<p> 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</p><p>CHILD PLACEMENT AGENCY REPORT</p><p>Provider Organization: PSI Family Services</p><p>Licensing Agency: DHR</p><p>Name of Chief Administrator: Dr. Sheila Pandit</p><p>License Type: Treatment Foster Care Type of Inspection: Mid-Licensure</p><p>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</p><p>Inspection Summary</p><p>Number of Records Reviewed: Youth 9 Staff 2 Foster Parent 12 Adoptive Parent NA</p><p>Number of Interviews: Youth 4 Staff 0 Foster Parent 4</p><p>CPA Office Inspection: Approved</p><p>Number of ILP Apartments Inspected: 0 Number of Foster Homes Inspected: 4</p><p>COMAR Violation: Ye X No s</p><p>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.</p><p>DHR/OLM (CPA) Updated: 12/11/2013 Corrective Action Plan: Yes X No If yes, date of CAP: 08/08/2014</p><p>Complaint Outcome: NA</p><p>Current Status of License: Continued</p><p>Licensing Coordinator Sherlema Ferguson Date: 08/08/2014 Email: [email protected] :</p><p>Program Manager: Richard Berger Date: 08/08/2014 Email: [email protected] </p><p>DHR/OLM (CPA) Updated: 12/11/2013</p>