective action order.\r\nâ€¢	Not all corrective action orders are CP reports\r\nâ€¢	 Foster home was current on all trainings, and had just received SUID/Unsafe sleep training and abusive head trauma just prior to the child fatality incident. \r\nâ€¢	The child fatality was â€œunfortunate and shockingâ€; the lic worker was out on medical leave when she learned of the child\'s death.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43391,366,22,71,13,322,'Free_Text','A CP report made on June 7, 2017, for suspected neglect regarding a licensing violation incident that occurred on May 2, 2017 was influenced a local agency response using defensive practice, as the critical incident occurred on June 6, 2017. At the time of the licensing violation on May 2, prior to the critical incident, the local agency made the decision to issue a correction order to the foster home rather than make a CP intake report for suspected neglect. The decision to not make a CP report was made through consultation between the worker, colleagues, and a supervisor. Supporting the consultation between agency staff was the belief that not every licensing violation is a CP report, as well as, the perception that the CP system would be inundated if every incident was reported.  \r\n\r\nFurther supporting a CP report being made on June 7, 2017 for an incident that occurred on May 2, 2017 was the fact that the foster mother reported that she was having a freezer delivered that day and the delivery people were coming in and out of the house, making the door alarm go off each time. The foster mother did shut the door behind the delivery people when it was left open as they went in and out. At the time, she was also vacuuming the house to get ready for the foster child\'s parents to come for a visit. Given this information, the staff\'s perception was that the safety risk did not reach the threshold of needing to make a CP report, and the child escaping outside when the door was left open was considered to be accidental in nature.\r\n\r\nAdditionally, the worker was new and was still learning the process of making a CP report.  This was also influenced by the guidance and interpretation of the guidance in regards to making a CP report.  Overarching this was the foster care licensing statute which supported a consult between the licensing social worker and a CP screener to discuss an incident and determine what action needed to be taken.  Normative practice for when these consultations occur is for the information to be documented on a form, rather than documenting it in SSIS.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43392,366,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43393,366,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43394,366,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43395,366,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43396,366,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43397,366,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43398,366,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43399,366,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43400,366,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43401,366,22,71,13,346,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43402,366,22,71,13,347,'Free_Text','LP1: The supervisor supported the staff by taking the 2/3/2017 CP intake off the staff\'s workload and the staff believed the report was screened timely within the 24 hour timeline. \r\nLP2: Supporting the consultation between agency staff was the belief that not every licensing violation is a CP report, as well as, the perception that the CP system would be inundated if every incident was reported.  \r\nFurther supporting a CP report being made on June 7, 2017 for an incident that occurred on May 2, 2017 was the fact that the foster mother reported that she was having a freezer delivered that day and the delivery people were coming in and out of the house, making the door alarm go off each time. The foster mother did shut the door behind the delivery people when it was left open as they went in and out. At the time, she was also vacuuming the house to get ready for the foster child\'s parents to come for a visit. Given this information, the staff\'s perception was that the safety risk did not reach the threshold of needing to make a CP report, and the child escaping outside when the door was left open was considered to be accidental in nature.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43403,366,22,71,13,348,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43404,366,22,71,13,349,'Free_Text','LP1: The CP intake being screened beyond the 24-hour timeline was influenced by jurisdictional complexity in this case. There were multiple states and several county jurisdictions identified as having responsibility to serve the family. Further adding to the jurisdictional complexity was the fact that the parents did not provide current or correct information regarding their identities and home address. This contributed to the confusion as to who had jurisdiction over the CP intake, and subsequently it took the agency more than 24 hours to decipher the facts before the agency was able to screen in the 2/3/2017 CP intake. \r\nThe agency had knowledge of the family, as a CP intake had been reported to the local agency on 2/1/2017, which was screened out and referred to Wisconsin\'s CP system due to the last known address for the family being located in the State of Wisconsin. When the 2/3/2017 report came in, staff consulted with their supervisor about the complexity of jurisdiction that needed attention for the case and gave the CP intake to their supervisor. The intake and screening workload was high at this time and the staff did not have time to dedicate to the complexity around jurisdiction. Therefore, the supervisor supported the staff by taking the 2/3/2017 CP intake off the staff\'s workload and the staff believed the report was screened timely within the 24 hour timeline.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43405,366,22,71,13,350,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43406,366,22,71,13,351,'Free_Text','LP2: Overarching this was the foster care licensing statute which supported a consult between the licensing social worker and a CP screener to discuss an incident and determine what action needed to be taken.  Normative practice for when these consultations occur is for the information to be documented on a form, rather than documenting it in SSIS.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43407,366,22,71,13,352,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43408,366,22,71,13,353,'Free_Text','Staff experienced a SSIS glitch/SSIS was down at the time of the critical incident. This posed a barrier for frontline staff, as the agency could not access information, and the inability to access information delayed staff in learning relevant history about the participants in this case. The technology barrier posed concern, as staff made decisions without having access to all information available, due to not being able to access it, and there was urgency to safety plan at the time of the critical incident.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43409,366,22,71,13,354,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43410,366,22,71,13,355,'Free_Text','LP1: The CP intake being screened beyond the 24-hour timeline was influenced by jurisdictional complexity in this case. There were multiple states and several county jurisdictions identified as having responsibility to serve the family. Further adding to the jurisdictional complexity was the fact that the parents did not provide current or correct information regarding their identities and home address. This contributed to the confusion as to who had jurisdiction over the CP intake, and subsequently it took the agency more than 24 hours to decipher the facts before the agency was able to screen in the 2/3/2017 CP intake. \r\nLP1: The supervisor supported the staff by taking the 2/3/2017 CP intake off the staff\'s workload and the staff believed the report was screened timely within the 24 hour timeline. \r\n\r\nOther: Coordination of interviews regarding child death investigation were conducted separately by law enforcement and child protection.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43411,366,22,71,13,356,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43412,366,22,71,13,357,'Free_Text','LP2: The worker was new and was still learning the process of making a CP report.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43413,366,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43414,366,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43415,366,22,71,13,358,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43416,366,22,71,13,359,'Free_Text','LP1: The CP intake being screened beyond the 24-hour timeline was influenced by jurisdictional complexity in this case. There were multiple states and several county jurisdictions identified as having responsibility to serve the family. Further adding to the jurisdictional complexity was the fact that the parents did not provide current or correct information regarding their identities and home address. This contributed to the confusion as to who had jurisdiction over the CP intake, and subsequently it took the agency more than 24 hours to decipher the facts before the agency was able to screen in the 2/3/2017 CP intake. \r\n\r\nLP1: Further contributing to the delay in screening was the fact that the report came in on a Friday. At the time, the local agency did not have the ability to screen reports after regular business hours. On Mondays, screeners felt added pressure to prioritize screening reports within 24-hours in order to meet the compliance metric, as CP reports accumulated over the weekend, increasing Monday\'s workload every week. It is not uncommon for screeners to gather more information using collateral contacts or contacting the reporter prior to making a screening decision. Yet if a CP intake is nearing the end of the 24-hour timeline, the agency\'s normative practice is to screen the report with the information the screener has been able to gather at the time. \r\n\r\nLP2: Additionally, the worker was new and was still learning the process of making a CP report.  This was also influenced by the guidance and interpretation of the guidance in regards to making a CP report.  Overarching this was the foster care licensing statute which supported a consult between the licensing social worker and a CP screener to discuss an incident and determine what action needed to be taken.  Normative practice for when these consultations occur is for the information to be documented on a form, rather than documenting it in SSIS.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43417,366,22,71,13,360,'Multiple_Choice','3',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43418,366,22,71,13,361,'Free_Text','LP1: The agency had knowledge of the family, as a CP intake had been reported to the local agency on 2/1/2017, which was screened out and referred to Wisconsin\'s CP system due to the last known address for the family being located in the State of Wisconsin. When the 2/3/2017 report came in, staff consulted with their supervisor about the complexity of jurisdiction that needed attention for the case and gave the CP intake to their supervisor. The intake and screening workload was high at this time and the staff did not have time to dedicate to the complexity around jurisdiction. Therefore, the supervisor supported the staff by taking the 2/3/2017 CP intake off the staff\'s workload and the staff believed the report was screened timely within the 24 hour timeline. \r\nFurther contributing to the delay in screening was the fact that the report came in on a Friday. At the time, the local agency did not have the ability to screen reports after regular business hours. On Mondays, screeners felt added pressure to prioritize screening reports within 24-hours in order to meet the compliance metric, as CP reports accumulated over the weekend, increasing Monday\'s workload every week. It is not uncommon for screeners to gather more information using collateral contacts or contacting the reporter prior to making a screening decision. Yet if a CP intake is nearing the end of the 24-hour timeline, the agency\'s normative practice is to screen the report with the information the screener has been able to gather at the time. The local agencies intake and screening staff were responsible for answering all the calls that came into the agency. The calls include those that are not specific to child protection. This universal answering coverage for the agency placed additional pressure on screeners at times when a 24-hour timeline screening decision needed to be made, especially when reports had complicating factors like this CP intake did (unknown information/ jurisdiction issue/ screener & supervisor had little to no time to gather additional information). \r\n\r\nLP2: Supporting the consultation between agency staff was the belief that not every licensing violation is a CP report, as well as, the perception that the CP system would be inundated if every incident was reported.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43419,366,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43420,366,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43421,366,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43422,366,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43423,366,22,71,13,366,'Multiple_Choice','2',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43424,366,22,71,13,367,'Free_Text','LP2: A CP report made on June 7, 2017, for suspected neglect regarding a licensing violation incident that occurred on May 2, 2017 was influenced a local agency response using defensive practice, as the critical incident occurred on June 6, 2017. At the time of the licensing violation on May 2, prior to the critical incident, the local agency made the decision to issue a correction order to the foster home rather than make a CP intake report for suspected neglect. The decision to not make a CP report was made through consultation between the worker, colleagues, and a supervisor. Supporting the consultation between agency staff was the belief that not every licensing violation is a CP report, as well as, the perception that the CP system would be inundated if every incident was reported.',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43425,366,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:08:23','2021-06-01 19:08:23',NULL),(43493,369,22,71,13,291,'Multiple_Choice','Kristine Frick',1,71,71,'2021-06-01 19:09:57','2021-06-01 19:09:57',NULL),(43494,369,22,71,13,292,'Short_Answer','Triage Team',1,71,71,'2021-06-01 19:09:57','2021-06-01 19:09:57',NULL),(43495,369,22,71,13,293,'Date','11/01/2016',1,71,71,'2021-06-01 19:09:57','2021-06-01 19:09:57',NULL),(43496,369,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:09:57','2021-06-01 19:09:57',NULL),(43497,369,22,71,13,294,'Multiple_Choice','Near Fatality',1,71,71,'2021-06-01 19:09:57','2021-06-01 19:09:57',NULL),(43498,369,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:09:57','2021-06-01 19:09:57',NULL),(43499,369,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:09:57','2021-06-01 19:09:57',NULL),(43500,369,22,71,13,297,'Short_Answer','Legally Unlicensed',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43501,369,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43502,369,22,71,13,299,'Multiple_Choice','Legally Unlicensed',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43503,369,22,71,13,300,'Multiple_Choice','7',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43504,369,22,71,13,301,'Multiple_Choice','Dakota',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43505,369,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43506,369,22,71,13,303,'Short_Answer','William',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43507,369,22,71,13,304,'Short_Answer','Merchant',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43508,369,22,71,13,305,'Date','08/12/2015',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43509,369,22,71,13,306,'Date',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43510,369,22,71,13,307,'Date','09/22/2016',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43511,369,22,71,13,308,'Multiple_Choice','1 Year',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43512,369,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43513,369,22,71,13,310,'Short_Answer','Legally unlicensed daycare provider',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43514,369,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43515,369,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43516,369,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43517,369,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43518,369,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43519,369,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43520,369,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43521,369,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43522,369,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43523,369,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43524,369,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43525,369,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43526,369,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43527,369,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43528,369,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43529,369,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43530,369,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43531,369,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43532,369,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43533,369,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43534,369,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43535,369,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43536,369,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43537,369,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43538,369,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43539,369,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43540,369,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43541,369,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43542,369,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43543,369,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43544,369,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43545,369,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43546,369,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43547,369,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43548,369,22,71,13,358,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43549,369,22,71,13,359,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43550,369,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43551,369,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43552,369,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43553,369,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43554,369,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43555,369,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43556,369,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43557,369,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43558,369,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:09:58','2021-06-01 19:09:58',NULL),(43560,372,22,71,13,291,'Multiple_Choice','Brittany Lochner',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43561,372,22,71,13,292,'Short_Answer','Brenda Mahoney',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43562,372,22,71,13,293,'Date','02/04/2020',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43563,372,22,71,13,342,'Date',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43564,372,22,71,13,294,'Multiple_Choice','Fatality',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43565,372,22,71,13,295,'Yes_or_No','No',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43566,372,22,71,13,296,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43567,372,22,71,13,297,'Short_Answer','Licensed',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43568,372,22,71,13,298,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43569,372,22,71,13,299,'Multiple_Choice','Licensed',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43570,372,22,71,13,300,'Multiple_Choice','3',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43571,372,22,71,13,301,'Multiple_Choice','Crow Wing',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43572,372,22,71,13,302,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43573,372,22,71,13,303,'Short_Answer','Zander',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43574,372,22,71,13,304,'Short_Answer','Miller',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43575,372,22,71,13,305,'Date','01/31/2019',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43576,372,22,71,13,306,'Date','11/12/2019',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43577,372,22,71,13,307,'Date',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43578,372,22,71,13,308,'Multiple_Choice','10 Months',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43579,372,22,71,13,309,'Multiple_Choice','1',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43580,372,22,71,13,310,'Short_Answer','Daycare provider',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43581,372,22,71,13,311,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43582,372,22,71,13,312,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43583,372,22,71,13,313,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43584,372,22,71,13,314,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43585,372,22,71,13,316,'Multiple_Choice',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43586,372,22,71,13,317,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43587,372,22,71,13,318,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43588,372,22,71,13,319,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43589,372,22,71,13,320,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43590,372,22,71,13,321,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43591,372,22,71,13,322,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43592,372,22,71,13,323,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43593,372,22,71,13,324,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43594,372,22,71,13,325,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43595,372,22,71,13,326,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43596,372,22,71,13,327,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43597,372,22,71,13,328,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43598,372,22,71,13,343,'Short_Answer',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43599,372,22,71,13,344,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43600,372,22,71,13,345,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43601,372,22,71,13,346,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43602,372,22,71,13,347,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43603,372,22,71,13,348,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43604,372,22,71,13,349,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43605,372,22,71,13,350,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43606,372,22,71,13,351,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43607,372,22,71,13,352,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43608,372,22,71,13,353,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43609,372,22,71,13,354,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43610,372,22,71,13,355,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43611,372,22,71,13,356,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43612,372,22,71,13,357,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43613,372,22,71,13,368,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43614,372,22,71,13,369,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43615,372,22,71,13,358,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43616,372,22,71,13,359,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43617,372,22,71,13,360,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43618,372,22,71,13,361,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43619,372,22,71,13,362,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43620,372,22,71,13,363,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43621,372,22,71,13,364,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43622,372,22,71,13,365,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43623,372,22,71,13,366,'Multiple_Choice','0',1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43624,372,22,71,13,367,'Free_Text',NULL,1,71,71,'2021-06-01 19:10:31','2021-06-01 19:10:31',NULL),(43625,372,22,71,13,370,'Yes_or_No','Yes',1,71,71,'2021-06-01 19:10:32','2021-06-01 19:10:32',NULL),(43693,350,22,92,13,291,'Multiple_Choice','Kristine Frick',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43694,350,22,92,13,292,'Short_Answer','Kari Rude',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43695,350,22,92,13,293,'Date','12/13/2018',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43696,350,22,92,13,342,'Date','04/09/2019',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43697,350,22,92,13,294,'Multiple_Choice','Near Fatality',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43698,350,22,92,13,295,'Yes_or_No','No',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43699,350,22,92,13,296,'Multiple_Choice',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43700,350,22,92,13,297,'Short_Answer',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43701,350,22,92,13,298,'Yes_or_No','No',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43702,350,22,92,13,299,'Multiple_Choice',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43703,350,22,92,13,300,'Multiple_Choice','3',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43704,350,22,92,13,301,'Multiple_Choice','Stevens',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43705,350,22,92,13,302,'Short_Answer',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43706,350,22,92,13,303,'Short_Answer','Rafael',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43707,350,22,92,13,304,'Short_Answer','Crayton',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43708,350,22,92,13,305,'Date','01/24/2018',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43709,350,22,92,13,306,'Date',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43710,350,22,92,13,307,'Date','08/10/2018',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43711,350,22,92,13,308,'Multiple_Choice','7 Months',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43712,350,22,92,13,309,'Multiple_Choice','2',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43713,350,22,92,13,310,'Short_Answer','Mother',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43714,350,22,92,13,311,'Short_Answer','Mother\'s boyfriend',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43715,350,22,92,13,312,'Short_Answer',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43716,350,22,92,13,313,'Short_Answer',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43717,350,22,92,13,314,'Short_Answer',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43718,350,22,92,13,316,'Multiple_Choice','2',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43719,350,22,92,13,317,'Short_Answer','A requested TPR was not filed by the County Attorney for an alleged father who was a registered predatory offender and a mother with an egregious harm maltreatment determination.',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43720,350,22,92,13,318,'Free_Text','Consults between CP and CA occurred (multiple)\r\nâ€¢	Petition written and provided to the CA\r\nâ€¢	Filing TPR was declined \r\nâ€¢	CA unsure if met TPR criteria\r\nâ€¢	Inexperience in both work areas; Social Services Staff and CA\'s office\r\nâ€¢	CA no mentor assisting; Not using green book\r\nâ€¢	CA want criminal case to go first before filing TPR',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43721,350,22,92,13,319,'Free_Text','A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \r\nBest practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \r\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.  \r\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43722,350,22,92,13,320,'Short_Answer','CP Intake was not screened within the 24 hour required timeframe',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43723,350,22,92,13,321,'Free_Text','â€¢	Wait for conformed test results\r\nâ€¢	Mother move around, jurisdiction concerns, mother was hard to reach/ difficulty engaging to conform where reside and find the family\'s location\r\nâ€¢	Positive for THC only = not as severe as meth, etc. â€œit\'s just THCâ€, mental model for agency\'s about what this means\r\nâ€¢	Previous PSOP  and CD assessment\r\n         -Mother declined services & no recommendations came out of the CD assessment\r\nâ€¢	One Primary intake worker\r\n         - Back up took intake info may not be as familiar 	w/internal processes for intakes since it\'s not their primary role the staff commonly 	works every day.  \r\note: presumptive  Vs Confirmed results',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43724,350,22,92,13,322,'Free_Text','Learning Point: A CP intake was not screened within 24 hours. \r\nContributing to the CP intake not being screened within 24 hours was the type of allegation that was reported, neglect - prenatal exposure to controlled substance. The agency made a decision to hold off on screening the maltreatment report that was entered into SSIS by a backup staff. The back-up intake worker was balancing intake responsibilities with responsibilities of their primary workload, which resulted in tradeoffs. Additionally, the backup staff was not as familiar with intake procedures, as local agency practices for prenatal exposure reports had recently changed, which occurred following changes to DHS\'s maltreatment, screening, and response path guidelines. The changes to the guidance stemmed from DHS\'s interpretation of legislative changes around prenatal exposure and best practices were also defined by the state from Legislative statutes. Also influencing was a local agency workgroup, where their input and feedback on practical implementation strategies in response to prenatal exposure allegations was incorporated into the changes to guidance. The changes in guidance can conflict with the mandate to screen reports within 24 hours, as obtaining comprehensive information at the time of the report can take longer than 24 hours to receive.  \r\nThe agency interpretation of guidance influenced an internal practice change, where the agency held intakes open for prenatal exposure until they received more comprehensive collateral information from the medical provider. The agency\'s new practice prioritized making screening decisions based on lab verified toxicology results versus a positive result on an initial screening. Hospitals have policies and practices that vary in regard to testing for prenatal exposure and also for when they make a report for prenatal exposure allegations to child protection. The variability suggests some hospitals test all children, where others only test when certain criteria/risks exist when the child is born. It is collectively known that some providers may test more mothers of marginalized groups using their mental models rooted from past experiences, creating an implicit bias. This bias subjects children of marginalized groups, and their mothers to increased toxicology testing, and potentially increases the number of reports made to child protection system when results are positive. It is also collectively known that other providers perceive there being a need to preserve the patient/doctor relationship which also influences a confirmed positive toxicology report being made or not. This information on testing and reporting variability across hospitals influenced the agency\'s decision to wait for lab confirmed toxicology results before screening the report.  \r\nThis practice change was an adaptation from how the agency previously screened out prenatal exposure reports (prior to receipt of confirmed toxicology results) in order to meet the 24 hour timeline. Further Influencing the decision to not screen within 24 hours and wait for a confirmed toxicology result, was the agency\'s past experience of getting involved and working with families based on a positive initial screen, and later receiving information that the initial screen proved to be inaccurate and was a false positive. The agency worked to find balance between two priorities, the agency\'s role to protect children from harm and keep them safe, and the agency\'s duty to protect the privacy of children and families by not getting involved unjustly when credible evidence does not suggest alleged maltreatment. This goal conflict influenced the agency\'s decision to hold off on making a screening decision. \r\nThe local agency\'s interpretation of all the guidance changes supported their decision to seek collateral comprehensive information, which is suggested as best practice. Understanding it takes time, and the amount of time it takes to receive confirmed toxicology results from the lab is also dependent on, which type of toxicology test the medical provider chooses to order (urine sample, meconium, or blood cord tissue). For this case, a blood cord tissue sample was chosen, which provides most accurate results of toxicology, however, takes the most time for the lab to provide a report on the confirmed toxicology results. The time needed for child protection to wait for confirmed toxicology results contributed to the delay in screening. \r\nThe maltreatment, intake, screening, and response path guidance also require that agencies focus on vulnerability and risk of harm by assessing the impact chemical use or misuse has on child safety and use this as the primary consideration when screening. Understanding the mother\'s use alone did not constitute an unsafe child, the agency resolved the goal conflict by prioritizing the clause about â€˜impact of use or misuse on child safety\', as the guidance suggests this be the primary consideration when screening. Furthermore, the agency considered risk associated with type of drug in which results are positive, for example, response to an allegation involving THC can be different than a response to an allegation involving methamphetamine. Since the child was presumed safe, consideration was given to the best interest of the child, and the agency sought to use a trauma informed approach that honored the newborn\'s innate biological needs for physical touch, bond, and attachment with the mother, prioritizing the presumption of safety over meeting the 24 hour screening compliance metric.',1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43725,350,22,92,13,323,'Short_Answer',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43726,350,22,92,13,324,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43727,350,22,92,13,325,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43728,350,22,92,13,326,'Short_Answer',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43729,350,22,92,13,327,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43730,350,22,92,13,328,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43731,350,22,92,13,343,'Short_Answer',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43732,350,22,92,13,344,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43733,350,22,92,13,345,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:28','2021-06-01 19:46:28',NULL),(43734,350,22,92,13,346,'Multiple_Choice','3',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43735,350,22,92,13,347,'Free_Text','LP1:  CP\'s mental model was that the new CA was not using \"the green book\" to guide their decisions, and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes. \r\nCP also developed a mental model regarding not receiving support from their CA due to a history of denial to file for TPR.',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43736,350,22,92,13,348,'Multiple_Choice','3',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43737,350,22,92,13,349,'Free_Text','LP1: Stevens County has limited staff employed, leaving little time for staff to mentor the CA, as priority is given to working CP cases coming into the system. When cases are exceptionally complex, staff do not sleep or sleep at the office to complete work tasks for complex cases.',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43738,350,22,92,13,350,'Multiple_Choice','0',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43739,350,22,92,13,351,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43740,350,22,92,13,352,'Multiple_Choice','0',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43741,350,22,92,13,353,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43742,350,22,92,13,354,'Multiple_Choice','3',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43743,350,22,92,13,355,'Free_Text','LP1: A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \r\n \r\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43744,350,22,92,13,356,'Multiple_Choice','3',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43745,350,22,92,13,357,'Free_Text','LP1: Best practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \r\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43746,350,22,92,13,368,'Multiple_Choice','0',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43747,350,22,92,13,369,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43748,350,22,92,13,358,'Multiple_Choice','3',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43749,350,22,92,13,359,'Free_Text','LP1: A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \r\nBest practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \r\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.  \r\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43750,350,22,92,13,360,'Multiple_Choice','1',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43751,350,22,92,13,361,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43752,350,22,92,13,362,'Multiple_Choice','3',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43753,350,22,92,13,363,'Free_Text','LP1: A Termination of Parental Rights (TPR) was not filed by county attorney (CA) under the predatory offender statute or maltreatment determined egregious harm statute although child protection (CP) staff had multiple consults with the CA throughout the life of the case regarding child safety and best interest factors.  CP Staff drafted a petition and provided it to the CA, describing the circumstances which CP perceived to meet the TPR criteria, as CP perceived they were implementing and completing the required tasks based on their interpretation of the predatory offender and egregious harm guidance, stemming from MN laws. \r\nBest practices prescribed for these types of cases and actual support received by CP from the CA was not congruent across the systems when CP petitioned for TPR, as the CA was not certain that criteria for TPR was met, and made the decision to not file for TPR. Both the CA and CP staff had little longevity with staff experience, and a knowledge gap presented difficulties integrating knowledge into practice, influencing the trajectory of case practice. There is a lot of information to take in when learning new roles in both professions, where professionals experience a window of time called a learning curve. \r\nIn regard to the CA working a new role, there is little assistance from other attorney\'s to mentor each other, and their workload influences the amount of time available for learning and interpreting laws, as in the predatory offender and egregious harm statues involved in this case.  CP\'s mental model was that the new CA was not using the green book to guide decisions either and staff perceived the absence of requisite knowledge contributed to the CA not filing for TPR in accordance with statutes.  \r\nThere was no legal basis under compelling reasons as the crime and egregious harm occurred in the past, and the child was presumed safe in real time. There was no present imminent harm or imminent danger to the child, therefore the CA did not prioritize filing for TPR. There was also a perception that the public places higher preference on criminal case outcomes over TPR cases, and the criminal proceedings had not been completed at the time CP drafted a petition for TPR. The CA also prioritized the criminal case proceedings over filing for TPR, as using the result of the criminal case to support meeting criteria for TPR is common practice for county attorneys.',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43754,350,22,92,13,364,'Multiple_Choice','1',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43755,350,22,92,13,365,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43756,350,22,92,13,366,'Multiple_Choice','0',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43757,350,22,92,13,367,'Free_Text',NULL,1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43758,350,22,92,13,370,'Yes_or_No','Yes',1,92,92,'2021-06-01 19:46:29','2021-06-01 19:46:29',NULL),(43765,375,375,124,10,76,'Short_Answer','CareManager',1,124,124,'2021-06-08 11:16:14','2021-06-08 11:16:14',NULL),(43766,375,375,124,10,77,'Date','05/26/2021',1,124,124,'2021-06-08 11:16:14','2021-06-08 11:16:14',NULL),(43767,375,375,124,10,78,'Multiple_Choice','Emily Miller',1,124,124,'2021-06-08 11:16:14','2021-06-08 11:16:14',NULL),(43768,375,375,124,10,79,'Multiple_Choice','Kristie Pittman',1,124,124,'2021-06-08 11:16:14','2021-06-08 11:16:14',NULL),(43769,375,375,124,10,80,'Short_Answer','W.W. Homes',1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43770,375,375,124,10,81,'Short_Answer','Amy Wersal',1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43771,375,375,124,10,82,'Short_Answer',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43772,375,375,124,10,83,'Short_Answer','507-388-8343',1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43773,375,375,124,10,84,'Multiple_Choice','Termination of Services',1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43774,375,375,124,10,85,'Multiple_Choice','Blue Earth County',1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43775,375,375,124,10,86,'Date',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43776,375,375,124,10,87,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43777,375,375,124,10,96,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43778,375,375,124,10,91,'Short_Answer',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43779,375,375,124,10,97,'Date',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43780,375,375,124,10,98,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43781,375,375,124,10,99,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43782,375,375,124,10,100,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43783,375,375,124,10,127,'Short_Answer',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43784,375,375,124,10,129,'Date',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43785,375,375,124,10,130,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43786,375,375,124,10,131,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43787,375,375,124,10,132,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43788,375,375,124,10,101,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43789,375,375,124,10,102,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43790,375,375,124,10,103,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43791,375,375,124,10,104,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43792,375,375,124,10,105,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43793,375,375,124,10,106,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43794,375,375,124,10,107,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43795,375,375,124,10,108,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43796,375,375,124,10,109,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43797,375,375,124,10,110,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43798,375,375,124,10,111,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43799,375,375,124,10,112,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43800,375,375,124,10,113,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43801,375,375,124,10,114,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43802,375,375,124,10,115,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43803,375,375,124,10,116,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43804,375,375,124,10,117,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43805,375,375,124,10,118,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43806,375,375,124,10,119,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43807,375,375,124,10,120,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43808,375,375,124,10,121,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43809,375,375,124,10,122,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43810,375,375,124,10,123,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43811,375,375,124,10,124,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43812,375,375,124,10,125,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43813,375,375,124,10,126,'Free_Text',NULL,1,124,124,'2021-06-08 11:16:15','2021-06-08 11:16:15',NULL),(43819,376,376,124,10,76,'Short_Answer','CareManager',1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43820,376,376,124,10,77,'Date','05/26/2021',1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43821,376,376,124,10,78,'Multiple_Choice','Rebekah Radiske',1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43822,376,376,124,10,79,'Multiple_Choice','Jill Tilbury',1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43823,376,376,124,10,80,'Short_Answer','REM River Bluffs',1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43824,376,376,124,10,81,'Short_Answer','Chris Bonnenna',1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43825,376,376,124,10,82,'Short_Answer',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43826,376,376,124,10,83,'Short_Answer','952-852-9590',1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43827,376,376,124,10,84,'Multiple_Choice','Termination of Services',1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43828,376,376,124,10,85,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43829,376,376,124,10,86,'Date',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43830,376,376,124,10,87,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43831,376,376,124,10,96,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43832,376,376,124,10,91,'Short_Answer',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43833,376,376,124,10,97,'Date',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43834,376,376,124,10,98,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43835,376,376,124,10,99,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43836,376,376,124,10,100,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43837,376,376,124,10,127,'Short_Answer',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43838,376,376,124,10,129,'Date',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43839,376,376,124,10,130,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43840,376,376,124,10,131,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43841,376,376,124,10,132,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:41','2021-06-08 11:26:41',NULL),(43842,376,376,124,10,101,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43843,376,376,124,10,102,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43844,376,376,124,10,103,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43845,376,376,124,10,104,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43846,376,376,124,10,105,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43847,376,376,124,10,106,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43848,376,376,124,10,107,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43849,376,376,124,10,108,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43850,376,376,124,10,109,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43851,376,376,124,10,110,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43852,376,376,124,10,111,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43853,376,376,124,10,112,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43854,376,376,124,10,113,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43855,376,376,124,10,114,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43856,376,376,124,10,115,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43857,376,376,124,10,116,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43858,376,376,124,10,117,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43859,376,376,124,10,118,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43860,376,376,124,10,119,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43861,376,376,124,10,120,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43862,376,376,124,10,121,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43863,376,376,124,10,122,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43864,376,376,124,10,123,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43865,376,376,124,10,124,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43866,376,376,124,10,125,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43867,376,376,124,10,126,'Free_Text',NULL,1,124,124,'2021-06-08 11:26:42','2021-06-08 11:26:42',NULL),(43872,377,377,124,10,76,'Short_Answer','CareManager',1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43873,377,377,124,10,77,'Date','05/26/2021',1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43874,377,377,124,10,78,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43875,377,377,124,10,79,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43876,377,377,124,10,80,'Short_Answer','Cardinal of Minnesota',1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43877,377,377,124,10,81,'Short_Answer',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43878,377,377,124,10,82,'Short_Answer',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43879,377,377,124,10,83,'Short_Answer','507-281-1077',1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43880,377,377,124,10,84,'Multiple_Choice','Termination of Services',1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43881,377,377,124,10,85,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43882,377,377,124,10,86,'Date',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43883,377,377,124,10,87,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43884,377,377,124,10,96,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43885,377,377,124,10,91,'Short_Answer',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43886,377,377,124,10,97,'Date',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43887,377,377,124,10,98,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43888,377,377,124,10,99,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43889,377,377,124,10,100,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43890,377,377,124,10,127,'Short_Answer',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43891,377,377,124,10,129,'Date',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43892,377,377,124,10,130,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43893,377,377,124,10,131,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43894,377,377,124,10,132,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43895,377,377,124,10,101,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43896,377,377,124,10,102,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:23','2021-06-08 11:29:23',NULL),(43897,377,377,124,10,103,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43898,377,377,124,10,104,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43899,377,377,124,10,105,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43900,377,377,124,10,106,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43901,377,377,124,10,107,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43902,377,377,124,10,108,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43903,377,377,124,10,109,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43904,377,377,124,10,110,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43905,377,377,124,10,111,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43906,377,377,124,10,112,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43907,377,377,124,10,113,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43908,377,377,124,10,114,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43909,377,377,124,10,115,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43910,377,377,124,10,116,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43911,377,377,124,10,117,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43912,377,377,124,10,118,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43913,377,377,124,10,119,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43914,377,377,124,10,120,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43915,377,377,124,10,121,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43916,377,377,124,10,122,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43917,377,377,124,10,123,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43918,377,377,124,10,124,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43919,377,377,124,10,125,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43920,377,377,124,10,126,'Free_Text',NULL,1,124,124,'2021-06-08 11:29:24','2021-06-08 11:29:24',NULL),(43927,378,378,124,10,76,'Short_Answer','BIRF',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43928,378,378,124,10,77,'Date','05/26/2021',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43929,378,378,124,10,78,'Multiple_Choice','Liz Harri',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43930,378,378,124,10,79,'Multiple_Choice','Kelly Sather',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43931,378,378,124,10,80,'Short_Answer','Northwoods Children\'s Services',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43932,378,378,124,10,81,'Short_Answer','Jamie Ross',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43933,378,378,124,10,82,'Short_Answer','jross@northwoodchildren.org',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43934,378,378,124,10,83,'Short_Answer','218-625-0625',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43935,378,378,124,10,84,'Multiple_Choice','Elopement',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43936,378,378,124,10,85,'Multiple_Choice','St. Louis County',1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43937,378,378,124,10,86,'Date',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43938,378,378,124,10,87,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43939,378,378,124,10,96,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43940,378,378,124,10,91,'Short_Answer',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43941,378,378,124,10,97,'Date',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43942,378,378,124,10,98,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43943,378,378,124,10,99,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43944,378,378,124,10,100,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43945,378,378,124,10,127,'Short_Answer',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43946,378,378,124,10,129,'Date',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43947,378,378,124,10,130,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43948,378,378,124,10,131,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43949,378,378,124,10,132,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43950,378,378,124,10,101,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43951,378,378,124,10,102,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43952,378,378,124,10,103,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43953,378,378,124,10,104,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43954,378,378,124,10,105,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43955,378,378,124,10,106,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43956,378,378,124,10,107,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43957,378,378,124,10,108,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43958,378,378,124,10,109,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43959,378,378,124,10,110,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43960,378,378,124,10,111,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43961,378,378,124,10,112,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43962,378,378,124,10,113,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43963,378,378,124,10,114,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43964,378,378,124,10,115,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43965,378,378,124,10,116,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43966,378,378,124,10,117,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43967,378,378,124,10,118,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43968,378,378,124,10,119,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43969,378,378,124,10,120,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43970,378,378,124,10,121,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43971,378,378,124,10,122,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43972,378,378,124,10,123,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43973,378,378,124,10,124,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43974,378,378,124,10,125,'Multiple_Choice',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(43975,378,378,124,10,126,'Free_Text',NULL,1,124,124,'2021-06-08 11:32:23','2021-06-08 11:32:23',NULL),(44180,186,23,81,10,76,'Short_Answer','Care Manager',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44181,186,23,81,10,77,'Date','12/16/2019',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44182,186,23,81,10,78,'Multiple_Choice','Charles Young',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44183,186,23,81,10,79,'Multiple_Choice','Kristie Pittman',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44184,186,23,81,10,80,'Short_Answer','Harry Meyering',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44185,186,23,81,10,81,'Short_Answer','Emily Britz / Tana Helleksen',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44186,186,23,81,10,82,'Short_Answer','ebritz / thelleksen /@harrymeyeringcenter.org',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44187,186,23,81,10,83,'Short_Answer',NULL,1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44188,186,23,81,10,84,'Multiple_Choice','245D Service Termination/Suspension',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44189,186,23,81,10,85,'Multiple_Choice','Blue Earth County',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44190,186,23,81,10,86,'Date',NULL,1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44191,186,23,81,10,87,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44192,186,23,81,10,96,'Multiple_Choice','2',1,81,81,'2021-06-11 18:55:24','2021-06-11 18:55:24',NULL),(44193,186,23,81,10,91,'Short_Answer','Person\'s services were terminated due to challenging behavior',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44194,186,23,81,10,94,'True_or_False','Yes',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44195,186,23,81,10,97,'Date',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44196,186,23,81,10,98,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44197,186,23,81,10,99,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44198,186,23,81,10,100,'Free_Text','Influencing why the ICF/DD provider terminated this person’s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated. The guardians of the other 3 individuals had an expectation that the provider would keep them safe, and due to their higher vulnerability the guardians expressed their concern often in this instance. Another impact to the provider’s responsibility for people’s health and safety include county case managers assigning this function to providers via the CSSP. Unique to ICF/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF/DDs are expected to protect the people they serve from “immediate jeopardy”. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from “immediate jeopardy” in the future, so this mandate shaped the perception of the provider’s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person’s services was part of their response as to how they would respond to MDH’s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe. \r\nThe provider noted that the team had explored the possibility of implementing rights restrictions with the individual, but the team determined they wouldn’t be possible due to the requirements of 245D surrounding rights restrictions, or wouldn’t be sufficient to meet the safety needs of the person and others in the home. Due to the ineffectiveness of a rights restriction, the provider felt they had few options to address the person’s challenging behavior. \r\nAnother influence as to why the provider terminated a person’s services due to challenging behavior was that the person’s challenging behavior did not dissipate as expected after the person moved to the home. While it was known prior to intake that the person sometimes exhibited challenging behavior, there was an assumption by the team that this environment would likely help decrease the triggers that impacted the challenging behavior in the past. \r\nA number of factors were identified that  person’s challenging behavior not dissipating. For one, the provider noted that the staff at the site were trained more on meeting the medical needs of the other people in the home than de-escalating challenging behavior. While Minnesota Statutes 245D and the Positive Supports Rule (9544) required the provider to ensure their staff had training and were competent on positive support strategies, de-escalation techniques and the use of restrictive interventions, because the other people in the home didn’t exhibit challenging behavior, the focus of their training was centered more on medical needs than ‘behavioral needs’. The provider also noted that the staff felt a fear to administer pro re nata (PRN) medication to the person during mental health episodes due to the stigma of providing medication at these times and the training and reporting requirements of the Positive Supports Rule. The Positive Supports Rule (MN Rule 9544) requires providers to report the use of PRN medications when administered in a behavioral situation, and there was a belief among staff that the use of PRNs in this manner were not ok because they required reporting. \r\nThe provider – and the person’s team - expected the person’s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person’s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person’s case manager – who would typically be expected to also help find needed services – was very busy and unable to devote much time to the person’s case. A number of influences as to why case managers would be busy were identified – between high case load and recent federal and state initiatives changing services. MnCHOICES, HCBS rule and person-centered planning initiatives were all noted as positive changes, but changes that took a lot of time away from case managers to learn and meet the new requirements. This program was located in southern Minnesota, and the team noted that this region in particular has a scarcity of mental health resources. The provider and the team did find a neuropsych practitioner that was willing to work with the person, but unfortunately they were too far away and the drive was too long. This made it hard to make regular meetings and implement the neuropsych’s recommendations. Additionally, the provider was able to bring the person to a nearby hospital during challenging episodes, but noted that any interventions offered by the hospital unfortunately were ineffective.\r\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a “med holiday” – taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered “med holidays”, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \r\nWithout interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe. The provider did note that one option they wanted to explore before terminating the person’s services was to find out if they could obtain 1 on 1 staffing for the individual, but didn’t know who to ask or where to start. ICF/DD rates have many regulations and oftentimes hard to navigate they noted. The provider noted that the ability to obtain reimbursement beyond the facility’s establish rate was a mystifying process.',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44199,186,23,81,10,127,'Short_Answer',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44200,186,23,81,10,128,'Yes_or_No','Yes',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44201,186,23,81,10,129,'Date',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44202,186,23,81,10,130,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44203,186,23,81,10,131,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44204,186,23,81,10,132,'Free_Text','Influencing why this person was placed in what was seen as an atypical placement was that the person had never stayed at an ICF/DD before and the other people in the home were seen as having more medical needs than behavioral challenges. Despite these differences, the team, including the case manager, guardian and the provider thought this could be a good fit for the person because they could have more attention from staff and the person wouldn’t see the other roommates as a ‘threat’. \r\nAnother factor into this placement was that the provider had an open ICFs/DD bed. The fact it was an ICF/DD bed was one of the reasons why the bed was open. The providers in the room noted that there isn’t much interest in ICF/DD beds any more. Regionally, statewide and nationally, ICF or other institutional placements are seen as undesirable and passed over for foster care or other community-based settings. A number of factors have influenced this opinion about ICFs/DDs, including; public sentiment shifting away from institutions and large settings; the HCBS settings rule which has required systems to move towards community settings; the Minnesota Olmstead Plan which reflects the Supreme Court’s 1999 Olmstead ruling determining people should be served in the “most integrated setting”, and; the Jensen Settlement Agreement which resulted in both Minnesota’s Olmstead Plan and the closure of some institutional services.\r\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn’t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF/DD bed that needed to be filled and hadn’t had much interest from other people in. The provider was also willing to take a risk because they determined the person could do well at the site.  This determination impacted the placement and was impacted by a number of factors. While the other people in the home didn’t have similar needs as this person, the team thought this might work well in this case. The other five people in the home had higher Activities of Daily Living (ADL) needs than this person so it was thought the person wouldn’t add much to the staff’s workload in this area. The five people also exhibited challenging behavior that was more easily redirected and managed by staff, so it was thought the house wouldn’t be overwhelming for staff to manage challenging behavior in the home as a whole. Additionally, it seemed to the provider that the person’s challenging behavior appeared manageable. This was due to a number of influences such as the case manager reporting there weren’t major recent behavioral concerns and the paperwork received from the person’s previous provider before intake. Beyond the concerns around the person’s challenging behavior, the paperwork from the previous provider supported the new provider’s assessment that the person could do well at this site. The person’s psychiatrist also weighed in and supported this particular placement, contributing to this assessment.\r\nAlong with the provider being willing to take a risk by accepting the person’s placement in this atypical setting was that both the case manager and the person’s guardian were willing to take a risk by placing the person in a home that didn’t fit the ‘typical’ profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can’t meet the supervision needs of the people living there.',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44205,186,23,81,10,101,'Multiple_Choice','2',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44206,186,23,81,10,102,'Free_Text','Unique to ICF/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF/DDs are expected to protect the people they serve from “immediate jeopardy”. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from “immediate jeopardy” in the future, so this mandate shaped the perception of the provider’s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person’s services was part of their response as to how they would respond to MDH’s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe.',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44207,186,23,81,10,103,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44208,186,23,81,10,104,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44209,186,23,81,10,105,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44210,186,23,81,10,106,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44211,186,23,81,10,107,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44212,186,23,81,10,108,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44213,186,23,81,10,109,'Multiple_Choice','2',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44214,186,23,81,10,110,'Free_Text','The provider – and the person’s team - expected the person’s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person’s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person’s case manager – who would typically be expected to also help find needed services – was very busy and unable to devote much time to the person’s case. A number of influences as to why case managers would be busy were identified – between high case load and recent federal and state initiatives changing services.',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44215,186,23,81,10,111,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44216,186,23,81,10,112,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44217,186,23,81,10,113,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44218,186,23,81,10,114,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44219,186,23,81,10,115,'Multiple_Choice','3',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44220,186,23,81,10,116,'Free_Text','Influencing why the ICF/DD provider terminated this person’s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated.',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44221,186,23,81,10,117,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44222,186,23,81,10,118,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44223,186,23,81,10,119,'Multiple_Choice','3',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44224,186,23,81,10,120,'Free_Text','The provider – and the person’s team - expected the person’s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person’s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. \r\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a “med holiday” – taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered “med holidays”, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \r\n\r\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn’t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF/DD bed that needed to be filled and hadn’t had much interest from other people in\r\n\r\nAlong with the provider being willing to take a risk by accepting the person’s placement in this atypical setting was that both the case manager and the person’s guardian were willing to take a risk by placing the person in a home that didn’t fit the ‘typical’ profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can’t meet the supervision needs of the people living there.',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44225,186,23,81,10,121,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44226,186,23,81,10,122,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44227,186,23,81,10,123,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44228,186,23,81,10,124,'Free_Text',NULL,1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44229,186,23,81,10,125,'Multiple_Choice','2',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44230,186,23,81,10,126,'Free_Text','Without interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44231,186,23,81,10,432,'Yes_or_No','Yes',1,81,81,'2021-06-11 18:55:25','2021-06-11 18:55:25',NULL),(44234,187,23,81,10,76,'Short_Answer','CY_Mains\'l-HC-2020-07',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44235,187,23,81,10,77,'Date','07/28/2020',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44236,187,23,81,10,78,'Multiple_Choice','Charles Young',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44237,187,23,81,10,79,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44238,187,23,81,10,80,'Short_Answer','Mains\'l Services',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44239,187,23,81,10,81,'Short_Answer','Kelly Boser McBroom',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44240,187,23,81,10,82,'Short_Answer','kbmcbroom@mainsl.com',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44241,187,23,81,10,83,'Short_Answer','763-494-4553',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44242,187,23,81,10,84,'Multiple_Choice','245D Service Termination/Suspension',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44243,187,23,81,10,85,'Multiple_Choice','Hennepin County',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44244,187,23,81,10,86,'Date','05/29/2020',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44245,187,23,81,10,87,'Free_Text',NULL,1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44246,187,23,81,10,96,'Multiple_Choice','1',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44247,187,23,81,10,91,'Short_Answer','Service termination was issued',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44248,187,23,81,10,94,'True_or_False','Yes',1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44249,187,23,81,10,97,'Date',NULL,1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44250,187,23,81,10,98,'Free_Text',NULL,1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL),(44251,187,23,81,10,99,'Multiple_Choice',NULL,1,81,81,'2021-06-11 18:59:13','2021-06-11 18:59:13',NULL);
