Maryland Department of Human Resources Office of Licensing and Monitoring 311 W. Saratoga Street Baltimore, Maryland 21201 Office: 410.767.7871 Fax: 410.333.8408

CHILD PLACEMENT AGENCY REPORT

Provider Organization: PSI Family Services

Licensing Agency: DHR

Name of Chief Administrator: Dr. Sheila Pandit

License Type: Treatment Foster Care Type of Inspection: Mid-Licensure

Name and Address of CPA Office License Capacity DHR Census by License#/ Date of site Contract Placing Agency Exp. date Inspection Limit PSI Family Services (CFSA) 92 TFC with 35 #00302/ 07/21/2014 8301 Professional Place, Suite 205 CFSA 07/09/2015 Hyattsville, MD 20785 PSI Family Services (Maryland) Unlimited 58 39 #00301/ 07/21/2014 8301 Professional Place, Suite 205 07/09/2015 Hyattsville, MD 20785

Inspection Summary

Number of Records Reviewed: Youth 9 Staff 2 Foster Parent 12 Adoptive Parent NA

Number of Interviews: Youth 4 Staff 0 Foster Parent 4

CPA Office Inspection: Approved

Number of ILP Apartments Inspected: 0 Number of Foster Homes Inspected: 4

COMAR Violation: Ye X No s

If Yes, list Cited Violation(s) below: Violation(s) Findings 07.05.02.18 D Missing face sheet in one out of four records reviewed. 07.02.21.07 (2) Missing referral sheet in one out of four records reviewed. 07.02.21.08 A (1) Missing initial review in one out of four records reviewed. 07.02.21.08 A (2) Missing treatment plan in two out of four records reviewed. 07.02.21.08 A (3) Missing monitoring notes in two out of four records reviewed. 07.05.02.18 D (6) Missing medical records in one out of four records reviewed. 07.05.02.18 D (2) Missing birth certificate in one out of four records reviewed. 07.05.02.17 A (3) Missing immunization record in one out of four records reviewed. 07.05.02.17 A (2) Missing dental/vision in two out of four records reviewed. 07.05.02.05 B Missing foster parent application in one out of three records reviewed. 07.05.02.11 A Missing home study in two of the three records reviewed. 07.05.01.07 C (2)(d) The Board of Directors has not been meeting on a quarterly basis.

DHR/OLM (CPA) Updated: 12/11/2013 Corrective Action Plan: Yes X No If yes, date of CAP: 08/08/2014

Complaint Outcome: NA

Current Status of License: Continued

Licensing Coordinator Sherlema Ferguson Date: 08/08/2014 Email: [email protected] :

Program Manager: Richard Berger Date: 08/08/2014 Email: [email protected]

DHR/OLM (CPA) Updated: 12/11/2013