HomeMy WebLinkAbout9C - Safe Haven for Youth CUP
STAFF AGENDA REPORT
DATE:
9C
JENNITOVAR,PLANNER
DON RYE, PLANNING DIRECTOR
CONSIDER APPROVAL OF RESOLUTION 98-XX
APPROVING CONDITIONAL USE PERMIT FOR
SAFE HAVEN FOR YOUTH
FEBRUARY 2, 1998
AGENDA #:
PREPARED BY:
REVIEWED BY:
SUBJECT:
INTRODUCTION:
Mr. Dan Saad has applied for a Conditional Use Permit
(CUP) at property located at 5240 l60th Street for Safe
Haven Shelter for Youth, serving ten adolescent clients.
The property is zoned R-3 Multiple Residential. "State
licensed residential facilities serving 7 to l6 persons" are
conditional uses in the R-3 Multiple Family Residential
zoning district.
Acting on advice from the City Attorney's office, the first
public hearing on December 8, 1997 was continued by the
Planning Commission. Upon review of the application for
a CUP, it became apparent that the Comprehensive Land
Use Guide Plan indicates a land use designation of
commercial. The proposed zoning district (as part of
revised Zoning Ordinance) for the property was to be
commercial. One of the conditions of approving a CUP is
that it be consistent with the Comprehensive Plan.
The December 8, 1997 Planning Commission agenda also
included a continued public hearing on the proposed zoning
ordinance. At this hearing, Mr. Saad requested the
proposed zoning of commercial for the property at 5240
160th Street be changed to R-4 High Density Residential.
(The current zoning district of R-3 Multiple Family
Residential is comparable to that of the proposed R-4 High
Density Residential district.) The Planning Commission
amended the proposed zoning map, changing the proposed
zoning district for the property from C-l Neighborhood
Business to R-4 High Density Residential. The Planning
Commission also directed staff to prepare a Comprehensive
Land Use amendment, changing the land use designation
from C-CC Community Commercial to R-HD Residential
L:\97FILES\97CUP\97-117\97-117CC.DOC 1
16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTCNIlY E"lPLOYER
High Density.
The request for Comprehensive Land Use will be heard by
the City Council before this request for CUP (Item 9B). If
the City Council should not approve the change in
Comprehensive Plan, then the Council should not approve
this requested CUP.
The continued public hearing for the CUP was heard on
January l2, 1998 before the Planning Commission. A
neighborhood meeting was conducted by the applicant on
Tuesday January 6, 1998. The Planning Commission has
unanimously recommended approval of this CUP, with 9
specific conditions:
1. The Comprehensive Land Use Guide Plan amendment
must be approved. The amendment changes the land use
designation from C-CC Community Commercial to R-HD
High Density Residential.
2. The applicant must submit a landscape plan indicating
size, species and location of two 2Y2" trees per front yard
prior to the issuance of a building permit.
3. Prior to the issuance of a building permit, the property
owner must sign and record the necessary document
granting the 1 foot sidewalk easement to the City as
indicated on the survey including legal description as per
amended Exhibit A.
4. The improvements must be done before certified copies
of the resolution are released for recording at the county.
The applicant has 30 days to submit plans that meet the
requirements of the ordinance and conditions set forth upon
approval (City Code Section 5-6-5B). The applicant has
until one year from the date of adoption of the resolution
by the City Council to complete the required improvements
and record the resolution or the Conditional Use Permit
becomes null and void (Section 5-6-8).
5. The applicant must comply with engineering memo
dated January 9, 1998, including: obtaining the proper
permits from the county; providing more information on
utility plans, and addressing storm water run-off.
6. The group home is for youths only aged 8 to l8 and
L:\97FILES\97CUP\97-117\97-117CC.DOC
2
adults responsible for supervising the youths.
7. The group home will be used for Emotional and
Behavioral Disorders (EBD) clients only.
8. The number of residents at the group home is limit to lO
clients.
9. The building must have internal sprinkling system for
additional fIre protection.
The attached Planning Report details the facility. Several
exhibits are attached to provide the Planning Commission
and City Council with as much information as possible.
DISCUSSION:
Section 7.5(C) sets forth criteria for approval of a CUP.
These criteria and the staff analysis of compliance with
these criteria are as follows:
1. The proposed use conforms to the district permitted
and conditional use provisions and all general
regulations of this Ordinance.
The proposed use is consistent with the conditional use
provisions for the R-3 Multiple Residential zoning district
and conforms to all general regulations of the Zoning
Ordinance (upon satisfaction of conditions).
2. The proposed use shall not involve any element or
cause any conditions that may be dangerous,
injurious, or noxious to' any other property or
persons, shall comply with the performance
standards listed below.
The proposed use is a state licensed residential facility
serving lO persons. Adjacent uses are that of multi-family,
single family and commercial. The proposed use does not
appear to be dangerous, injurious, or noxious to any other
property or persons.
3. The proposed use shall be sited, oriented and
landscaped to produce harmonious relationship of
buildings and grounds adjacent to buildings and
properties.
The landscape ordinance does not apply. The subdivision
L:\97FILES\97CUP\97-ll7\97-ll7CC.DOC
3
ordinance requires two 2)12" trees to be planted in the front
yard of all lots platted under the current subdivision
regulations. Because this property is metes and bounds
(not part of a recently platted subdivision) the planting
requirements do not apply. However, under this
conditional use permit, it is appropriate to require plantings
similar to single family dwellings. Two 2)12" trees per front
yard are recommended. In this case, the lot fronts on two
streets (Franklin Trail and l60th Street). Therefore, 4 trees
are recommended, two in each front yard.
4. The proposed use shall produce a total visual
impression and environment which is consistent
with the environment of the neighborhood.
The building will be finished with typical residential
structure materials (Exhibit B). The applicant's building
elevations indicate brick and cedar siding to be the exterior
materials. The surrounding buildings are brick with wood
trim on the apartment building and residential siding on the
adjacent single family homes. The proposed materials are
consistent with adjacent materials and the effect on the
visual impact within the neighborhood is minimal.
The attached letter from Ronn Hechter dated January 3,
1998 (Exhibit I), adjacent commercial property owner,
suggest the building materials be consistent with that of the
surrounding properties. In a conversation with Mr. Hechter
on January 5, 1998, he stated that the materials should be
of brick and have a commercial or institutional appearance
to blend with the other buildings in the neighborhood. This
is a condition the Planning Commission considered, but did
not incorporate into the resolution. The Planning
Commission and staff are of the opinion that the facility is
to blend into the neighborhood and to require a commercial
or institutional appearance will make the facility stand out
and not blend with the residential character of the single
family dwellings to the east.
5. The proposed use shall organize vehicular access and
parking to minimize traffic congestion within the
neighborhood.
The proposed facility provides sufficient area for vehicular
parking. The garage can accommodate two vehicles. The
drive area and parking spaces can accommodate three to
L:\97FILES\97CUP\97-1l7\97-1l7CC.DOC
4
four additional vehicles. Considering that there are two on
site staff at all times, the parking will be adequate. City
Code requires two off street parking areas for each single
family dwelling. The traffic and vehicles at the site will be
similar to that of a single family dwelling. Access from
Franklin Trail will require a permit from Scott County.
6. The proposed use shall preserve the objectives of this
Ordinance and shall be consistent with the
Comprehensive Plan.
The current Comprehensive Plan designates the property as
commercial. The proposed use is residential. The City
Attorney's office has reviewed this issue and under State
Statute 473.858 the Comprehensive Plan is the deciding
map if a conflict between the Comprehensive Plan and
Zoning Map exists. Therefore, as directed by the Planning
Commission on December 8, 1997, staff has prepared an
amendment to the Comprehensive Plan designating this
property as R-HD (Residential High Density). Approval of
the amendment will make the proposed use compatible.
The current Comprehensive Plan designates the property as
C-CC Retail Shopping (Community). However, the
Zoning Map indicates this property to be R-3, Multi-family
Residential. The proposed Zoning Map was changed on
December 8, 1997 to zone the property as R-4 (High
Density Residential). Approval of the CUP is contingent
on approval of the amendment to the Comprehensive Land
Use Guide Plan (Item 9B).
The performance standards are set forth in Section 7.5(D)
and relate to the following factors;
. Fire protection ·
. Noise ·
. Odors ·
. Glare ·
. Water pollution.
Electrical disturbance,
Vibrations,
Air pollution,
Erosion,
The proposed project is not expected to result in any of the
nuisance factors set forth in the performance standards and
is thus consistent with these standards.
ISSUES:
The City Council must determine if the applicant meets the
requirements for granting a CUP as listed. The Planning
L:\97FILES\97CUP\97 -ll7\97 -lI7CC.DOC
5
ALTERNATIVES:
RECOMMENDATION:
ACTION REQUIRED:
Commission and staff feel that with the change of
Comprehensive Land Use Plan to R-HD, the criteria have
been met and the plans can be revised and submitted to
meet the conditions.
One of the conditions the Planning Commission
recommends in the approving resolution, is the installation
of an interior sprinkler system for additional fire protection
of the residents. The applicant is opposed to this condition.
Attached is a memo from Building Official Robert
Hutchins detailing the Uniform Building Code requirement
for such a system.
The attached resolution, if approved, grants the CUP with
specific conditions to meet the listed criteria within a
designated time frame. The attached resolution also lists
conditions to address those issues that remain unsatisfied
including landscaping and engineering issues. Revised
drawings & plans must be submitted within 30 days of
adoption of the resolution and completion of the
improvements must be done within one year of adoption of
the resolution.
1. Approve the CUP by adopting Resolution 98-XX.
2. Deny the CUP by directing staff to prepare a resolution
of denial with findings supporting such action.
3. Other specific action as directed by the Council.
Alternative #1.
Adoption of Resolution 98-XX approving a CUP for
Safe Haven for Youth.
L\97FILES\97CUP\97-ll7\97-1l7CC.DOC
6
RESOLUTION 98-XX
APPROVING A CONDITIONAL USE PERMIT TO CONDUCT "STATE LICENSED
RESIDENTIAL FACILITY SERVING 7 TO 16 PERSONS" AT 5240 160TH STREET ON
PROPERTY LOCATED IN THE R-3 MULTIPLE FAMILY ZONING DISTRICT
MOTION BY: SECOND BY:
WHEREAS, the Prior Lake Planning Commission conducted public hearings on December
8, 1997 and January 12, 1998, to consider an application from Dan Saad for a
Conditional Use Permit (CUP) for Safe Haven Shelter for Youth and the City
Council heard the case on February 2, 1998; and
WHEREAS, notice of the public hearing on said CUP has been duly published In
accordance with the applicable Prior Lake Ordinances; and
WHEREAS, the Planning Commission proceeded to hear all persons interested in this
issue and persons interested were afforded the opportunity to present their
views and objections related to the CUP of Safe Haven Shelter for Youth;
and
WHEREAS, the City Council has amended the Comprehensive Land Use Plan on
February 2, 1998 and now finds the proposed use consistent with the Year
2010 Comprehensive Plan; and
WHEREAS, the Planning Commission and City Council find the CUP of Safe Haven
Shelter for Youth in harmony with both existing and proposed development
in the area surrounding the project; and
WHEREAS, the Planning Commission and City Council find the proposed CUP is
compatible with the stated purposes and intent of the Zoning Ordinance as
they relate to conditionally permitted uses, and further, that the proposed
CUP meets the criteria for approval of CUP as contained in Section 7-5 C 1-6
of the Zoning Ordinance and Section 3 of the City Code.
NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF PRIOR LAKE:
that it approve the CUP for Safe Haven Shelter for Youth for property located at:
5240 160th Street, legally described as the South 241.7 feet of the East 200 feet of the
Southwest Quarter of the Southwest Quarter of Section 36, Township 115, Range 22,
Scott County Minnesota.
1:\97fiIes\97 cup\97 -117\res98-xx.doc E~g~ I
16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (61~) 447-4245
AN EQUAL OPPORTUNIlY EMPLOYER
Subject to the following conditions:
1. The applicant must submit a landscape plan indicating size, species and location of two 2W'
trees per front yard (Franklin Trail and 160th Street) prior to the issuance of a building
permit.
2. Prior to the issuance of a building permit, the property owner must sign and record the
necessary document granting the 1 foot sidewalk easement to the City as indicated on the
survey including legal description as per amended Exhibit A.
3. The improvements must be done before certified copies of the resolution are released for
recording at the county. The applicant has 30 days to submit plans that meet the
requirements of the ordinance and conditions set forth upon approval (City Code Section 5-
6-5B). The applicant has until one year from the date of adoption of the resolution by the
City Council to complete the required improvements and record the resolution or the
Conditional Use Permit becomes null and void (Section 5-6-8).
4. The applicant must comply with engineering memo dated January 9, 1998.
5. The group home is for youths only aged 8 to 18 and their adult supervisors.
6. The group home will be used for Emotional and Behavioral Disorders (EBD) clients only.
7. The number of residents at the group home is limited to 10 clients.
8. The building must have internal sprinkling system for additional fire protection
CONCLUSION
Based upon the Findings set forth above, the City Council hereby grants a Conditional Use
Permit for Safe Haven Shelter for Youth. The contents of Planning Case File #97 -117 are hereby
entered into and made a part of the public record and the record of the decision for this case.
Passed and adopted this 2nd day of February, 1998.
YES
NO
Mader
Kedrowski
Petersen
Schenck
Vacant
Mader
Kedrowski
Petersen
Schenck
Vacant
{Seal}
City Manager,
City of Prior Lake
1:\97fiIes\97cup\97-117\res98-xx.doc
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LEGAL DESCRIPTION:
The South 241.7 feet of the East 200 feet of the Southwest Quarter
. of the Southwest Quarter of Section 36, Township 115, Range 22,
Scott County r Minnesota.
Subject to eas~ments of record.
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fiLE COpy
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DATE:
January 9, 1998
TO:
FROM:
Jenni Tovar, Planner
Sue McDermott, Assistant City Engine:;7LJ
Safe Haven for Youth Review
RE:
The Engineering Department has reviewed the plat for the subject project and has the
following comments.
1. There are no existing sewer and water stubs to this property. A $200.00 water
tapping fee will be charged at the time of building permit application if the watermain
is tapped.
2. Westwood Drive is a private street. The applicant shall coordinate all construction
with the School District. Many issues will have to be addressed if Westwood Drive
must be closed to traffic for connection to the sewer main.
3. Illustrate emergency overflow (EOF) location and elevation for surface stormwater
overflow.
4. Show where all storm water is going (for example, direction of flow in culvert under
Westwood Drive).
5. Existing storm drain must be protected so that no silt enters the drain.
6. Provide water shut off at the property line per city specifications.
7. Show more detail of the driveway (24 foot max. at the right-of-way line).
8. Move the swale to the east and north property lines. Proposed drainage swale must be
sodded lO' wide.
9. Show more detail of insulation of sewer and water services. The survey shows only
1.5 feet of cover over the services.
. 10. Any damaged concrete walk will be the responsibility of the builder to repair.
ll. Westwood Drive is lO to II feet higher than the existing elevation near the property
line. How will this be maintained?
l2. Setbacks from county roads is 85 feet from the center line. Show the Centerline of
each county road.
13. Applicants shall draft and file all required easements.
14. Provide a copy of the access permit from Scott County.
g:\letters\sue\safehav.doc
2
tI ~, SAFEHAVENSHELTERFoRYOUTH
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I~I JAN 2 2 008 I~I
To: The members of the Prior Lake City Council
From: Dan Saad, Executive Director, Safe Haven For Youth
RE: Fire Protection Plan for Proposed Group Home
The intent of this letter is to inform you about our fire protection plan for the proposed
group home and to request the removal of a condition suggested by the planning
commISSIOn.
As a State Licensed residential facility, we will have to meet stringent building and fire
codes. One commissioner respectfully suggested we install a residential sprinkler
system. At first I thought this would be a good idea. However, after researching
sprinkler systems the following concerns were raised:
1) Because the height of the ceilings in a home are so low, the kids could have access to
them and set them off by pulling on the sprinkler head or by using a match.
2) If one sprinkler goes off, they all go off. This can cause major water damage to the
whole house.
3) The State Fire Marshall and the Building Codes do not require residential sprinkler
systems.
The main concern in the event of a fire is that everyone in the home have time to get out.
Our fire protection plan is based on the guidelines set by the State Fire Marshall and
Prior Lake Building inspectors. This plan includes: automatic interconnecting
fire/smoke detectors (with battery backups) in all bedrooms, hallways, and living areas,
a fire extinguisher mounted in the kitchen area, egress windows in all bedrooms, amble
exits from both levels of the house, and 24 hour awake supervision. If one fire/smoke
detector goes off, they all go off, and everyone in the home will be able to get out.
We feel this fire protection plan accomplishes itsgoal of allowing occupants to get out of
the home in case of fire, but does not result in water damage in case of a false alarm.
We ask that you remove the condition requiring a sprinkler system.
Th~. ' Y 0";1
~Jfr~
Dan Saad
cc: Jenny Tovar, City Planner
Memorandum
Date:
To:
From:
Re:
January 23, 1998
Jane Kansier
Robert D. Hutchins (2. \) w. .
Safe Haven for Youth
A state licensed residential facility serving 7 to l6 persons is proposed on Franklin Trail in Prior
Lake. A condition of approval from the Planning Commission is to install a sprinkler system for
the interior of the structure. In doing a preliminary plan review for this type of structure, we find
that this is an R-l Congregate Occupancy based on the 1994 Uniform Building Code (U.B.C.)
Section 3l O.l. An automatic sprinkler system is not required according to U.B.C. Section
904.2.8 unless the occupant load is 20 or more. A smoke detection system is required in all
sleeping rooms and halls and they sound an alarm in all sleeping areas. U.B.C. 3l 0.9.l.4. At the
time a complete set of building plans is submitted, a plan review can be done to determine the
code complying requirements of the building.
B7MEMO.DOe
Stamson:
. Three of the four sides are surrounded by residential.
. Identified in the Comprehensive Plan as residential.
. The use would be appropriate. Rezone the rest of the block or amend the
Comprehensive Plan.
. R-3 is appropriate.
PLANNING COMMISSION MINUTES
1/12/98
.................
. . . . . . . . . . . . . . . . . .
....................
MOTION BY STAMSON, RECOMMEND TO THE CITY COUNC~J~MEND THE
COMPREHENSIVE PLAN FOR THIS PROPERTY FROM THE c;Q:::m~SIGNATION
TO THE R3 PROPERTY, SECOND BY CRAMER. . .....
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IScusslon.:,) ..,
Kuykendall could rationalize either way but agrees with~~,r"Itrif3.kes a better
transition. The use is not there today and nothing is ta.k#.ffiaway(:
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Vote taken signified 4 ayes, 1 nay. MOTION C.ARIuEQ:;?:
~
D. Case #97-117, Safe Haven Shelter for Youth request~:)l:.Conditional Use
Permit for State licensed residential fa.:i~~::~f[Ving 10 persoi(~:::m(the R-3 District
for the property located at 5240 160th Sleee::::tt:: ..
..
..... ..... ........... .
Planner Jenni Tovar presented the Planning ~~P9fe'dat~~r'j;p.fuy l2, 1998.
........... ......
.......... ......
. . . . . . . . . . . . . . . .
The applicanFp;9P9!~S:to construct a single family dwelling for the purpose of a state
licensed residerit.~iFracility serving 10 persons. The property is on the northeast comer of
Franklin Trail a1fd 160th Street (Exhibit A). The proposed split level home will have a
total of 2,700 square feet on two levels with a 624 square foot attached garage (Exhibit
B). The house will have typical single family kitchen and dining area and living rooms
with 2 or 3 bathrooms and 6 bedrooms. The property is zoned R-3 Multiple Residential.
"State licensed residential facilities serving 7 to l6 persons" is a conditional use in the R-
3 zone.
Safe Haven Shelter for Youth is a non-profit organization, licensed by the state, to
provide group residential facilities. This is a Rule 8 group home for youth ages 8-l8.
1 :\98fi1es\98plcornrn\pcmin\rrmO 11298.doc
12
MN Statute 462.357 (or 245A.11, Exhibit C) Subdivision 3, provides for legislation
regarding zoning of group homes. Safe Haven currently has a home serving 6 persons
located at l6706 Dublin Road in Prior Lake, which opened in February 1997. Attached is
a copy of the police report for the facility on Dublin Road (Exhibit D). Group homes
serving 6 or fewer persons are permitted in the R-l Residential zoning district. The home
will serve the counties of Dakota, Scott, Le Sueur and Carver. The youth are referred by
county social services or are court ordered to the group home.
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Activities at the facility are very similar to those at a single family re~~4.igce. Visually,
the house is designed to blend in with the neighborhood. V ehicle.. s9#:sH~:~~wlude a van
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for transporting the residents and employee vehicles. There are sGI~dule(rHi'gpor
recreation activities such as football. The property is mainta;Atg..~~the staft6f.~ited
contractors including lawn maintenance and snow remova.V""
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Upon request of the Planning staff, the applicant helg@l.infomiatipnal meeting on)'
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Tuesday, January 6, 1998 to answer general questi&ns.ff.9ffi.the<p~g~Rorhood
The proposed CUP should be reviewed in accordance withlh~Bpteria found in Section
7.5(C) of the Zoning Ordinance. Section}'N?tG) provides A c6hq~~~9g~ use shall be
approved if it is found to meet specific crttfiiU"'<'"
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Comments from the publi~;:
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Applicanh:pWi:S:i~~~.14.750 WeS~~Hmsville Parkway, said he is familiar with Prior Lake
and h~:l%en a HighS~~ppl coac1i~ii6e 1993. He explained the boys are appropriate for
the!iitifhmunity and areilPtiye in chh1ll1unity programs. Staffing ratios are 1 to 3
........... .......
su;petij~~~pn. Mr. Saad re~~a letter of support from Ted Newcome, a neighbor on Dublin
Road.'A;!~wilar letter of~iipport from a neighbor on Erin Circle was submitted. The
program d~~RJpr for th@:.I~cility was also present for any questions.
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Stamson asked\\i;:IJ.Fihe plan was for the Dublin Road facility. Saad explained the boys
will transfer to menew facility and hopefully start a girl's facility on Dublin Road. The
facility will be finished right away.
Kuykendall asked if they were non-profit. Saad said they are tax exempt just like a
church would be.
Criego questioned the floor size. Saad responded the home on Dublin Road works very
easily for 6 clients. The proposed downstairs will be recreational with three bedrooms. It
is a 6 bedroom home. The office will be in the porch.
1:\98fi1es\98plcomm\pcmin\mnOI1298.doc
13
Dallas Blakeborough, representing his mother with the neighboring property said he was
hoping the zoning would stay the same because then part of her (his mother's) property
could be in the commercial district. He is concerned with the runaways in the police
report noting an elementary school and elderly home is right next door. He asked Mr.
Saad about the availability of boys from other counties. He said Saad responded that the
counties are playing hardball, if they do not agree with the program they wUltnpt use it.
Mr. Blakeborough said a halfway house was stopped from coming into !g,NMigl1borhood
a while back.:::::::::::
Peggy Howell, 9642 86th Street, Program Director for the existi~::facilitY:::I4.ressed
some of the issues above. First, the elementary school - she}Y~,fl-'.ij{ogram m~,!&~r for a
lO bed facility next to an elementary school. There were H9'jjf6b1efus and had :i:\tix::::<
comfortable position with the school. Safe Haven has~iB'beel1,:~ very comfortabl~::::::::::}
relationship with the neighbors. Secondly, Scott C"=w1i:is verY!ooited in where they are
placing children. They may not meet the strict criteria=&g~f.fe ij~*ej'b: It terms of
runaways - one of the things you will find that differentiate,~:::9pler faCilities, it is a strict
environment. Once a child leaves the facility they are consl'di~4a runaway. There are
continual head counts regarding the care9Plgr::~ildren.
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Stamson asked about where the children ai~:::f.omlhg:::.~::ty1s.H6well responded there
are many scenarios and gave examples. The::i9st.~t=:Earirfl61~~:::fu-e overloaded. The
majo~ty of children come ~9gM~~*of fosteriFe. She al~~:fexplained age limit
opemngs.
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Lawrence Blakebor9~!I~is very c9vcemed for tli:~'~afety of the neighborhood, bringing
in boys from otherC'6U1i~1~::h~~:::!9Ntmgf:Rf9lWrtY values.
..
Renee Kaiser~M\w~en, 15()5$,::Nf~en Oaks Trail, has been working as a counselor at Safe
Haven. ~A~mH!s:tW'9:::8m,1dren ag~::~:::8U9:5 and feels her children are very safe with the
c1ient~Ji~tSafe Have&':::~fif is also:9pmfortable with her own safety. It has been her
expm~nce it is safe. '::"{{::::. .:.::'
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The pllbl%mh~aring was s~'~ed at 10:l5 p.m.
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Comments:reqW:,th~i~hmmissioners:
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Cramer:
. While it is difficult for some neighborhoods, this sounds like it was a very sound run
facility. There should be some conditions.
. It meets what we are trying to do in this community.
. Supported request.
V onhof:
. Is this going to be a lock down facility? Saad responded it would not.
. What type of fire protection? Saad said they have to have meet State Fire Code.
1:\98fi1es\98plcomrn\pcmin\mnO 11298.doc
14
· Going to recommend additional fire protection and prevention via a sprinkler system.
. Support.
. Under new zoning ordinance for use with conditions with 6 to l2.
Kuykendall:
. Agreed with Commissioner V onhof.
Stamson:
. Support the CUP.
. Needed in the community.
. Appropriate area.
Criego:
. Agreed
. Add condition indicate the quality use for EBD only.
would have to come forward.
Tovar read through the conditions.
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l. The Comprehensive Land Use Gili:qe:P~~~tP~ent be approved. The
amendment changes the land use designati68fro91:e4t<4:::@~mPnunity Commercial to R-
HD High Density Residential. . .......
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2. The applicant mY:~tsubmiriJandscape:pJanindicating size, species and location
of two 2W' trees perW9ht yard prig#to the issmi.i19~bf a building permit.
5. The applicant must comply with engineering memo dated January 9, 1998,
including 85 feet from the center line of Franklin Trail.
6. The group home is for youths only aged 8 to 18.
7. The group home will be used for Emotional and Behavioral Disorders (EBD)
clients only.
8. Limit to lO clients.
1:\98files\98plcomm\pcmin\rnnO I 1298.doc
15
9. The building must have internal sprinkling system for additional fire protection.
MOTION BY CRAMER, SECOND BY CRIEGO, TO MAKE A
RECOMMENDATION TO CITY COUNCIL TO APPROVE THE CONDITIONAL
USE PERMIT FOR SAFE HAYEN AT 5240 l60TH STREET, WITH THE
CONDITIONS NOTED ABOVE AND THE CONDITIONS LISTED IN THE STAFF
REPORT.HHHHHHHH
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Vote taken signified ayes by all. MOTION CARRIED.
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E. Case #97-127, City of Prior Lake considering a pr9P9~~~::amendriiiif::~~ the
City of Prior Lake Year 2010 Comprehensive Plan ch~pgmg'tbe designatioli:gIJ4~::
property located at 6867, 6885 and 6899 Boudin Stt;'f.t:=trol1!,~ow to Medium '::'::::':.::j:'
Density Residential to the Community Retail s~,0glpg desigg:;t.Jion. H'
H
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Planning Coordinator Jane Kansier presented the Plannirig:I~p'6rt dated January l2,
1998. H' HH
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The purpose of this public hearing~..::ts.::::::::e9!Wi~er an arri~pdfnent to the 2010
Comprehensive Plan to the Community It~t~iISfi9iin.lg}:9.:~sigrtaiion. This amendment
was initiated by the Planning Commissiorl:::::~:~t:H~sii1f\qg:9i'scussion on the proposed
Zoning Ordinance. 'HH'
This site consists of aPPH~*hnately iiQ~ acres of :ilWA:f:l,nd is located at 6867, 6885 and 6899
Boudin Street. This pq:~P.ifty is 10catsP.bn the west siq~V6fHighway 13, directly south of Boudin
Street, and is the site:6N~::::waters@,g!~,9ffif~JmH9ij1g and marina.
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This property is identified asRtl&ID (Low to Medium Density Residential) on the 2010
Comprehen~~y!tM1.Mt\JJlis design@fiqp is ~haracterized by a low to medium range of residential
densitie~~:,(@?":::::':'..""" ......:.::::,:;:,:,:.....:.:...}:.. ..\,:,:://::::. ......../::.
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Thpj!iiposal is to designat~:::t,pis property for C-CC (Community Retail Shopping) uses. This
d~'fgrii~!9P is characterizeq'py retail shopping centers designed to provide shopping and
conveniEij~~,Jacilities to aJ~f3ader residential area.
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Under the prdpl!;g z:,gpHlg Ordinance, this property will be zoned C-2 (Community Business).
The purpose onhi~::'~iMrict is to allow the concentration of general commercial development for
the convenience gp:the public.
This property is the current site of an office building and marina. There is no proposal to change
these land uses.
This amendment to the Comprehensive Plan Land Use Map was initiated by the Planning
Commission as a result of discussions on the proposed Zoning Ordinance. The property owner
requested the C-2 zoning district in order to allow uses more suitable to property with highway
frontage, than uses in the C-1 district, which are primarily neighborhood oriented. The Planning
Commission agreed the property should be zoned C-2. Upon review of the Comprehensive Plan
Land Use Map, it was discovered the designation of this property is not consistent with the
1:\98fi1es\98plcomm\pcmin\mnOI1298.doc
16
PLANNING COMMISSION MINUTES
12/8/97
9
D. Case #97-1l7 Consider a Conditional Use Permit to construct a State Licensed
residential facility servicing lO persons at the property located at 5240 l60th Street.
Jenni Tovar explained proposal. One of the conditions is that use is consistent with
Comprehensive Plan. Property currently zoned R-3, but is designated for Community
Commercial on 2010 Comprehensive Land Use Plan Map. The City Attorney has
advised us to continue this item due to the upcoming zoning ordinance which may have
an effect on this property.
Dan Saad, l4750 West Burnsville Parkway, Bumsville, operate group home located on
Dublin Road in Prior Lake, and is coach at Prior Lake High School. Asking to resolve
inconsistency between Comp plan and zoning ordinance, by changing Comp Plan to R-
HD.
Explained his current operation of group home. Have had no problems in community.
Home is located on Dublin Road, in residential area. Has been a great success. Take
boys in middle and high school, and let them play football. Are looking for property in
R-3 district to allow 7-16 residents in group home. Have chosen this piece of property
near high school. Has been residential, but was designated Commercial on Comp Plan in
1996. Surrounding property is R-4, high school, commercial. The justification for change
is as follows: property is rather small, changing to R-4 would make it consistent with
surrounding area. Are also a business, so have employees. Home would fit in nicely
with area. Looking for feedback from Planning Commissioners. Have done extensive
work on this property, and have several letters of support. Prior Lake Rotary, $5,000,
Edina Realty, $7,500, Lions Club, $1,000, Optimists Club, $1,000. Other businesses
have donated products. This inconsistency came up late in the process. Asking to amend
the Comprehensive Plan to High Density Residential.
Stamson- Staffhas asked to table indefinitely to work out legalities.
Tovar- Look at this zoning map with discussion of new zoning ordinance. House
cleaning Comp Plan amendments would have to be done as a result of new zoning map.
Would be done after new zoning ordinance is amended.
Open Public Hearing:
Doug Boyle, 5140 150th Street, asked is facility. Tovar explained Safe Haven Youth is a
state licensed facility for court ordered juveniles ages 8-l7, order to live in group home
facility. Has some experience with group homes, in Sioux City, Iowa, doesn't want a
facility a block away from him. Moved to Prior Lake to get away from gangs and
criminals. Has no problem with helping kids.
Tovar explained children are there with emotional or behavioral disorders. Police report
for existing house, shows seven calls, three for runaways, two harassing phone calls to
house, noncriminal activities.
L:\97FILES\97PLCOMM\PCMIN\V1N 120897 .DOC l2
Larry , representing mother who owns adjoining property. Concerned about how many
residents would be allowed in R-4. Is there a buffer required between R-I and R-4.
Kansier Explained bufferyard requirements.
Alex ?, represents mother who owns adjacent residents. Facility is across the street form
an elderly home. Have already voiced concerns about safety of children. Also concerned
about security. If it is included, can there be request for a security fence. Is not
advantageous to area. Has developer talked to neighboring people to get
recommendations. She was not notified until found in the newspaper.
Dan Saad, incidents at existing house very minor. Runaways went home, but ended up
back at house. Facility is set up to be a step up from a foster home. The kids are already
in school. We offer a 1:5 ratio ofstaffto kids at facility. State requires a 1:l0. Staffis
all BA or MA certified. Kids are supervised when they are in the community. Intend on
going to neighbors to answer any questions. Want to work with communities. Stamson
asked if kids are coming from social services rather than criminal courts. Yes. Goal is to
get kids back to their homes whenever possible.
Kuykendall- How is program funded. Saad explained funded by a per diem from Scott
County, which covers administration. Also do some fund raising to cover costs. Host
county contract is with Scott County. Other counties abide by same contract as Scott
County. Saad explained they have looked at several sites in Chaska, but could not offer
the security he can offer now. Other locations in Scott County, have looked for over a
year. Found a rental home on Dublin. Is looking in Prior Lake because of support
received in Prior Lake.
Bill Schmokel, 415l Grainwood Circle, owner of property . Would like to speak to
process, This process was designated Commercial in June, 1996. Have had numerous
meetings with staff over past years about this property. Mr. Saad checked with staff prior
to application. When you have a conflict between Comp Plan and Zoning Ordinance,
City has 9 months to resolve issue. City has already exceeded this by 5 months. Leaves
City opened to liability. Quite dismayed that this type of application can get this far.
Kuykendall asked staff to rephrase how this got here. Tovar explained criteria number 6
states use must be consistent with Comp Plan. Right now attempting to change ordinance
to be consistent with Comp Plan. Zoning Ordinance is catching up, applicant caught in
middle.
MOTION BY VONHOFF TO CONTINUE PUBLIC HEARING INDEFINITEL Y.
SECOND BY CRAMER. MOTION CARRIED 5-0.
Tovar explained new notices will be sent.
5. Old Business: 9:20 p.m.
L:\97FILES\97PLCOMM\PCMIN\MN120897.DOC 13
PLANNING REPORT
AGENDA ITEM:
SUBJECT:
PRESENTER:
PUBLIC HEARING:
DATE:
4D
Conduct public hearing to consider a conditional use
permit (CUP) for Safe Haven for Youth (Case #97-019)
Dan Saad
5240 160th Street, located on the north side of 160th Street
and on the west side of Franklin Trail.
Jenni Tovar .J;q-
-X-YES _NO-N/A
December 8,1997
APPLICANT:
SITE:
Staff would like to table this item indefinitely. The item will be discussed prior to the 60
day statutory deadline with a 60 day extension. There is inconsistency with the
Comprehensive Plan and the pending revised Zoning Ordinance and Zoning Map will
have an effect on this request.
ACTION REOUlRED:
Because this hearing was published in the paper and legal notices were mailed, the
Planning Commission must motion to table indefinitely the public hearing. Notices will
be sent out again prior to the scheduled public hearing.
L:\97FIL.ES\97CT)P\PC~TI2.DQC L
16200 Eagle Creek Ave. ::'.t.., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER
PLANNING REPORT
AGENDA ITEM:
SUBJECT:
4D
Conduct public hearing to consider a conditional use
permit (CUP) for Safe Haven for Youth (Case #97-117)
Dan Saad
5240 160th Street, located on the north side of 160th Street
and on the west side of Franklin Trail.
Jenni Tovar
-LYES NO-N/A
January 12, 1998
APPLICANT:
SITE:
PRESENTER:
PUBLIC HEARING:
DATE:
INTRODUCTION:
The City received an application for a Conditional Use Permit (CUP) from Dan Saad on
November l7, 1997. This item was originally scheduled to be heard by the Planning
Commission on December 8, 1997. Due to inconsistency with the Comprehensive Plan
(guided commercial) and the proposed change of zoning to commercial (as part of the
revised Zoning Ordinance), the item was continued. During the continued public hearing
on the revised Zoning Ordinance, the applicant requested this property remain zoned
residential. The Planning Commission amended the proposed zoning of the lot to remain
residential and directed staff to prepare a Comprehensive Plan Amendment to designate
the land use guide as residential. The applicant has requested the CUP be reviewed
concurrently with the Comprehensive Plan Amendment. Notices were re-sent regarding
this public hearing.
The applicant proposes to construct a single family dwelling for the purpose of a state
licensed residential facility serving lO persons. The property is on the northeast comer of
Franklin Trail and 160th Street (Exhibit A). The proposed split level home will have a
total of 2,700 square feet on two levels with a 624 square foot attached garage (Exhibit
B). The house will have typical single family kitchen and dining area and living rooms
with 2 or 3 bathrooms and 6 bedrooms. The property is zoned R-3 Multiple Residential.
"State licensed residential facilities serving 7 to l6 persons" is a conditional use in the R-
3 zone.
Safe Haven Shelter for Youth is a non-profit organization, licensed by the state, to
provide group residential facilities. This is a Rule 8 group home for youth ages 8-l8.
MN Statute 462.357 (or 245A.ll, Exhibit C) Subdivision 3, provides for legislation
regarding zoning of group homes. Safe Haven currently has a home serving 6 persons
L:\97FI.kES\97ClJP\97-.I.17\97-.l17PC.DOC;; 1
16200 Eagle Creek Ave. ~.E., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNllY EMPLOYER
located at l6706 Dublin Road in Prior Lake, which opened in February 1997. Attached is
a copy of the police report for the facility on Dublin Road (Exhibit D). Group homes
serving 6 or fewer persons are permitted in the R-l Residential zoning district. The home
will serve the counties of Dakota, Scott, Le Sueur and Carver. The youth are referred by
county social service or are court ordered to the group home. Attached is Safe Haven's
contract with Scott County (Exhibit E).
Safe Haven has specific criteria for accepting residents, including participation in a
treatment program prior to move in. This home is to serve youths with emotional
behavioral disorders (EBD). The purpose of the shelter is not to be a drug or alcohol
treatment facility or half way house. It's purpose is that of a foster home by providing
care and supervision for court ordered youths. Safe Haven has 5 full time staff (director,
program coordinator, and 3 counselors) and 8 part time staff at their existing facility in
Prior Lake. All employees and volunteers must pass background checks as required by
the state. The state requires a ratio of 1 staff person at the facility to every lO residents.
However, the state recommended ratio is 1 staff person on site to every 5 residents. The
facility on Dublin Road is 1 on site staff person per 3 residents. A requirement of the
facility licensing includes 24 hour awake supervision. Attached are the licensing
requirements from the state (Exhibit F).
Activities at the facility are very similar to those at a single family residence. Visually,
the house is designed to blend in with the neighborhood. Vehicles on site include a van
for transporting the residents and employee vehicles. There are scheduled outdoor
recreation activities such as football. The property is maintained by the staff or hired
contractors including lawn maintenance and snow removal.
Upon request of the Planning staff, the applicant held an informational meeting on
Tuesday, January 6, 1998 to answer general questions from the neighborhood (Exhibit
G).
REVIEW PROCESS:
The proposed CUP should be reviewed in accordance with the criteria found in Section
7.5(C) of the Zoning Ordinance. Section 7.5(C) provides that a conditional use shall be
approved if it is found to meet specific criteria. The criteria are discussed on the
following pages.
SITE ANALYSIS:
The subject site consists of 23,994 square feet located at 5240 160th Street (Exhibit A).
The site is adjacent to single family uses to the east, along l60th Street. Directly to the
south is Westwood Drive serving the school administration building. Vacant commercial
is to the south of Westwood Drive. Multi-family apartment building is across Franklin
Trail to the west. Across l60th Street, to the south is Memorial Park and Prior Manor
senior apartments (see Site Location Map Exhibit H). The proposed building and access
will be constructed to face Franklin Trail.
L:\97FILES\97CUP\97-117\97-117PC.DOC
2
CONDITIONAL USE PERMIT ANALYSIS:
Section 7.5(C) sets forth several criteria for approval of a CUP. These criteria and the
staff analysis of compliance with these criteria are set forth below;
1. The proposed use conforms to the district permitted and conditional use
provisions and all general regulations of this Ordinance.
The proposed use is consistent with the conditional use provisions for the R-3 Multiple
Residential zoning district and conforms to all general regulations of the Zoning
Ordinance (upon satisfaction of conditions).
2. The proposed use shall not involve any element or cause any conditions that may
be dangerous, injurious, or noxious to any other property or persons, shall
comply with the performance standards listed below.
The proposed use is a state licensed residential facility serving lO persons. Adjacent uses
are that of multi-family, single family and commercial. The proposed use does not
appear to be dangerous, injurious, or noxious to any other property or persons.
3. The proposed use shall be sited, oriented and landscaped to produce harmonious
relationship of buildings and grounds adjacent to buildings and properties.
The landscape ordinance does not apply. The subdivision ordinance requires two 212"
trees to be planted in the front yard of all lots in platted under the current subdivision
regulations. Because this property is metes and bounds (not part of a recently platted
subdivision) the planting requirements do not apply. However, under this conditional use
permit, it is appropriate to require plantings similar to single family dwellings. Two 212"
trees per front yard are recommended.
4. The proposed use shall produce a total visual impression and environment which
is consistent with the environment of the neighborhood.
The building will be finished with typical residential structure materials (Exhibit B). The
applicant's building elevations indicate brick and cedar siding to be the exterior materials.
The surrounding buildings are brick with wood trim on the apartment building and
residential siding on the adjacent single family homes. The proposed materials are
consistent with adjacent materials and the effect on the visual impact within the
neighborhood is minimal.
The attached letter from Ronn Hechter dated January 3, 1998 (Exhibit I), adjacent
commercial property owner, suggest the building materials be consistent with that of the
surrounding properties. In a conversation with Mr. Hechter on January 5, 1998, he stated
that the materials should be of brick and have a commercial or institutional appearance to
blend with the other buildings in the neighborhood. This is a condition the Planning
L:\97FILES\97CUP\97-1 17\97-1 17PC.DOC
3
Commission may consider. Staff is of the opinion that the facility is to blend into the
neighborhood and to require a commercial or institutional appearance will make the
facility stand out and not blend with the residential character of the single family
dwellings to the east.
5. The proposed use shall organize vehicular access and parking to minimize traffic
congestion within the neighborhood.
The proposed facility provides sufficient area for vehicular parking. The garage can
accommodate two vehicles. The drive area and parking spaces can accommodate three to
four additional vehicles. Considering that there are two on site staff at all times, the
parking will be adequate. City Code requires two off street parking areas for each single
family dwelling. The traffic and vehicles at the site will be similar to that of a single
family dwelling. Access from Franklin Trail will require a permit from Scott County.
6. The proposed use shall preserve the objectives of this Ordinance and shall be
consistent with the Comprehensive Plan.
The current Comprehensive Plan designates the property as commercial. The proposed
use is residential. The City Attorney's office has reviewed this issue and under State
Statute 473.858 the Comprehensive Plan is the deciding map if a conflict between the
Comprehensive Plan and Zoning Map exists. Therefore, as directed by the Planning
Commission on December 8, 1997, staff has prepared an amendment to the
Comprehensive Plan designating this property as R-HD (Residential High Density).
Approval of the amendment will make the proposed use compatible. The current
Comprehensive Plan designates the property as C-CC Retail Shopping (Community).
However, the Zoning Map indicates this property to be R-3, Multi-family Residential.
The proposed Zoning Map was changed on December 8, 1997 to zone the property as R-4
(High Density Residential). Approval of the CUP is contingent on approval of the
amendment to the Comprehensive Land Use Guide Plan.
The performance standards are set forth in Section 7.5(D) and relate to the following
factors;
. Fire protection . Electrical disturbance,
. Noise . Vibrations,
. Odors . Air pollution,
. Glare . Erosion,
. Water pollution.
The proposed project is not expected to result in any of the nuisance factors set forth in
the performance standards and is thus consistent with these standards.
L:\97FILES\97CUP\97-1 17\97-1 17PC.DOC
4
CONCLUSION
Staff is of the opinion that the proposed use would be appropriate to the proposed
location and blend into the neighborhood. Staff recommends the Planning Commission
recommend approval of the CUP with the condition that two front yard trees be planted in
each front yard as required in the Subdivision Ordinance for new lots of record and that
the Comprehensive Plan amendment to R-HD Residential High Density be approved.
ALTERNATIVES:
l. Motion and second to recommend the City Council approve the CUP with specific
conditions as presented or with changes recommended by the Commission.
2. Continue the public hearing to a date and time certain to allow the developer
and/or staff to provide additional information specifically requested by the
Planning Commission.
3. Based upon expressed findings of fact, recommend the City Council deny part or
all of the application based upon consistency of the proposal with specific
regulations of the Zoning Ordinances.
RECOMMENDATION:
Staff recommends Alternative #l Motion and second recommending the Council
approve the CUP with the following conditions:
1. The Comprehensive Land Use Guide Plan amendment must be approved. The
amendment changes the land use designation from C-CC Community Commercial to
R-HD High Density Residential.
2. The applicant must submit a landscape plan indicating size, species and location of
two 212" trees per front yard prior to the issuance of a building permit.
3. Prior to the issuance of a building permit, the property owner must sign and record
the necessary document granting the lO' sidewalk easement to the City as indicated
on the survey.
4. The improvements must be done before certified copies of the resolution are released
for recording at the county. The applicant has 30 days to submit plans that are meet
the requirements of the ordinance and conditions set forth upon approval (City Code
Section 5-6-5B). The applicant has until one year from the date of adoption of the
resolution by the City Council to complete the required improvements and record the
resolution or the Conditional Use Permit becomes null and void (Section 5-6-8).
ACTION REOUIRED:
Motion and second of recommendation to the City Council.
L:\97FILES\97CUP\97-117\97-117PC.DOC
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Chapter 245A
EXHIBIT C
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surroundings.
Subd. 2. Permitted single-family residential use. Residential programS with a licensed capacity of six or
fewer persons shall be considered a permitted single-family residential use of property for the pUrposes of
zoning and other land use regulations. Programs otherwise allowed under this subdivision shall not be
prohibited by operation of restrictive covenants or similar restrictions, regardless of when entered into, which
cannot be met because of the nature of the licensed program, including provisions which require the home's
occupants be related, and that the home must be occupied by the owner, or similar provisions.
Subd. 2a. Adult foster care license capacity. An adult foster care license holder may have a maximwn
license capacity of five if all persons in care are age 60 or over and do not have a serious and persistent
mental illness or a developmental disability.
SuDd. 20. Adult foster care; family adult day care. An adult foster care license holder licensed under
the conditions in subdivision 2a may also provide family adult day care for adults age 60 or over if no
persons in the adult foster or adult family day care program have a serious and persistent mental illness or a
developmental disability. The ma."'<:imwn combined capacity for adult foster care and family adult day care is
five adults. A separate license is not required to provide family adult day care under this subdivision. Adult
foster care homes providing services to five adults under this section shall not be subject to licensure by the
commissioner of health under the provisions of chapter 144, 144A, 157, or any other law requiring facility
licensure by the commissioner of health.
~
Subd. 3. Permitted multifamily residential use. Unless otb.erwise provided in any town, municipal, or
county zoning regulation, a licensed residential program with a licensed capacity of seven to 16 persons shall
be considered a permitted multifamily residential use of propeny for the purposes of zoning and other land
use regulations. A town, municipal, or county zoning authority may require a conditional use or special use
permit to assure proper maintenance and operation of a residential program. Conditions imposed on the
residential program must not be more restrictive than those imposed on other conditional uses or special uses
of residential property in the same zones, unless the additional conditions are necessary to protect the health
and safety of the persons being served by the program. Nothing in sections 245A.01 to 245A.16 shall be
construed to exclude or prohibit residential programs from single-family zones if otherwise permitted by local
zoning regulations.
Subd. 4. Location of residential programs. In determining whether to grant a license, the commissioner
shall specifically consider the population, size, land use plan, availability of community services, and the
number and size of existing licensed residential programs in the town, municipality, or county in which the
applicant seeks to operate a residential program. The commissioner shall not grant an initial license to any
residential program if the residential program will be within 1,320 feet of an existing residential program
unless one of the following conditions apply: (1) the existing residential program is located in a hospital
licensed by the commissioner of health; (2) the town, municipality. or county zoning authority grants the
residential program a conditional use or special use permit; (3) the program serves six or fewer persons and
is not located in a city of the first class; or (4) the program is foster care.
Subd. 5. Overconcentration and dispersal. (a) Before January 1, 1985, each county having two or more
group residential programs wirhin 1,320 feet of each o2~er shail su~~! DEe _ J iCQ7 services a
l
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12/01/97
ICR RPD
-/lU"l 90 - Of~ fG--b q 7 EXHIBIT 0
....J V PAGE 1
ICR PLC ICR UOC 1 LIT
-------------------
---------------------------------------------
O)./L.L./:1tl
03/17/97
07/04/97
08/13/97
08/24/97
08/26/97
09/03/97
11/08/97
11/21/97
.J.b/Ub ,uC':BLIM Ron
16706 DUBLIN
16706 DUBLIN
16706 DUBLIN
16706 DUBLIN
16706 DUBLIN
16706 DUBLIN RD
16706 DUBLIN
16706 DUBLIN
,uOME.s~'J:C
RUNAWAY
ALL OTHERS - AJ 0 J!) -c \)., m I A) I'l L.
RUNAWAY
RUNAWAY
PROWLER
ALL OTHERS -IJD () C iZ./Ynlvf!L.
PUBLIC PEACE-HARASSING PHONE CALLS TO MOOSe
PUBLIC PEACE-HARASSING PHONE CALLS TO rlou)F
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EXHIBIT E
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980131
LEAD COUNTY
PURCHASE OF SERVICE AGREEMENT
THIS AGREEMENT, made and entered into by and between the County of Scott, Courthouse 300, 428
Holmes Street South, Shakopee, Minnesota 55379-1375, through the Human Services Department.
hereinafter referred to as the "County," and Safe Haven Shelter for Youth, DBA Safe Haven For Youth,
16706 Dublin Road, Prior Lake, Minnesota 55372 hereinafter referred to as the "Provider."
WITNESSETH:
WHEREAS, the County, through the Department, wishes to enter into a lead county contract with
the Provider for the provision of group home care and support services; and
WHEREAS, the Provider desires to and represents that he is qualified to furnish these services
according to the terms and conditions stated herein; and
WHEREAS, the County, through the Department, and the Provider, according to Minnesota
Statutes Section 256E.05, and Minnesota Rule 9550.0040, Subparts 7 and 8, understand and agree that
this Agreement shall serve as a lead county contract for group home care and support services purchased
by financially responsible agencies of other Minnesota counties;
WHEREAS, the Scott County Human Services Committee of the Whole on December 17, 1996,
directed the County to enter into a contract with the Provider for the provision of said services, and
NOW THEREFORE, in consideration of the mutual understandings and agreements set forth
herein, the County and Provider agree as follows:
1. Definitions
----
The following definitions apply to the terms used in this Agreement:
A. Aqencv of Financial Responsibility The county responsible for the arrangement for
payment of individual client social services by the Minnesota Department of Human
Services pursuant to Minnesota Statute 256G.02, subd. 4.
B. Lead or Host County. A county (in this instance, Scott County) that negotiates and
administers a contract for the provision of social services from an approved vendor on
behalf of itself or at the request of another county pursuant to Minnesota Rule 9550.0040,
C. Placement Aqencv. An agency responsible through voluntary agreement with the client's
parent or guardian, or court order, for arranging and providing social services to children.
2. Purchased Services
A. As specified in this Agreement and in the attachments hereto and herein incorporated in
this Agreement, the Agency of Financial Responsibility agrees to purchase and the
Provider agrees to furnish to eligible county clients group home care and support services
under Minnesota Rule 9545.1400-.1500, as described in Attachment A. Such services
shall hereinafter be referred to as "Purchased Services."
B. The Provider also agrees to provide:
1
(1) An explicit description of the services to be provided, including admission and
demission criteria;
(2) A description of the staffing, including job descriptions and professional
qualifications of personnel;
(3) An organization chart, including names and addresses of the Board of Directors;
.(4) The number of program participants and the licensed capacity of program; and
copy of the Rule 8 license,
(5) Program content,
(6) Program budget. and
(7) Copy of the Lease for the premises.
C. The Provider shall, in writing within ten (10) days. notify the County whenever it is unable
to, or going to be unable to. provide the required quality or quantity of the Purchased
Services. Upon such notification, the County shall determine whether such inability shall
require modification or cancellation of said Agreement.
D. The term of this Agreement shall be from February 1, 1997, through January 31, 1998,
not withstanding the date of the signatures of the parties to this Agreement. This
Agreement may be renewed at the option of the County.
3. Eliqibilitv for Services
Eligibility for Purchased Services shall be determined by the following criteria:
A. The amount. frequency, and duration of purchased services shall be in accordance with
the placement agency's client's placement plan. The parties understand and agree that
the agency of financial responsibility shall determine preliminary and final client eligibility.
B. The amount, frequency and duration of purchased services shall be directed towards
achievement of client's goals and objectives as specified in the placement agency's
placement plan and the Provider's individual placement plan.
C. Referrals shall be accepted by the Provider only from a child placement agency
authorized to make placements by the State of Minnesota(includes Interstate Compact
referrals from other states.)
D. The placement agency and agency of financial responsibility shall together designate only
one primary placement worker, who shall coordinate all Client information and shall be
responsible for the following:
Complete the placement plan required by M.S. 257.071 and provide a copy to the
Provider.
Be responsible for all court and administrative reviews required by law.
Establish client financial responsibility, eligibility, fee collection, and fee setting.
Provide all required referral information at time of admission.
Review and authorize or disallow proposed services by the Provider that are not covered
by this document or the Placement Agreement.
2
-- ----T
E. The Provider shall be responsible as follows:
(1) Maintain control and authority over and autonomy with respect to program
implementation and personnel for providing service.
(2) The Provider, placement agency, and agency of financial responsibility shall
complete a Placement Agreement form (Attachment B) prior to admission
whenever possible, or within seven (7) days of admission.
(3) No charge shall be incurred for any program or service fee for services provided
to social services eligible clients in excess of the daily rate, unless it was
established in the client's Placement Agreement or other written document
between Provider and agency of financial responsibility.
F. When the agency of financial responsibility has determined that a client is no longer
eligible to receive services or that services are no longer needed or appropriate, the
agency of financial responsibility shall notify the Provider within five (5) days of the
determination.
G. The Provider shall notify the agency of financial responsibility and the client in writing
whenever the Provider proposes to discharge or terminate service(s) to a client. The
notice must be sent at least ten (10) days prior to the proposed date of discharge or
termination and must include the specific grounds for discharge or termination of
service(s). The Provider shall not discharge or terminate services to a client prior to the
proposed date unless delay would seriously endanger the health, safety, or well-being of
the client or others.
H. The Provider shall establish written procedures for discharging a client or terminating
services to a client. The written procedures shall include:
(1) Preparation of a summary of findings, events, and progress during the period of
service to the client.
(2) Written evidence of the reason for the discharge.
(3) Specific recommendations for future programming.
4. Individual Service Plans
A. Services provided shall be designed to assure that the client attains the goals specified in
the client's Individual Service Plan (ISP).
B. If requested, the Provider agrees to submit monthly reports and progress notes on
individual clients to the agency of financial responsibility, the client, and the client's legal
guardian, if any. The Provider agrees to develop requested reports that shall contain
sufficient specificity to enable the agency of financial responsibility to determine the
progress made in relation to the objectives in the client's ISP.
C. The Provider agrees to participate in all interdisciplinary team meetings related to each
client receiving services under this Agreement.
D. Performance of the Provider shall be monitored and evaluated in accordance with client
outcomes as specified in the ISP goals and objectives.
E. The agency of financial responsibility shall not delegate the development of ISPs to the
Provider.
3
5. Host/Lead County Contract
This Agreement may be accessed as a host or lead county contract under applicable law and
rules of the Minnesota Department of Human Services. All local agencies that purchase services
from Provider shall abide by the terms of this Agreement. Such local agencies shall be financially
responsible under the terms of this Agreement for those clients they refer to Provider for services.
The County shall monitor the terms of this Agreement and shall make available, upon request of
other local agencies, copies of this Agreement.
The Provider also agrees that other requesting counties, subject to availability, shall be authorized
to avail themselves of the services of the Provider pursuant to the terms, conditions, and mutual
obligations of this Agreement with the County. Upon approval, from the authorized agent of the
County, the Provider shall bill the requesting county directly for services provided. All other terms
and conditions of this Agreement shall remain in full force and effect as to the Provider, the
County, and the requesting county as a third-party beneficiary.
6. Cost and Delivery of Purchased Services
In order to maintain the highest level of the provision of Purchased Services to the client as
described in the client's ISP, Purchased Services shall be furnished and payment shall be made in
the following manner.
A. The unit cost for providing group home care and support services for clients shall be one
hundred fifteen dollars ($115.00) per day from February 1, 1997, through January 31,
1998.
B. The Provider shall establish and submit to the County an operating budget for the contract
year based on the projected expenses. The operating budget for 1997 is $204,845 and
the average number of clients in residence per day is 4.88. The unit cost is established
by dividing the operating budget by the anticipated average number of clients in residence
and by the number of operation days for the contract year.
C. The Provider certifies that the Purchased Services to be provided under this Agreement
do not reflect any administrative or program costs assignable to private payor third-party
pay service recipients.
D. The County, placement agency, or agency of financial responsibility, does not guarantee
operational costs of the Purchaser's facility and shall only pay for services agreed to in
the Placement Agreement.
E. Purchased Services shall be provided at 16706 Dublin Road, Prior Lake, Minnesota
55372.
7. Method of Payment
A. Within fifteen (15) working days following the last day of each calendar month, the
Provider shall submit to the agency of financial responsibility duplicate invoices, in form
approved by the County, identifying Purchased Services provided individual clients during
the preceding month. The authorized agent of the agency of financial responsibility shall
have the authority to review invoices, and no payment shall be made without the approval
of the authorized agent.
4
B. The agency of financial responsibility shall make payment directly to the Provider within
thirty (30) days after receipt of invoices identifying Purchased Services provided to clients,
provided that such payments shall be subject to adjustment by the agency of financial
responsibility due to inaccuracies in invoices both before and after payment is made.
C. Payment for Purchased Services shall be made by the agency of financial responsibility at
the stated payment per unit of service. Payments to the Provider for Purchased Services
shall be based on actual units of service provided, with payments commencing the date
in, but ending the day prior to the day of discharge. Actual units of service are those units
in which the enrolled client is in attendance, but also include up to four (4) days following
the client having absconded or emergency hospitalization.
D. In the event that services provided to eligible recipients may be reimbursed by private
health insurance or Medical Assistance, the Provider shall bill such third parties prior to
billing the agency of financial responsibility.
E. It is understood and agreed by the parties that the County assumes no obligation to
purchase from Provider any minimum amount of services as defined by the terms of this
Agreement.
F. It is understood and agreed by the parties that the County assumes no financial
responsibility to Provider for Purchased Services provided pursuant to an agreement
between Provider and any entity other than Scott County.
8. Condition of Payment
All services provided by Provider pursuant to this Agreement shall be performed to the satisfaction
of the County, and in accordance with all applicable federal, state, and local laws, ordinances,
rules, and regulations. Payment shall be withheld for work found by the agency of financial
responsibility to be unsatisfactory, or performed in violation of federal, state, or local laws,
ordinances, rules, or regulations. If Provider and the County or agency of financial responsibility
agree, any controversy or claim arising out of or relating to this Agreement may be settled
between the parties by arbitration in accordance with the commercial Arbitration Rules of the
American Arbitration Association. Each party shall pay its own costs resulting from the utilization
of the arbitration process. The fees and costs charged by the American Arbitration Association
shall be bome equally by the parties.
9. Information. ReportinQ Requirements
A. The Provider shall do the following
(1) Maintain records on all admissions as stated in Minnesota Rule 9545.1400-.1500.
(2) Complete an individual placement plan within thirty (30) days of placement for
each client, signed by the client, the parents, the group home, and the placement
worker. (This plan is to supplement the placement plan required of the placement
worker by M.S. 257.071).
(a) This plan shall include a description of the issue that led to placement,
the placement goals for the client and family, and the steps and tasks
necessary to complete the goal.
(b) The goals and length of the group home program enrollment for each
client shall itemize projected completion dates. The plan shall be
5
reviewed no less frequently than every three (3) months by all parties,
with the time and place to be set by the group home staff.
(3) Assist the County in its obligation to evaluate and monitor the Provider's
performance and allow personnel of the County access to the Provider's
premises.
(4) The Provider shall, upon reasonable notice. meet with County personnel to assist
the County in evaluation of services.
B. The Provider shall furnish the County financial and program information required for
effective contract management, program evaluation. and development. At a minimum
such information shall be provided to the County within fifteen (15) days of the end of
each quarter during the contract year and include the following:
(1) Expenditure and revenue reports related to providing the services within this
Agreement in the format of the contract budget.
(2) Performance and Outcome Measures Quarterly Report in a format provided by
the County. (See Attachment C.)
(3) Summary of quality assurance surveys to clients, parents, and placing agencies
shall be provided to the County quarterly.
(4) Summary of the status of the residents' goal attainment.
C. The Provider agrees to maintain books, records, documents, and other evidence and
accounting procedures and practices which sufficiently reflect all direct and indirect costs
of any nature incurred in the performance of this Agreement, as well as program records
reflecting services provided. These books, records, documents, accounting procedures
and practices, and program records relevant to the Agreement shall be subject at all
reasonable times to inspection, review, copy, or audit on site by personnel of the County,
personnel authorized by the County, the Minnesota Department of Human Services, the
Untied States Department of Health and Human Services, and either the Legislative
Auditor or the State Auditor as appropriate. The Provider agrees to maintain financial
records for six (6) years after the last date of service under this Agreement or such
additional period of time as may be required by state or federal law and provided that the
County may, by furnishing written notice during the term, require continued retention of
records to allow completion of an audit by the County or its ultimate funding source. The
retention period shall be automatically extended during the course of any administrative or
judicial action involving the County regarding matters to which the records are relevant.
The retention period shall be automatically extended until the authorized agent of the
County notifies Provider in writing that the records need no longer be kept.
D. The County may duplicate, use, and disclose in any manner consistent with the provisions
of the Data Privacy Clause in this Agreement, and have others do so. all data delivered
under this Agreement.
E. The County may evaluate the performance of the Provider in regard to the provisions of
this Agreement prior to its termination. The County reserves the right to authorize and
purchase an independent evaluation under this paragraph.
F. The Provider agrees to inform the County of facility location, licensure. or ownership
changes within five (5) days after such changes occur. The Provider agrees to inform the
6
County of Board of Director membership, program or staffing plan changes, within fifteen
(15) days of the end of each quarter.
G The Provider agrees to maintain on file ISPs for all clients.
H. The Provider agrees to maintain other program records required by the County and
records on each eligible recipient as required by the Minnesota Department of Human
Services.
I. The Provider hereby agrees that it shall submit annual audit reports to the authorized
agent of the County as identified in Clause 10 herein.
10. Authorized AQents
The County and Provider shall appoint an authorized agent for the purpose of administration of
this Agreement. Provider is notified the authorized agent of Scott County is:
Tom 8ehr, Social Services Manager
Scott County Human Services
Courthouse 300
428 Holmes Street South
Shakopee, Minnesota 55379-1375
(612)496-8120
The County is notified the authorized agent of Safe Haven Shelter for Youth, D8A Safe Haven for
Youth, is:
Daniel Saad, Executive Director
Safe Haven Shelter for Youth, DBA Safe Haven for Youth
16706 Dublin Road
Prior Lake, Minnesota 55372
11. Standards and Licenses
A. If required to be licensed by any federal, state, or local statute, ordinance, or rule to
provide services contemplated herein, the Provider shall remain licensed during the term
of this Agreement. The County shall only pay for Purchased Services provided pursuant
to such licensing requirements.
8. When licensing is required, loss of the same shall be cause for cancellation of this
Agreement effective as of receipt of notice of cancellation, other provisions for
cancellation of this Agreement notwithstanding.
C. The Provider shall comply with all applicable federal and state statutes and regulations,
as well as local ordinances and rules, now in effect or hereafter adopted.
D. Other provisions for cancellation of this Agreement notwithstanding, failure to meet the
requirements of At 8, and C as stated above may be cause for cancellation of this
Agreement effective as of receipt of notice of cancellation.
12. Data Privacy
Provider and any subcontractor of Provider agree to abide by the provisions of the Minnesota
Government Data Practices Act, Minnesota Statute Chapter 13, as amended, and Minnesota
7
Rules promulgated pursuant to Chapter 13 in providing all services hereunder. The Provider
designates Daniel Saad, Executive Director, as its Responsible Authority pursuant to the
Minnesota Government Data Practices Act, Minnesota Statute Chapter 13, as the individual
responsible for the collection, maintenance, use, and dissemination of any set of data on
individuals, government data, or summary data pursuant to this Agreement.
13. Equal Emplovment Opportunity and Nondiscrimination
In connection with the work performed under this Agreement, Provider agrees to comply with the
applicable provisions of state and federal equal employment opportunity and nondiscrimination
statutes and regulations. In addition, upon entering into this Agreement, Provider certifies that it
has been made fully aware of the County's Equal Employment Opportunity and Americans with
Disabilities Act policy, attached hereto and incorporated herein as Attachment D, through both
oral and written communications. that it supports this policy. and that it shall conduct its own
employment practices in accordance therewith. Failure on the part of the Provider to conduct its
own employment practices in accordance with the policy may result in the withholding of all or part
of regular payments by the County due under this Agreement unless or until Provider complies
with the County policy. and/or suspension or termination of this Agreement.
14. Fair Hearinq and Grievance Procedure
A. The Provider shall establish a system through which eligible recipients may present
grievances about the operation of the service program, and the Provider shall advise
eligible recipients of this right.
B. The agency of financial responsibility shall advise applicants and eligible recipients of all
of their rights to a fair hearing and the appeal process as provided by Minnesota Rules
Chapter 9550.0092, including, but not limited to, their right to appeal denial or exclusion
from the program or failure to recognize an eligible recipient's choice of a service and of
his/her right to a fair hearing. The agency of financial responsibility shall make
arrangements to provide such a hearing through its regular fair hearing procedures. The
applicant or eligible recipient shall be informed of such rights by information on the
application for Purchased Services.
15. Technical Assistance and Disputes
A. The County shall offer assistance to the Provider to develop service, understand the
terms of the Agreement, and provide consultation to the Provider and the County, through
the Department. A coordinator from the County shall be identified by the Department's
authorized agent in dealing with the Provider.
B. Except as otherwise provided in this Agreement, any dispute concerning a question of
fact arising under this Agreement which is not disposed of by negotiation and agreement
shall be decided by the Contract Manager, who shall reduce his/her decision to writing
and furnish a copy thereof to the Provider. The decision of the Contract Manager shall be
final and conclusive unless, within thirty (30) days from the date of receipt of such copy,
the Provider furnishes to the Contract Mal1ager a written appeal addressed to the County.
The decision of the County, or its duly authorized representative for the determination of
such appeals, shall be final and conclusive unless determined by a court of competent
jurisdiction to have been fraudulent, capricious, arbitrary, so grossly erroneous as
necessary to imply bad faith, or not supported by substantial evidence. In connection with
any appeal proceeding under this Clause, the Provider shall be afforded an opportunity to
be heard and to offer evidence in support of its appeal. Pending final decision of a
8
dispute hereunder, the Provider shall proceed diligently with the performance of the
Agreement and in accordance with the Contract Manager's decision.
16. Indemnitv. Insurance. and Independent Provider Status
A. Indemnity. The Provider shall save and protect. hold harmless, indemnify, and defend the
County, its commissioners, officers, agents, employees, and volunteer workers against
any and all liability, causes of action, claims, loss, damages, or cost and expense arising
from, allegedly arising from, or resulting directly or indirectly from any professional errors
and omissions and/or negligent acts and omissions of Provider, its agents, officers, or
employees in the performance of this Agreement.
B. Insurance. The Provider does further agree that in order to protect itself as well as the
Department and Scott County under the indemnity agreement provision hereinabove set
forth, it shall at all times during the term of the Agreement have and keep in force:
(1) Workers' Compensation: Provider shall obtain and maintain for the duration of
this Agreement statutory workers' compensation insurance and employers'
liability insurance as required under the laws of the State of Minnesota.
(a) State: Minnesota - Statutory
(b) Employers' Liability
(c) Benefits Required by Union labor Contracts: As Applicable
In the event Provider is excluded or excepted from this requirement pursuant to
Minnesota Statute Section 176.041 Subdivision 1, and has not elected to provide
workers' compensation insurance pursuant to Minnesota Statute Section 176.041
Subdivision 1a, Provider shall be required to execute and submit a sworn and
attested affidavit of exclusion or exemption in a form satisfactory to the County
prior to entering into this Agreement.
(2) Comprehensive General Liability (including Premises-Operations; Independent
Providers' Protective; Products and Completed Operations; Broad Form Property
Damage; Contractual):
Provider shall obtain the following minimum insurance coverage and maintain it at
all times throughout the life of the Agreement.
Bodily Injury:
$1,000,000 per occurrence
$1,000,000 products and completed operations
$1,000,000 per occurrence
Property Damage:
(3) Personallniurv Liability (with Employment-Related Exclusion Deleted):
Limit:
$1,000,000 per occurrence
(4) Professional Liability (Malpractice):
Limit:
$1,000,000 per occurrence
(5) Comprehensive Automobile Liability (Owned, Nonowned, Hired):
Bodily Injury:
$1,000,000 per person
$1,000,000 per occurrence
9
Property Damage:
$1,000,000 per occurrence
(6) 80ndinq: The Provider shall obtain and maintain at all times during the term of
this Agreement a fidelity bond in the amount of not less than $10,000.00 covering
the activities of each person authorized to receive or distribute monies.
C. Proof of Insurance. Insurance certificates evidencing that the above insurance is in force
with companies acceptable to the County and in the amounts required shall be submitted
to the County for examination and approval prior to the execution of the Agreement, after
which they shall be filed with the County. The insurance certificates shall specifically
provide that a certificate shall not be modified, canceled, or nonrenewed except upon
thirty (30) days' prior written notice to the County. Neither the County's failure to require
or insist upon certificates or other evidence of insurance, nor the County's acceptance of
a certificate or other evidence of insurance showing a variance from the specified
coverage, changes Provider's responsibility to comply with the insurance specifications.
D. The County may withhold payment for failure of the Provider to furnish certificates of
bonding and/or insurance as required above.
17. Independent Provider
It is agreed that nothing contained in this Agreement is intended or shall be construed as creating
the relationship of copartner, joint venturers, or an association with the County and the Provider.
The Provider is an independent Provider and neither it, its employees, agents, nor representatives
shall be considered employees, agents. or representatives of the County. Except as otherwise
provided herein, the Provider shall maintain, in all respects, its present control over the application
of its intake procedures and requirements to clients and the means and personnel by which this
Agreement is performed. From any amounts due the Provider, there shall be no deduction for
federal income tax or FICA payments, nor for any state income tax, nor for any other purposes
which are associated with an employer/employee relationship unless required by law. Payment of
federal income tax, FICA payments, and state income tax are the sole responsibility of the
Provider.
18. Modification of AQreement
The parties agree that no change or modification to this Agreement, or any attachments hereto,
shall have any force or effect unless the change is reduced to writing, dated, and made part of this
Agreement. The execution of the change shall be authorized and signed in the same manner as
for this Agreement.
19. Conditions of the Parties' ObliQations
A. It is understood and agreed that if during the term of this Agreement reimbursement to the
agency of financial responsibility from state and/or federal sources is not obtained and
continued at an aggregate level sufficient to allow for the purchase of the indicated
quantity of Purchased Services, then the agency of financial responsibility may cancel or
amend this Agreement, provided that any cancellation of this Agreement shall be without
prejudice to any obligations or liabilities of the parties already accrued prior to such
cancellation.
8. Claims for expenditures made in excess of budget categories which do not increase the
County's total cost for this Agreement shall be allowed only when approved in writing by
the Contract Manager. Such approval shall not be deemed a material modification of the
Agreement.
10
C. The Provider shall comply with all of the provisions of:
(1) The Maltreatment of Minors Reporting Act, Minnesota Statutes Section 626.556,
as amended, and Minnesota Rules, Chapter 9560, implementing such Act now in
force or hereafter adopted.
(2) The Vulnerable Adults Reporting Act, Minnesota Statutes Section 626.557, as
amended, and Minnesota Rules, Chapter 9555, implementing such Act now in
force or hereafter adopted.
D. If the County, through the Department, has sufficient reason to believe that the safety or
well-being of eligible recipients receiving service hereunder may be endangered by
actions of the Provider, its agents, and/or employees, the County, through the
Department, may require the immediate cessation of services to eligible recipients, as
well as their removal from the facility, and may discontinue referrals to the Provider. No
payments shall be made for the period during which services are suspended unless
otherwise determined by the County.
E. The County shall withhold reimbursement to the Provider if either the County or the
Minnesota Department of Human Services has reasonable grounds to believe that the
Agreement of the County with the Provider or the subcontractor of the Provider has been
breached in any manner. If the breach occurs, the County or agency of financial
responsibility may recoup any payments made. The Provider acknowledges and agrees
that the Minnesota Department of Human Services is a third-party beneficiary, and as
such is an affected party under this Agreement and as such may recoup payments made
by the County to the Provider in event of breach of this Agreement if the County does not
recoup the payments.
20. SubcontractinQ and AssiQnments
The Provider shall neither enter into subcontracts for performance of any of the Purchased
Services contemplated under this Agreement, nor assign this Agreement, without the prior written
approval of the County and subject to such conditions and provisions as the County, through the
Department, may deem necessary. The Provider shall be solely responsible for the breach,
nonperformance, or performance of all subcontractors.
21. Default
The Provider, after receipt of notice by the Contract Manager of any of the following conditions or
other circumstances warranting cancellation of this Agreement, shall have ten (10) days (or such
longer period as the Contract Manager may authorize in writing) after receipt of notice from the
Contract Manager to cure the specified failure, including, but not limited to:
A. If the Provider fails to provide services called for by this Agreement within the time
specified herein or any extension thereof; or
B. If the Provider is in such financial condition so as to endanger the performance of this
Agreement; or
C. If the Provider fails to perform any of the other provisions of this Agreement, or so fails to
prosecute the work as to endanger performance of this Agreement in accordance with its
terms; or
11
D. If it is discovered that material misrepresentations were made by the Provider as to
conditions relied upon by the County which purported to exist by the terms of this
Agreement and all exhibits and documents attached hereto and incorporated by
reference.
If the Provider fails to cure the specified condition after notice within the prescribed period of time,
then the County may upon written notice immediately cancel the whole or any part of this
Agreement.
22. Termination and Finalization
A. This Agreement or a portion thereof may be terminated by either party at any time, with or
without cause, upon thirty (30) days' written notice, delivered by mail or in person to
Provider or the authorized agent of the County. The Provider and the County shall
address its communication to the authorized agents as identified in Clause 10 of this
Agreement.
B. After receipt of a notice of termination. and except as otherwise directed, the Provider
shall:
(1) Discontinue provision of Purchased Services under this Agreement on the date,
and to the extent specified, in the notice of termination.
(2) Terminate all orders and subcontracts to the extent that they relate to the
performance of Purchased Services terminated by the notice of termination.
(3) Settle all outstanding claims and liabilities for orders and subcontracts existing at
the time of the notice of termination, provided, however. that the claims and
liabilities for orders and subcontracts had been approved by the County.
(4) Complete performance of such Purchased Services as shall not have been
terminated by the notice of termination.
(5) Submit a revenue and expense statement for the performance of Purchased
Services prior to the effective date of termination within thirty (30) days of said
date.
(6) Maintain all records relating to performance of the terminated portion of the
Agreement as may be required by the County, through the Department.
(7) Notify all clients and any other counties of financial responsibility of the
termination of this Agreement.
23. Notices
Any notices to be given under this Agreement shall be given by enclosing the same in a sealed
envelope, postage prepaid, and depositing the same in the United States Postal Service,
addressed to Provider at its address stated herein and to the authorized agent of the County at
the address stated herein.
24. Controllina Law
This Agreement is to be governed by the laws of the State of Minnesota.
12
25. Successors and AssiQns
The County and Provider, respectively, bind themselves, their partners, successors, assigns, and
legal representatives to the other party to this Agreement and to the partners, successors,
assigns, and legal representatives of such other party with respect to all covenants of this
Agreement. Neither the County nor Provider shall assign, sublet, or transfer any interest in this
Agreement without the prior written consent of the other.
26. Separability
In the event any proVIsion of this Agreement shall be held invalid and unenforceable, the
remaining provisions shall be valid and binding upon the parties unless such invalidity or
nonenforceability would cause the Agreement to fail its purpose. One or more waivers by either
party of any provision, term, condition, or covenant shall not be construed by the other party as a
waiver of a subsequent breach of the same by the other party.
27. MerQer
It is understood and agreed that the entire Agreement between the parties is contained herein and
that this Agreement supersedes all oral agreements and negotiations between the parties relating
to the subject matter hereof. All documents referred to in this Agreement are incorporated or
attached herein and are deemed to be a part of this Agreement. Any inconsistencies between the
terms of this Agreement and any attached or incorporated documents shall be resolved in favor of
this Agreement.
28. Third-Partv Beneficiary
The Provider acknowledges and agrees that the Minnesota Department of Human Services is a
third-party beneficiary and, as a third-party beneficiary, is an affected party under this Agreement.
The Provider specifically acknowledges and agrees that the Minnesota Department of Human
Services has standing to seek appropriate administrative or civil relief available in law or equity to
enforce the provisions of this Agreement between the County and the Provider. The Provider
specifically acknowledges that the County and the Minnesota Department of Human Services are
entitled to and may recover from the Provider reasonable attorney's fees, costs, and
disbursements associated with any action taken under this paragraph that is successfully
maintained. This provision shall not be construed to limit the rights of any party to the Agreement
or any other third-party beneficiary, nor shall it be construed as a waiver of immunity under the
Eleventh Amendment to the United States Constitution or any other waiver of immunity.
13
IN WITNESS WHEREOF, the parties hereto have set their hands on the dates written below.
SCOTT COUNTY HUMAN SERVICES BOARD
BY:
Ralp . Malz, Chairman
DATE: ~ ~~ /~??
~/~
ATTEST~tf.h"...,-~ a~
ary L. Cunningham, Co ty Ad inistrator
c;;ll,T(/; .
Thomas J. Harbinson
Scott County Attorney
DATE: 1- '16 -f7
SAFE HAVEN SHELTER FOR YOUTH,
DBA SAFE HAVEN FOR YOUTH
"
BY:
/;.. /' I if
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(C'~ ~ ,/ )?~.?(.v. .
aniel Saa(f, Executive Director
~
DATE: I~ /)/1'7
14
A'ITACHMENT A
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SAFE HAVEN SHELTER FOR YOUTH
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Company Summary
Safe Haven Shelter For Youth is a charitable 50 I (c )(3) private non profit corporation formed in the State of
Minnesota in March of 1995. Founder and Executive Director Daniel Saad feels that our society means well
in wanting to preserve the safety and future of our children, but points out that there is an immediate need to
help those children who have lost faith, hope, and have a great need for love. Our staff and volunteers will be
committed to providing the highest quality of therapeutic service to the children and families we serve.
After great consideration for the needs of the Social and Court Services Departments of both Carver and Scott
Counties. Safe Haven Shelter For Youth is looking at purchasing a facility in one ofthese counties to open a
group home.
Purpose of Group Home as set bv the State of Minnesota:
Group homes provide a type of care that is not available through traditional foster families or institutions.
Group homes are not meant to replace either of these types of care but present a unique opportunity to
combine different aspects of treatment from both resources. Group homes can provide adult guidance and
professional services to the child placed out of the child's own home and yet keep the child in community
living. The facility is community based, and the program is community oriented.
PROGRAM AND SERVICES
Safe Haven Shelter For Youth will primarily serve Scott and Carver Counties, but will be available to all
Minnesota counties. The needs of Scott and Carver Counties are increasing rapidly as they move from
predominantly rural to "ex-urban"; in fact, they are two of the fastest growing counties in the Midwest with a
population of approximately 125,000. The two counties now have the fastest growing juvenile crime rate in
the metropolitan area (Bureau of Criminal Apprehension, 1992). Yet, a United Way Survey (1990) indicated
that the counti~s have fewer services than any other in the seven county metropolitan area.
The facility will have a capacity of6 children (male only) ranging in age from 10-17. The length of stay will
be based on individual need with an average stay of6 months. A brief description of services are listed on the
next page. The typical children we will serve are victims of physical or sexual abuse, neglect, or children
being pulled from their home by the juvenile justice system. The goal of our services is to successfully reunite
the child back home with their family as soon as possible.
The facility will be staffed 24 hours a day. The State recommends a 1:5, staff to client ratio. We plan to
maintain a 1:3 ratio of children to adults during waking hours. It is our goal to hire the most qualified staff to
carry out the group home program and maintain a high levei of supervision and structure.
D8NEFITS OF SAFE HAVEN
,,(:ife Haven \."ill provide an array of services included at the per diem rate.
The ~ervices include group counseling, individual counseling, family counselin~,
pro-social skills training, independent living skills (if indicated as a need),
recre~tion skills, and follow up after discharge. All residents completing
their program will leave Safe Haven with fl Success Plan and a Discharge
Summary.
Safe H~ven will be an asset to referral agen~s with a need for more options
and a desire to work with a flexible program. The Scott County location will
allow for maximum parentnl involvement. Frequent home visits are encouraged
to reintegrate each child with his famil~. Safe Haven will create an
environment where paren ts feel they are oelng heara;fn-ar--e-rerra-.r-n-9"ffi"ll.::>
continue to be key participants in treatmenc planning.
S~fe HAven also gu~rantees a commitment to customer service. Our desire is
to be a community r~:::;ource. The small environrne:1t at Safe Haven will allow
or a home-like setting for boys who will begin a rapid rcinteqraticn with
their fami lies. A higher staff ratio in the home wi J 1 be scheduled; a 1 staff
to 3 resident ratio will be maintained during awake hours. TIle group home
will provide 24 hour awake staff.
Additional services will he available upon referral agent request on a flat rat8
basis. The first ~f these services Safe Haven will offer is a parent
training which focuses on skiJ.ls .1nd techniques for parenting adolescen-cs
wi-ch behavioral problems.
S~fe Haven will have trained staff prepnred to deal with the typical group
home routine as well as ccrr~on group home crises.
~--
Group Home Services
· Crisis Counseling for Youth and Families -
The purpose of this counseling is to help the child and family successfully reunite. Our staff
will be trained to work with aggressive youth. how to help high-risk families stay together, and
other preventive. corrective, and intensive teaching techniques in dealing with dysfunctional
families. The service will be initiated with the opening of the group home. The service will be
conducted at the group home or over the phone by our staff working in conjunction with
community resources.
. Social and Interpersonal Skills Development -
Development of social and interpersonal skills are designed to achieve these outcomes: 1) the
child develops and maintains friendships; and 2) the child communicates and interacts with
peers and adults. These services will be initiated with the opening of the group home and
conducted on site by the staff.
. Recreational. Leisure. and Plav Activities -
Development of these activities are designed to achieve the outcomes of: I) the child develops
recreational skills; and 2) the child and family learn how to plan and participate in recreational
and leisure activities. These activities will be initiated with the opening of the group home and
conducted by trained staff on and off group home grounds.
. Independent Living Skills -
Instruction in independent living skills designed to strengthen a child's ability to function in a
less restrictive environment than a group home. The services will support the child in carrying
out the tasks of daily living, encourage the development of self-esteem, and promote self-
sufficiency. These services will be initiated with the opening of the group home and conducted
on site by the staff.
tI ~, SAFE HAVEN SHELTER FOR Youm
lCOR1JJNI4: 15 16706 Dublin Road. Prior Lake. Minnesota 55372 (612) 440-5379
!~~~
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PROGRAM ORGANIZATION Page
Philosophy, Purpose & Function 2
Children Accepted for Care 3
Age, Population & Per Diem 3
Resources 4
Referral Criteria 5-6
Admission 6
Program Plan For Residents 7-8
Family Involvement 8
Requirements 8
Control & Discipline Policies 9
A. PHILOSOPHY. PURPOSE & FUNCTION
Safe Haven Shelter For Youth's Boys Group Home is designed to provide a structured and nurturing
environment for boys ages 10-18 in need of" out of the home" placement.
1. The goals of the program include empowering young men to identify and evaluate behaviors and issues
causing problems in their lives.
2. Educating and teaching them skills to solve problems assertively.
3. To provide a therapeutic environment where issues can be worked through assertively within the
program or by utilizing existing community resources.
4. To promote and assist communication and problem solving with families.
5. To reunite clients with their families whenever possible or facilitate transition into foster care or
independent living.
2
B. CHILDREN ACCEPTED FOR CARE: (Specific extent, limitations and scope of service for which the
Group Home is established).
We will accept applicants both legally adjudicated delinquent and on C.H.I.P.S. petitions. For those legally
adjudicated, this Group Home will provide an alternative to institutionalization for those applicants exhibiting
sincere effort to correct their lifestyle. The Group Home would further serve to facilitate re-entry into the
applicant's own home and community as a transitional living unit following institutional stay. Further, the
Group Home would serve as a preventative measure providing an alternative for applicants who have never
been formally involved in the Criminal Justice System but who are demonstrating behavior likely to result in
involvement with the system.
We will accept applicants into the Group Home who are giving solid evidence-to be substantiated by the
referring person and/or agency- that the applicants can be motivated to make efforts to achieve those goals
which are determined necessary for reunification with their family. We will not accept referrals with behaviors
which are an immediate threat to themselves or others. In the event that a resident complains or is suspected of
having suicidal or self-injurious ideation's, an outside agency or qualified individual may be contacted for
assessment and recommendations.
It is preferred that applicants be court ordered and in county custody before placement at Safe Haven Shelter
For Youth's Boys Group Home. The purpose of this would be to ensure that the legal system has granted
permission and support for treatment services, to safeguard the program, and to safeguard the rights of the
applicants and their families. This would also help to assure that premature interruption of services due to
voluntary placements would not occur.
Equal treatment and access to services will be provided to all applicants without regard to race, creed, color,
national origin, religion, physical handicap, sexual preference, public assistance status or marital status.
C. AGE, POPULATION AND PER DIEM
We will accept appropriate referrals between the ages of 10 and 17 years.
We intend to operate with six boys.
The per diem rate is $IIS.OO. (est.)
3
1 --
D. RESOURCES
Area resources are used to meet the needs of each individual resident's program as well as Group Home
licensing requirement. These resources include:
1. Scott County Social Services
2. Licensed Psychologist - Matthew Gundlach; Licensed Psychiatry - Behavioral Health Services. MA
payments will be accepted.
3. Carver-Scott Educational Cooperative which offers many programs to prepare young people for being
on their own. .
4. A Public School System equipped to provide educational programs for nearly any situation.
5. Medical Care at S1. Francis Medical Center, Park Nicollet Clinics, and S1. Francis Hospital.
6. Dental Care through several local dental offices.
7. All residents wishing to attend church (of their choice) are provided the opportunity to do so.
8. Minnesota River Valley Special Education Cooperative.
9 The CAP Agency (local food and supply shelf)
10. Scott County Public Health
II. Scott County Employmentffraining
12. City recreational and continuing Education Programs.
13. City parks, skating rinks, Area Lakes, Clearly Regional Park, Dakotah Health Club, and the Chaska
Theater.
We closely coordinate all of our program services with those provided by outside persons or agencies by direct
personal contact and / or Inter-agency Staffings. These contacts are maintained by all Group Home personnel
and coordinated by the Group Home Director or Program Director.
4
E. REFERRAL CRlTERIA
The geographic area served by the Group Home of Safe Haven Shelter For Youth will be the seven County
Metropolitan Area, McLeod, Sibley, Le Sueur, Rice, Goodhue, Steele, Waseca, Nicollet, RenviIle, Meeker,
Kandiyohi, Blue Earth, and Chippewa of Minnesota
Admission to the Group Home may be initiated by Social Services and/or Corrections by contacting the
Director of the Group Home with a referral which will then be reviewed by the Director and the Group Home
Staff. Admission criteria to be considered are:
I. Generally the applicant should be lO to 17 years of age. If the applicant is 9 years of age at the time of
referral, a verbal and written waiver must be requested and received before admission may take place.
If placement is emergent, admission may Occur by verbal waiver through the Department of
LicensingJDepartment of Human Services. However, this verbal waiver must be followed by a written
request and written approval waiver within thirty (30) days of admission.
If the applicant is 17 years of age at the time of placement but will reach the age of 18 years during
placement, a waiver will be requested in writing thirty (30) days prior to the client's birthday. Ifwaiver
approval is received from the Department of Licensing! Department of Hwnan Services, the client will
be provided with an individual abuse prevention plan as well as orientation to this plan. The plan and
orientation must include internal reporting protocol as well as reporting process for maltreatment of
vulnerable adults.
The Group Home Program requires that any client younger than age 10 or older than 18 be currently in
grades 4 - 12.
2. The applicant must be of good health. A medical and dental examination must be obtained either prior
to Admission or within the resident's first month of his placement ifhe has not had one within the last
12 months. If the resident is accepted and placement continues beyond the 12 month period in which
physical and dental examinations were received, another physical and dental examination will be
scheduled. Signed verification by dentist and physician will be obtained for client file.
3. The applicant must be interested in improving his life situation and be willing to contract for specific
areas of improvement.
4. The contractual agreement must be made with referring agency for fmancial responsibility.
The following information is required at the time of referral:
A. General Information.
B. Social History.
C. Psychological Evaluation. If a current evaluation is not available, Save Haven will schedule an
appointment with a Licensed Psychologist and provide transportation to appointments.
5
Referral Criteria continued...
The following information is required at the time of admission:
1. Verification of physical and dental examination signed by the providing
physician/dentist if received during the past 12 months prior to admission.
2. Insurance or Medical Assistance information.
We do not accept residents who pose any threat to other residents or who have severe acting out behaviors. If
the child is to return to his home environment, his family must be willing to become involved with our
program.
F. ADMISSION
If, from the referral information, it appears that the applicant is appropriate for the program, a Pre-Placement
Staffing can be scheduled.
At the Admission Staffing or Pre-Placement Visit, the resident and family's prior areas of difficulty as well as
strengths are outlined by the referring agent, parent(s) and the client being referred. These areas are then
written as target behaviors to be addressed during the resident(s) treatment program at the Group Home.
On the day of admission, those target behaviors are discussed with the referring agent(s), parent(s) and the
client. It is explained that the client will be assigned weekly goals that address these target behaviors and will
be evaluated daily. The Group Home Rules and Policies are also discussed.
Any needed medical and dental examinations will be discussed and set up by the Group Home if the client has
not received either during the previous twelve (12) month period. If these services are set up by the Group
Home, financial responsibility rests with client's legal guardian.
A release will also be signed by parent and/or guardian to allow for any other necessary medical services
required during placement. These services will be documented at the time received for parental, client and
licensing reviewal. Necessary release of information forms will be signed. An activity authorization will also
be signed.
At the Admission Staffing, placement plans, estimated length of placement and discharge are discussed.
6
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G. PROGRAM PLAN FOR RESIDENTS
After the resident is accepted for admission, an individual plan will be formulated for that resident. A part of
each resident's program will include the following:
1. Upon admission and for the first thirty (30) days of placement each resident's goals
include:
I. Familiarizing himself with Group Home Rules and Policies.
2. Beginning to build positive relationships with her peers and authorities.
3. Follow the rules of the Group Home, school and community as well as accept the
consequences when he does not.
4. Further explore the areas he would like to work on while at the Group Home.
After thirty (30) days a Staffing is held to discuss the client's transition into the Group Home Program and
school. His progress and areas of difficulty, areas and issues he has identified as those he would like to work
on as well as any further issues the group home has identified will be reviewed. Discussion involves
opportunities for client, parents, referring agents and outside therapists to give input on the goals the client will
work on throughout his program as well as those that will be concentrated on in the next six to eight
weeks. A staffing including all of the above people will continue to be held every six to eight weeks
throughout placement. Written Staffing Reports outlining the client's goals, progress or lack of progress on
these goals as well as the status of the family meetings, jobs, community services, medical, school and any
other outside activity information are also given to the client, parent, referring agent and therapists every six to
eight weeks. A Discharge Staffing will also be provided to discuss completion of the program,
recommendations and After-care plans.
2. Upon entering the group home, each resident is assigned a Primary Counselor who will function as that
resident's primary worker throughout and after his placement at the Group Home. The Primary Counselor will
work closely with resident and his family/foster family, supervising home visits and providing counseling and
support to the resident and his family.
3. All clients participate in behavioral/self awareness group daily, which is conducted by the Group Home
Counselors. The modality of the group is geared toward positive peer culture and behavioral modification.
Each resident works on a behavioral Check List which is designed for their specific needs. Residents are asked
to reevaluate these weekly and give their recommendations to Staff. The Group Home Staff review these
weekly. The group home also offers sexuality, chemical awareness, spirituality, and communication groups.
4. One to one counseling is provided by the Group Home Counselors and Primary Counselor. This will
be done both formally as well as informally and be supervised by the Program Director. The Program Director
will also be involved in one-to-one counseling upon the request from the Group Home Staff. If further
counseling outside of the Group Home program is needed, it will be closely coordinated by the Primary
Counselor and Program Director.
5. Family Meetings are a most important part of our program and are begun once it is felt the client is
ready to begin taking responsibility for his behavior. Family Meetings are facilitated by the Primary Counselor
and are for the purpose of building communication, problem solving, and developing age appropriate rules,
responsibilities and consequences.
6. A sound educational program will be worked out with the Prior Lake Public Schools in relation to each
resident's needs.
7
G. Program Plan for Residents continued...
7. Recreational activities will be provided each resident, both in, and outside the Group Home. These
activities will alternately be designed either to meet the resident's interest or to promote new interests.
H. F AMIL Y INVOLVEMENT
Parental visits are scheduled as each situation indicates. Visits to home or potential foster home are
encouraged as they are beneficial to the resident and their progress in the program. Visits usually start out
slowly and increase until they are weekly closer to discharge. During these weekend visits, the parents will be
instructed to utilize home visit reports and to discuss specific areas assigned with their child. Also, parents
will be asked to discuss what progress they have seen made in these areas and any suggestions they may have
for achieving the desired behaviors. Visitation to the Group Home will be on a prearranged basis so there will
be no conflicts in the resident's schedule. The family will be invited to attend weekly family group.
The Program Director and lor Primary Counselors of the Group Home will have regular contact with the
resident's family, potential foster family, referring agent and any outside Therapist working with the client.
1. REQUIREMENTS
Discharge decisions are already in progress at the time of admission. During our admission procedure, each
resident is made aware of what is expected of them while they are at the Group Home, what specific areas of
behavior they need to address in order to be considered for discharge and approximately how long they can
expect to be residents of the Group Home. Each resident is made clearly aware of the following areas that
affect discharge decisions:
1. Goal Progress or how the resident has gained in those behavioral areas that initially necessitated
placement.
2. Group progress or how the resident has learned to give and take in the group process, i.e., has he
helped other residents to learn to deal with their problems, has he accepted helpful suggestions
from other residents to better deal with his problems.
3. Home visit progress: how the resident's home visits have gone, have previous problems been
worked out. This progress is detennined by written home visit evaluation reports, family group
participation, and family meetings with the Primary Counselors.
4. Attitude towards treatment: has the resident actively taken part in helping the process, has the
resident cooperated or rather just played games, has the resident's attitude improved to the point
of withstanding strong negative peer pressure once discharged.
5. School improvement: has the resident made a fair effort to do well in school, is the resident
passing, has the resident had any major problems in relation to school.
6. Job attainment: (in appropriate cases where job securement is a requirement for discharge), has
the resident secured a fair job that has promise for good pay and continued employment.
7. Recommendation of all concerned parties: Is the Group Home recommending discharge, has
the Social Worker. parent(s), Probation Officer and resident accepted the idea. 8
8. All discharge decisions are based on all of the above. and all of the above are also thoroughly
discussed at Staffings for each resident.
9. Each resident is measured daily in the areas outlined above. The weekly evaluation form shows
each resident how he is performing in the areas of goal achievement, 'house attitude and house
responsibility. Criteria for discharge is that consistent behavior levels are being maintained and
that all of the initial target behaviors have been satisfactorily addressed and accomplished.
Satisfactory accomplishment of a target behavior is determined by daily scores earned in the
area of goal achievement.
10. The resident's family and the resident negotiate a home contract prior to discharge. This
contract will have been put into practice on home visits prior to discharge.
II. Aftercare: Follow-up calls will be made to the home 1 or more times per week for the first eight
weeks. The boy and his family will be invited to weekly family group.
J. CONTROL AND DISCIPLINE POLICIES
DISCIPLINE
Discipline for misbehavior or failure to comply with Group Home Rules results in being restricted.
Refer to a subsequent sheet for clear definition as to what our specific restriction policy is. Staff alone has the
authority to place any resident on restriction and it is up to the discretion of the on-duty Staff to specify type,
duration and documentation of said restriction in the Staff Log.
In any case where a resident is involved with behavior so severe or with a major infraction of Group Home
Rules that it involves possible expulsion from the Group Home, the decision for said expulsion rests with the
Director and the Director alone-although the Director's decision may be a result of a Staff Consultation as
well as Resident Consultation. In most cases, the Director will attempt to mediate each situation to prevent
expulsion from taking place, but when expulsion is called for, it is the sole responsibility of the Director.
Corporal punishment is absolutely forbidden by any and all Group Home Staff, and any physical contact with
any resident is absolutely forbidden, unless the client is in danger of harming himself or others. If counselors
find themselves in a situation where a resident is out of control, they are to telephone the Prior Lake Police
Department at (911) and the police will respond to the call within minutes. The Group Home's Policy for
restraining clients must be used if a restraint is necessary until the police arrive.
9
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CHAPTER 15
Safe Haven for Youth Procedure Manuel
Policy
Safe Haven for Youth Group Home believes that the best prevention for violent
behavior from the residents is the use of verbal defusing techniques and the use of
positive physical exertion, before the situation escalates to the point where physical
restraint is required. But when, for the safety of residents and staff, physical restraint is
needed, the following procedures and techniques must be followed.
Definitions
Therapeutic intervention: When staff confronts a resident in an attempt to secure the
group home and keep both staff and residents safe. Therapeutic intervention includes
both verbal and physical techniques.
Therapeutic holding techniques: Physical restraint that is used to keep the residents and
staff safe until police assistance is obtained. Physical restraint may only be administered
in the techniques listed in this policy Manual and after utilizing all other means of
intervention.
Procedure
Violent behavior from a resident, acting physically aggressive, although not common
behavior, is always possible. This is an extremely serious situation as the residents place
themselves and others at risk. When this happens, residents must be handled exactly as
outlined in the following chapter. Staff needs to learn the warning signs for predicting
violent behavior, causes of aggression and confrontation techniques so as to avoid
whenever possible the use of physical restraint. It is always preferred that staff use re-
direction and defusing techniques in therapeutic intervention before physical restraint.
When initiating a physical restraint, the police should be called so that the resident may
be placed at a higher level of care to maintain his safety and the safety of others.
Causes of Aggression
Physical restraint can best be avoided by learning what causes aggression. Staff should
observe and be sensitive to the behavior of residents so as to learn the specific reasons
residents become aggressive.
1. Fear. When people are frightened they are most likely to strike out. Identify the fear
and reassure the upset person.
2. Denied request. Anytime a resident is told "no" or if the environment says "no". Try
to suggest alternatives instead of giving the client a flat" no".
3. Given orders. No one likes to be given orders. Give requests and options instead.
4. Frustration. Inability to complete tasks, inability to communicate. Often this is the
cause of many events. Try again to give alternatives. Joumaling or physical activity will
sometimes help in venting frustration.
5. Revenge. For real or imagined reasons.
6.Physical discomfort. Especially if unable to communicate it.
7. Delusions or loss of contact with reality.
8. Jealousy. Of staff, peers, and others.
Warning Signs for Predicting Violent Behavior
1. History-this is the best predictor of future behaviors.
2. Threats-Take threats seriously.
3. Increased motor activity-pacing, running, inability to sit down.
4. Decreased motor activity- may appear withdrawn, even catatonic.
5. Tense appearance-clenched fists, tightened jaw muscles.
6. Increased perspiration / rapid breathing.
7. Change in volume- Loud raised voice, low muttering voice.
8. Target touching- unexpected touch by an angry or agitated individual.
9. Unusual speech content- Delusional, nonsensical or paranoid speech content.
10 Unwillingness to make eye contact.
11. Col following stare. If the anger seems to be directed at you directly, utilize another
staff in defusing. If the stare seems to be directed at a specific resident, separate the
residents physically while defusing (i.e. ask the resident who is not escalated to move to
a different room temporarily).
'. ..-/
Confrontation Avoidance Techniques
1. Prevent the unpleasant event.
2. Divert the resident's attention from the event.
3. Remove the resident from the situation.
4. Teach the resident new responses to the event.
5. Maintain your state of relaxation and self-control at all times.
6. Approach calmly, non-dramatically. Use a calm, low voice.
7. Talk to the resident at eye level. Invite the resident to sit down with you.
8. Don't corner the resident physically or psychologically. Leave the resident some
options.
Acting Out Behaviors and Action Plans
Low Risk
Low risk behaviors include mild agitation, harsh language, mild hyperactivity, and
reluctance to comply with prompts. The action plan for handling these situations
should utilize processing in group, processing in a session with counselor, use of a
relaxation tape or a physical activity (recreation), some time in private, encourage use of
assertiveness skills, assign consequences as needed.
Medium Risk
Medium risk behaviors include verbal statement indicating desire to destroy property
with threats against others, moderate agitation, hyperactivity, abusing property short of
destruction, pushing others, refusal to comply with prompts, mild resistance to physical
or verbal contact. The action plan for defusing and de-escalating a resident at moderate
risk for physical behaviors should include isolating the resident from others, remove
the audience. Remove any potential weapons, i.e. pencils. Kitchen knives, etc. Remain at
arms length from the resident. Process the incident or feelings as soon as possible with
counselor or in group. Provide one to one staff attention. Encourage use of
assertiveness skills. Suggest use of relaxation or meditation techniques( could be as
simple as counting backwords from 10). Re-integrate the resident when a low risk level
is achieved. Assign consequences as needed after de-escalated.
Actual Acting Out
This includes destruction of property, assault of others, severe agitation and or
hyperactivity, general loss of control of emotions. The plan for handling actual acting
out should be put in place as follows:
Isolate the resident using all available staff.
Use physical therapeutic intervention techniques as needed. Call the police for
assistance. If the police are contacted, you must also phone the program director as
soon as the situation allows.
Assign one staff member for observation when medium risk is achieved.
Terminate one to one observation when low risk is achieved and integrate with others.
Process in group or one to one with Primary Counselor as soon as possible. Assign any
consequences when low risk is achieved.
Program Director must notify the Executive Director whenever police are called to the
faciH ty.
An incident of actual acting out should always be written up in the staff log and on an
incident report.
Staff should NEVER use another resident in a physical restraint. A resident may be
utilized to make an emergency call if directed to do so by staff (this would be only in an
extreme emergency).
Approved Techniques for Therapeutic Holding (restraint)
Escorts
A simple escort may be used, a one person escort may be used, or a two person escort
may be used. Training on these techniques will be provided at regular interval. If you
are not comfortable with your knowledge on any of these techniques, see your
supervisor immediately.
Blocks
Basic stance, Inside Block, Outside Block and Down Block may be used. Yau will note in
training that each of these procedures are purely defensive. Safe Haven does not
approve the use of any offensive blocks.
Takedowns
A group of three staff encircles the resident and holding him gently lowers him to the
ground.
Holds
Prone Holding Position may be used after a take-down if the person remains actively
resistive or aggressive, or if it appears the resident will resume his threatening
behavior, the prone position may be used. The police should be in route in this
circumstance.
Reminders
It is essential that the incident is properly documented. If the police are called the
Program Director or Executive Director must be notified!
In all cases of restraint a staff interview will be conducted by Program Director within
five working days to examine the use of restraint, the use of less restrictive measures,
the prevention of further incidents, and reviewing all documentation.
Incident reports will be sent to the placing county.
Incident Reports
Incident reports are written for behaviors and incidents which require attention Iwyone! the
normal routine. Examples of these situations include;
Medical attention/emergency
Theft
Physical aggression/threatening statements
Run
Smoking/use of tobacco product or paraphernalia
Weapon possession
Use of chemicals
Property destruction
Suicidal ideation
Harassment/ threats by parent/legal guardian
Ofr grounds A WOL
Law Enforcement Center assistance
Mandated reporting issues
Therapeutic holding(restraint)
Self-injurious behavior
Incident reports are to be tilled out before leaving the shift. If more than one slall witnessed
the event be sure to discuss who will complete this duty. The original copy is 10 be given
to the Program Director. The incident should also be described in the staff log with as
much information as possible allowing other staff to be aware of the incident.
Incident reports will be typed and filed in the resident's file and a copy will be m:liled to the
placing agent within three working days. Incidents such as this frequently will n:sult in all
immediate call to the placing agent. This is a decision which will be made by the Program
Director and the Primary Counselor.
PROGRESS REPORT AND GOAL PROGRESS
At each staffing (intake, treatment planning, progress, and discharge) the Primary
Counselor for each resident will prepare a typed summary of the resident's progress. This
will include a cover sheet with a brief numeric rating of the resident's key areas Il
programming. The numeric scale will range from one to five, with live denoting all
treatment goals/ methods completed and one denoting regression.
The second portion of monthly report will state the treatment goals and a briet" st~llement
regarding the progress or lack of progress. This document should, when read al dischargl:,
give an overview of the resident's stay at Safe Haven and the sllccess of their
individualized treatment plan.
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DAILY ROUTINE
The boys will begin the wee]<:days at 6 a.m. The boys will be responsible for
tidying their rooms, morning hygiene, and breakfast. At 7:00 a.m. most residents
will load a bus for mainstream school. Any resident remaining, would begin
~tudyhall in the group home. The boys who attend mainstream school will
return to the group home shortly after 2 p.m. The early afternoon would begin
"
with two hours of group recreational activity. Examples of recreation include
te~m sports, Project Adventure games, and community outings to sample other
recreational opportunities.
At 5 p.m. the boys will prepare for dinner. The dinner will be served at 6 p.m.
At 7 p.m. the boys would gather for evening group. The groups held will
include pro-social skills training, power of choice, and spirituality. On
Friday evening, p~rents will be invited for f~rnily group. This will be an
opportunity to prepare families for the weekend visits. Boys in the progr'arn
will be visiting their homes typically every weekend or every other weekend.
~t 8 p.m. the boys .will have free time. The r~sidents will be expected
to be in their beds with the lights out at 10 p.m.
Saturday will begin with a 7:30 a.m. waking time followed by breakfast. The day
continues with household duties to ensure that all areas of the home are
properly cleaned. Follo~i~g the Saturday cleaning, the residents will have
free time until lunch prep3.T'~t:ion begins. Parents will be encouraged tp
visiL residents who are not on homevisits. Visiting hours will be flexible
t.:> encourage parental support and relationship bUilding.
The weekends wil.1 31so contain ~c;heduled community outings to enhance
interests, t.eech access to community resourcc8, and model pro-social skills
in a communi1:.y environment.. i\n example would be spending time at t~he library.
Sunday mornings each resident will have the opportunity to attend church wich
family or with a Safe Haven Volunteer. The Sunday scbedule will also allow
for flexible family visits for boys who are not on home visits.
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ROUTINE CONTINUED
'creational activities will be scheduled at the group home. Home visits will
end on Sunday evenings. The parents will be encouraged to either fill out a
summary qHestionnare of the weekend visit or meet with a counselor to
discuss the weekend.
Financin!! the Group Home:
Sources of funds will come annually from three primary sources:
1) Client Ft:es - The host county contract per diem for placement of a child is expected to be approximately
$115.00:<: 6 kids :<: 365 days = 5251.850.00
Operating at 80% or greater capacity will allow us to attain financial stability.
2) Grants'" and Private Gifts...", - $45,000 has been largest gift to date.
3) Soecial Events and Fund Raisin!! *....
Note: We receive no money from the United Way.,
Safe Haven Shelter For Youth plans to have 5200,000 raised before purchasing a home. This is how Safe
Haven Shelter For Youth will sustain future financial stability and continued growth. We recently signed a one
ye:n- lease for a home in Prior Lake to begin operating. This home will have a capacity of six boys.
'" FOlllldation support is pending for the following: Northern States Power 51,000, the Larry O'Shaughnessy
Charitable Trust 510,000, Rauenhorst Foundation 515,000.
** An anonymous gift of 545,000.00 was reeeived in January of 1996 with additional funds offered and
available if needed. \ ~ ~
*** An all night Dance-a-thon was held at St. Michael's Church in Prior Lake on June 28, 1996. Over
51,000.00 was pledged to support the group home. Over 20 companies donated prizes and c:lSh,
including: RolIerblade, Ine., K-Mart, Dayton's, Super VaIu, Marquette Ba~ Signal Ba~ Prior Lake
State Bank, and First Bank.
9
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ITEM
Salaries
Liability, Vehicle, Business
Workman's Compensation
F1CNMedicare
State Unemployment
Phone
Rent/Mortgage
Food
Vehicle License
Vehicle Lease
Utilities
Waste Management
Emp loyee Benefits
Clinical Services
Legal! Acctg.
Computer
Copier-Maintenance
Dues/S ubscJL ic.F ees
Marketing
Miscellaneous
Building Repair
Office Supplies
Program SuppliesIProgram Exp.
Postage
Printing
SeminarslTraining
Vehicle Gas
Vehicle Maintenance
Linens
Allowances
Clothes
TOTAL
Per diem
MSP'~:bu~hfdn2
SAFE HA YEN SHELTER FOR YOUTH
BUDGET FOR 1997
1997
Projected
Expenses
$ 139,000
$ 4,000
S 1,500
$ 8,735.
$ 2,190.
$ 1,300.
$ 10,995.
$ 6,000.
$ 150.
S 3,000.
$ 2,500.
S 400.
$ 4,000.
$ 4,000.
S 500.
$ 500.
$ 300.
$ 450.
$ 1,750.
$ 1,000.
$ 1,500.
$ 500.
S 3,500.
S 200.
S 1,000.
S 3,000.
S 1,000.
S 300.
$ 75.
$ 1,000.
S 500.
S 204,845.00
$ 115.
13
Safe Haven Shelter For Y outb
Balance Sheet
December 31, 1996
ASSETS
Cash S 25,770.83
Accounts Receivable O.
Invesnnent and Securities O. -- - ..- . -. -. ----- --.. -<--
Land, Building, and Equipment O.
Other Assets O.
Total Assets S 25,770.83
LIABILITIES
Accounts Payable $ O.
Mortgage and other Notes O.
Fund Balance 25,770.83
Total Liabilities & Fund Balance S 25,770.83
Mspc::boardlr2
14
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Budget Narrative
Clinical Services: Dollars allocated for this budget item will cover incidental cost related to Safe Haven
contracting with, but not limited to, Licensed Social Workers, Outside Counseling Services, Psychological
consultants, Psychiatric consultants, and medical, dental, or nursing professionals.
Program Supplies and Expenses: Dollars allocated for this budget item will cover training materials for clients
and staff, manuals, curriculum materials, or copying and development of curriculums. (Example, Boys Town
curriculum). TItis item will also include small stipends earned by residents for shoveling, cutting the lawn, or
other work beyond the normal expected chores.
Allowances: Allowances will be given to each resident on a weekly basis. The allowance will be a maximum
of $5.00 per week. The plan is to give coins only; This way, if a resident has dollar bills, staffwill know
something is happening.
Clothin!!: Dollars allocated for this budget item will cover only incidental clothing for residents. It is up to the
county and the parents to fund the child's primary clothing.
Emplovee Benefits: Full-time employees will receive about $1,000.00 in benefits to offset
healthJdental/1ife/disability insurance, or day care costs.
MSP:c:bushfdn2
14
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Per Diem Inclusions and Exclusions
Inclusions: Room and board, most recreational activities, 24 hour supervision. most transportation,
counseling for youth and their families, program supplies, most school supplies, various skills training and
development, incidental clinical consultation. incidental clothing, and general (vs. fashion or expensive name-
brand) personal care products.
Exclusions: Primary clothing and wardrobe, medical and dental charges, psychological evaluations, extra-
curricular or other school fees, equipment needs for extra-curricular activities, other items normally reimbursed
by the placement agency, County, or parents of group home placements.
15
Management
The board of directors governs the organization with a passionate concern for its direction. No
compensation is paid to any member of the Board ofDirecrors for services as a member of the
Board of Directors.
OmaniztionaI Chart
2 Primary Counselors
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Volunteers & Interns
Board of Directors
Exeeutiv1i=tor
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Program Director
2 - 3/4 time Jght Staff
Office Manager
2-3 Part-time Counselors
Staff:
EJ:ecutive Director - Dan Saad 440-5379
Program Director - Peggy Howell 226-1488
Grouo Home Information:
Group Home Phone - (6U) 226-1488
Group Home Address -16706 Dublin Road, Prior Lake, MN 55372
Safe Haven Shelter For Youth
Board of Directors (1-9-97)
Name
Daniel D. Saad
Address
14750 West Burnsville Pkwy. #149, Burnsville, MN 55306
.".. . .-- ... --- .-..... .-.--' --------- .--- ....
5541 Portland Ave., Minneapolis, MN 55417
14750 West Burnsville Pkwy. #149, Burnsville, MN 55306
3331 Akers Lane, Jordan, MN 55352
1400 Blue Heron Trail, Shakopee, MN 55379
2965 Spring Lake Road, Prior Lake, MN 55372
Stephen A. Frenz
Rebecca D. Saad
Jeanne M. Pahl
Dr. Craig Olson
Charles F. De Vet
SAFE HAVEN SHELTER FOR YOUTH
JOB TITLE; PROGRAM DIRECTOR
DEP ARTMENT:
GROUP HOME
TITLE OF Il\1MEDlATE SUPERVISOR:
EXECUTIVE Q[RECTOR
JOB SUMMARY:
Coordinates Services regarding supervision of clients programming and case management.
AssistS in the administration of the group home. Coordinates services regarding client medical. educational.
and employment needs.
TASK NO.
DESCRIPTION:
A. Determines treatment programs, recommends goal and objectives in cooperation with Executive
Director and Staff to the Advisory Board for approval of the Board of Directors: develops and maintains
operating procedures to implement and ensure compliance with State Rules. Regulations and County
Policies.
B. Supervises Group Home Staff and interns, e.g. Assigns C3SeS. Monitors and reviews case records.
evaluates performance, interviews, hires, facilitates training, discipline and terminates with the approval of
the E.xecutive Director.
C. Supervises Treatment Programs including scheduling, conducting Admission Staffings. Assisting or
guiding Counselors with difficult cases. and determining appropriateness of Discharges. Placements and
Referral Plans.
D. Prepares reports including Quarterly Status ReportS, Licensing ReportS, Annual N-E Cost Analysis and
determines monthly bills to Counties for Per Diem E.xpenditures.
E. Determines client Admissions by conducting interviews and/or reviewing referral information to assess
client needs and level of services required.
F. Collaborates with Referral Sources to coordinate individual client program needs and report Client
StaruslProgress: may provide Court Testimony regarding reportS.
G. May provide Direct, Individual, Group, Family Counseling or Crisis Intervention. Document client
contacts, activities and phone conversations.
H. Responds to and resolves problems/concerns from the GeneraJ Public/ReferraJ Agencies; serves as
Resource to Community; participates in Public Hearings regarding Group Home Programs.
I. Attends workshops and conferences pertinent to the mission of the Group Home. Attends bimonthly
meetings of Directors of Rule 8 Group Homes. Completes a minimum of thirty hours per year of
continuing education.
Page 1
TASK NO.
DESCRIPTION:
J. Provide on the job training to new employees.
K. Perform other related work as apparent of assigned.
L. Coordinates clients' medical needs.
I. Ensures communication to families and referring agents.
2. Purchases medications and ensures reimbursement by parent or medical assistance.
M. Coordinates Clienes' Educational needs.
1. Provides initial background information to assist schools in setting up individual education plan.
2. Serves as liaison between the group home and schools
3. Coordinate daily completion of assignments and progress reports with client, tutor and staff.
N. AssistS in the coordination of clients' employment needs.
O. Coordinates Scheduling. Allowance account records, and informs Executive Director of facility
maintenance needs.
P. Prepare reports regarding Medical. Dental, School and Community Services prior to client Staffings.
Q. Assist in the design. coordination and implementation of summer activities.
WORK EN"V'm.ONMENT:
Work ins performed within the Group Home Facility, in vehicles. client's homes. COWlty Courthouses.
Schools, Medical and Mental Health Facilities, and Recreational settings.
Exposures may include potentially volatile clients. Occasionally a hold may need to be performed on a
client who is in danger of harming himself or others. Other exposures include body fluids, communicable
diseases and household hazardous chemicals.
Duties include being able to perform the following movements: Walking, bending, turning, twisting,
pushing. pulling, kneeling, squatting, reaching, sitting, driving, grasping, and finger manipulations.
Occasionally some lifting up to 50 Ibs.
EMPLOYML~ STANDARDS:
Education and Exoerience:
BA Degree in Psychology, Sociology, Social Work or related field, and at least three years of related
work experience.
Page 3
Knowledsze. Abilities and Skills:
Excellent knowledge of Adolescent Behavior, Development and Treaonent Approaches. Knowledge of
Community Resources. Knowledge of Trends in Adolescent Care. Must be skilled in Individual Counseling,
Group Counseling, Family Counseling, Crisis Interventio~ Staff Management. Budget Planning, and Fiscal
Management. The Ability to work under high stress situations and communicate effectively and professionally
at all levels, including angry and potentially volatile clients, parents and visitors. The ability to work as a T earn
member and independendy. The ability to emotionally detach from issues and be objective as well as determine
when Referral Services are needed..- . - - - ----- -- .
ORGAJ."fIZATIONAL REUTIONSBlPS:
EXECUTIVE DIRECTOR
I
PROGRAM DIRECTOR
I
I
OffiCE ASSISTANT
~
PRIM.ARY COUNSELORS OVERNIGHT STAFF PART-TIME STAFF
SAFE HA YEN SHELTER FOR YOUTH
JOB TITLE; Primary Counselor
DEP ARTMENT:
GROUP HOME
TITLE OF IMMEDIATE SUPERVISOR:
Program Director
JOB SUMMARY:
Provide counseling and supervision for up to six residents. Provide Primary Care for three to four
Group Home residenG and their family.
TASK NO.
DESCRIPTION:
r. Provide counseling services for up to 6 residents.
A. Provide a supportive, nurnuing environment with consistent consequences and positive reinforcements to
ensure consistency and quality of care.
B. Supervise and ensure that residents operate within program guidelines to provide opportUnity for behavioral
analysis and ensure safety.
C. Keep current on all background information and overall program in order to participate as a team member
and quality of care. .
D. Role model, recommend., and teach conflict resolution techniques, assertiveness skills, anger resolution
techniques. personal relationship skins. communication skills, and problem solving skills.
E. Provide crisis intervention, explore., identify, and/or resolve conflictS.
F. Conduct one-to-one counseling sessions.
G. Facilitate daily behavioral groups.
H. Read and respond to client's daily goal writings to ensure cHenG are able to understand and relate news
infonnation to themselves.
r. Organize and supervise recreational activities.
J. Supervise, teach, evaluate, and document daily on clients regarding:
1. Responsibilities of home maintenance, personal hygiene, cooking, studies, employment, doctor,
dentist, and psychiatric appointments, and recreational activities.
2. Behaviors: interactions with peers. authority, and family.
3. Efforts of lack of efforts in working on or with tre:1tment approaches such as daily journaling,
behavioral groups. and one-to-one counseling sessions.
:..,
page 2
TASK NO.
o ESCRlPTION:
K. Conduct incertiews and prepare reportS of abuse or neglect other than staff'to client.
L. Provide transportation.
II. Coordinate case management on up to four residents.
A. Maintain client files including weekly score sheetS. goals complet~ and any incoming information.
B. Coordinating services to ensure necessary communic:uion with parents. referring agents. and other
professionals working with primary clients and their family.
C. Facilitate 10 week staffings and prepare staffing reports.
1. Recommend and establish goal direction for the next 10 weeks.
2. Develop plan to c:my out these goals, commWlicare this direction and plan to all involved parties.
3. Review for all involved parries previous goal directions. progress or lack of progress, and any
significant event such as medical, schoo~ recreational, community service, or restitution activities.
D. Attend court when necessary.
E. Facilitate family meetings to promote and teach commWlication skills and conflict resolutions.
F. Provide crisis intervention, assist parents and client in the negotiating ofreaIistic age-appropriate rules,
expectations, and responsibilities as wen as consequences.
G. Conduct weekly one-to-one sessions to ensure consistent progress on all curren! goals, evaluate the status of
the goals, and determine further issues.
H. Prepare for Tuesday Team Staffing.
1. Recommend client goals and objectives.
2. Briefte:un members on significant occurrences of the past week.
3. Utilize team for support and direction.
4. Report significant progress or lack of progress in all areas of the Group Home program.
ill. Perform any other related work as apparent of assigned.
page J
WORK ENVIRONMENT:
Work ins perfonned within the Group Home Facility. in vehicles. client's homes, County Courthouses.
Schools. Medical and Meneal Health Facilities. and Recreational settings.
Exposures may include potentially volatile clients. OCc:1Sionally a hold may need to be perfonned on a
client who is in danger of harming himself or others. Other exposures include body fluids. communicable
dise:l.Ses and household hazardous chemicals.
Duties include being able to perform the following movements: Walkin~ bendin~ tumin~ rwistin~
pushing, pulling, kneeling, squatting, reaching, sitting, driving, grasping, and finger manipulations.
Occ:l.Sionally some lifting up to 50 Ibs.
EMPLOYlVIENT STANDARDS:
Education and Experience:
Associates Degree in Human Services or related fields of e.~rience.
Knowledsre. Abilities and Skills:
Excellent understanding of Adolescent Behavior, Knowledge of Juvenile Civil Rights, Interpersonal
relationships, Family Dynamics. Reality Therapy, Behavior Modificatio~ Positive Peer Culture, Dynamics of Abuse,
and the Laws pertaining to Reporting, Communication. Assertiveness, Crisis Intervention, Conflict Resolution, Group
Facilitation, Behavioral Analysis, Problem Solving and Recreational Skills.
Tn~ ability to understand written and oral directions and instructions. The ability to work under
stressful situations. The ability to communicate and deal effectively and professionally at all levels within our
community including with angry and/or potentially volatile clients, parents of visitors. Ability to work as a team
member and independently. The ability to emotionally detach from issues and be objective.
ORGANIZATIONAL RELATIONSHIPS:.
EXECUTIVE DrRECTOR
I
PROGRAM DlRECTOR
OFFiCE ASSISTANT
PRIMARY COUNSELORS
OVERNIGHT STAFF
PART-TIME STAFF
." .;J;'
~:
SAFE HA YEN SHELTER FOR YOUTH
JOB TITLE: 3/4 Time Night\Vatch Supen'isor
D EP ARTME:,(T:
GROUP HOME
TITLE OF IMMEDlATE SUPERVISOR:
Program Director
JOB SUMMARY:
Provide counseling and supen'ision for up to six residentS during overnight shift. Perfonn home
maintenance duties as assigned.
TASK NO.
DESCRIPTION:
I. Provide supen'ision and care for up to ten residents during overnight shift.
A. Provide a supportive, nurturing environment with consistent consequences and positive reinforcements to
ensure consistency and quality of care.
B. Supervise and ensure that residents operate within progr:nn guidelines to provide opportunity for behavioral
analysis and ensure safety.
C. Role model, recommend, and teach conflict resolution techniques, assertiveness skills, anger resolution
techniques, personal relationship skills, communication skills, and problem solving skills.
D. Provide crisis inten'ention, explore, identify, and/or resolve conflicts.
E. Facilitate daily behavioral groups.
F. Readjoumals daily.
G. Supen'ise, reach, evaluate, and document dally on clients regarding:
1. Responsibilities of home maintenance, personal hygiene. cooking. studies, employment, doctor.
dentist, and psychiatric appointments, and recreational activities.
2. Behaviors: interactions with peers, authority, and family.
3. Efforts of lack of efforts toward working on or cooperating with all elements of Group Home
Program.
H. Ensure residents are made aware of daily appoinnnCJtS, inform the schools of any e."tcused absences.
I. Check residents nightly as many times as needed to c:ndurc they are safe and still there. Residents must be in
their own beds and asleep, with their music off.
J. Notify the Director in the event of an emergency situation.
IT. Perfonn home maintenance duties as assigned.
III. Perfonn related work as apparent or assigned.
page 2
WORK ENVIRONMENT:
Work ins performed within the Group Home Facility and in vehicles.
Exposures may include potentiaUy volatile clients. Occasionally a hold may need to be performed on a
client who is in danger ofhanning himself or others. Other e."tpOsures include body fluids. communicable
diseases and household hazardous chemicals.
Duties include being able to perform the following movements: Walking, bending, turning. twisting,
pushing. pulling, kneeling. squatting. reaching. sitting. driving, grasping. and finger manipulations.
Occasionally some lifting up to 50 Ibs.
EJ.'\1PLOYMENT STAJ."IDARDS:
Education and Experience:
2 year T echnica1 Certificate or related experience.
Knowledee. Abilities and Skills:
Basic knowledge of adolescent behavior, communication, assertiveness, crisis intervention, conflict
resolution skills. The ability to understand written and oral directions and instructions. The ability to work
under streSsful situations. The ability to communicate and deal effectively and professionally with angry and/or
potentially volatile clients, parents ofvisitoIS. Ability to work as a team member and independently.
,.
ORGAJ."fIZATIONAL RELATIONSHIPS:
PRIMARY COUNSELORS OVERNTGHr STAFF PART-TIME STAFF
---;-r
ATTACHMENT B
SAFE HAVEN FOR YOUTH
16706 Dublin Road
Prior Lake, MN 55317
PLACEMENT AGREEMENT
Placement Agency I
I Minnesota,
(Address)
places and is
(City, County)
(Zip Code)
responsible for
; son of
(Parent/Guardian Name)
at Safe Haven Shelter
(Client's Name)
of
, Minnesota,
(Name of City) (Zip Code)
for Youth (Provider), for the period from
,199 .
The agency of financial responsibility is
address:
199_, to
The Placing and Financially Responsible Agencies and the Provider agree to abide by the
provisions of the Lead County Purchase of Service Agreement made by the County of Scott
and the Safe Haven Shelter for Youth. The dates of the Lead County Agreement are from
February 1, 1997, through January 31, 1998. (Copies of the Lead County Agreement are
available from the Provider upon request.)
The Placement Agency shall be responsible to the Provider for the following:
a. A specific statement in writing clarifying the legal authority for placement and the legal
status of the child at the time of placement.
b. Information in writing of any information known of the destructive and violent nature of
the client. This shall include, but not be limited to : arson, sexual assault, physical
assault, criminal damage to property, unauthorized use of motor vehicles, suicidal
threats or gestures, or animal abuse.
c. Full responsibility for providing for and arranging for the medical needs and expenses of
the child in placement. The Provider shall assist the placing agency by helping identify
and secure needed services.
d. Direct participation of the Placement Agency's assigned worker for planning after the
youth is admitted.
e. A copy of the child's placement plan and documentation of private insurance or Medical
Assistance coverage at the time of admission, or within seven (7) days of placement
upon approval of the Provider.
f. Inform the Provider of all administrative and court hearings.
The Provider agrees to be responsible to the Placement Agency for the following:
a. Inform the Placement Agency within one working day when a child is absent from the
Provider's facility.
b. Scheduling an individual placement plan review no less than every three months and at
the time of discharge.
c. Provision of a monthly progress report to the primary worker and a written summary and
recommendation within 15 days of a child's discharge.
All verbal communication delineating issues not contained in this document or the lead county
agreement must be confirmed in writing within 5 working days.
The Primary Worker for the Placement Agency is
phone: , to whom the Provider shall direct all client communication.
All other limitations, reports, provisions or agreements should be added here:
Signature, Safe Haven Shelter for Youth Date
Signature, Agency of Financial Responsibility Date
Signature, Placement Agency
Date
Distribution of Copies:
Parent
Placing Agency
County of Financial Responsibility
Safe Haven
ATTACHMENT C
Quarterlv Report
Quarter:
Aqencv: Safe Haven for Youth
First Second Third Fourth
Quarter Quarter Quarter Quarter
A. PERFORMANCE MEASURES
1. Number of clients residing in the home at
quarters end.
2. Number of clients admitted:
3. Number of clients discharged by facility:
a. Planned
b. Unplanned
4. Average length of placement of youth
discharged during the quarter:
a. Planned
b. Unplanned
8. OUTCOME MEASURES
1. Of those discharged, the percentage of
children reunited with their biological or
adoptive families.
2. Of those discharged, the percentage of
children placed in foster care ( long or short
term):
3. Of those discharged, the percentage of
children placed in another Rule 8 facility:
4. Of those discharged, the percentage of
children placed in a Rule 5 facility (residential
treatment, including state hospital):
5. Of those discharged, the percentage of
children placed in a psychiatric facility (acute
care hospital):
6. Of those discharged, the percentage of
children placed in a correctional setting:
7. Percentage of children living in a less
restrictive environment six months post
discharge:
Namerritle:
Date:
Safe Haven for Youth
NR/jm
01-22-97
__6_'__._..-
------
A'ITAcmmzr.r. D
~
. +-"'"
.
." ~
I!. FOLIC! sn~!:~
It is t~e ~clicy of Scot~ County Gcve=nment to ~rovide Equal
Oncc=~~nit7 to all employees and a~plicants .for employment in
ac=or~ancg w~th all applicable Equal Employment Cpport~ty laws,
dir~c~ives and r~gulations of feee=al, State and Local gove~~g
bodies cr agencies ther~of, including Minnesota Statutes Cha~ter 363.
Scott County will not engage in any employment ~ractices whic~
discriminate against or harass any employee or applicant for
employment because of race, color, creee, religion, national origin,
se~, disability, age, marital status, or status wit~ regard to public
assistanc~. Suc~ employment practices include, but a=e not li~ted
to, the following: hiring, upgrading, demction, transfer, rec~~i~ent
or r~c~~i~~ent advertising, selection, layor:, c~ci~lina~l action,
te~ination, rates of payor other fo~s 0: compensation, and
i -'on fo~ --~~n~nc ;ncluc.';n~ ac~~=~t;c=~~;c
se_gc..l. - '--_":'~ _4. ... I ... _ _ ": .. ~__... - __44_:' .
Fu~~e=, Scott County tully suppo~s incor;craticn of
nonciscrimination r~les and regulations into contrac~s and will commit
the necessa~l time and resour~es to achieve the goals of E~~al
Emolcvment Cppo~unity.
- .
Anv emoloyee of the County who dces not comply with the Equal
Emclo~ent Oppcrtunity Policies and Procecures as set forth in this
Statement and Plan will be subject to disciplina~f action. ~~y
subcontract~r of the County not complying with all applicable Equal
Emolcyment Opportunity laws, directi7es and regulations of the
Federal, state and local gcve~ing bcdies or agencies thereat, -
including Minnesota Statutes Chapter 363, w~ll be subject to
aocrooriate contractual sanctions.
- . -
Scott County has designated the Personnel Director as the manager of
the Equal Employment Opportunity Program. These responsibilities will
include monitoring all Equal Employment Opportunity activities and
recorting the effectiveness of this program, as required by Federal,
State and Local agencies. The Scott County Administrator will receive
and r~view reports on the progress of the program. If any employee or
.acclicant for employment belie~'es he/she has been discriminated
against, p~aa~e contact the Scott County Personnel Directorr Scott
County Personnel Depa~~ent, Room 104, Scott County Courthouse,
Shakopee, Minnesota 55379, or call (612) 496-8103.
6 [r r.cJ)
r/-: ,~" ,-n /.J".V'/Yi IYVt~-09-96
. Ga~! ~unningh:m /) ... Da te
Scott County Adm~~s~rator
/~ 7: a0l-09-96
Ralpn T. Malz~ Date
Chai~an, Ecar~ of Commissioners
n~l..CJUO:JJ
DEe 2 ~ 1996
. I __"'a~ ,-rlmA' co.:P~ ~.,.- azg -.MOn COUNTY HUMAN SERVlCfS
Policy Administrator EMPLOYERS INSURANCE OF WAUSAU A Mutual Company
Certificate of Insurance
This fs to certify that the Insurance policies (described below by a policy IUllber) ..ritten on fo..-
In use by the cCllllplll1'f have been Issued. This certificate Is not I policy or I binder of Insurance and
does not In any way alter, 8IllInd or extend the coverage afforded by any policy referred to herein.
I SSUED TO
NAME AIID MAILING ADDRESS OF INSURED
SAFE HAVEN SMELTER FOR YClIfH
14750 W IURMSVILLE PKWY '149
BURNSVILLE MI 55306
AGENT OF RECORD
ISSUING DATE
Ju)1 ALOLIN
SCOTT COUNTY HUMAN SERVICES
COURTHClJSE 1300
428 HOLMES ST S
SHAICOPEE MIIJ 5537'9
WESTERII IllS AGEIICY
1740 RIe! ST
Sf PMJL MI 55113
12 23 96
Type of Insurance
Workers compensation
Policy NUJber
Policy
Effective Date
(HO/DAIYR)
Po li cy
Expiration Date
(HOIDA/YR)
0317 00 137068
12 03 96
12 03 97
SPECIAL PROVISIONS/LOCATIONS/SPECIFIED AUTOS:
THIS POLICY PROVIDES COVERAGE FOR MINNESOTA EXPOSURE ONLY.
EACH ACCIDENT S100,000/DISEASE POLICY LIMIT S500,000/DISEASE EACH EMPLOYEE S100,000
Notwithstanding any require.ent, te~ or condition of any contract or other ~t ..ith respect to which this certificate ..y
be issued or MY pertain, the insurance dforded by the pol icy (pol ieies) described above is subjeet to all of the terms,
exclusions and conditions of such policy (policies) during the teMII(s) thereof.
PROOUCER NO.
ISSUING OFFICE
REGION
0929
PO BOX 1357
MINNEAPOLIS 14M 55440-1357
(612) 830-1700
MPL
Signed
I..ACDRD".
PRODUCER
Western Insurance Agency
1740 Rice Street
St Paul MN 55113
~..r;~[!~;~J~'~i!~::q~:.~~~~~~lfF)fJI\IStJRA.N'CE~~~~l ............. DA~7~;;;~
THIS CERTlFICA TE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIRCA TE
HOLDER. THIS CERTlRCATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
Phon. No. 512-489-4119 FuNo.512-489-0507
INSURED
COMPANY
A Non Profits Mutual R~~ :~nn:n
. --.
COMPANY
B nt:"(' ':' ~ 1QQh
Safe Haven Shelter For Youth
14750 W. Burnsville Pkwy.,#149
Burnsville MN 55305
COMPANY
C
MOnTT 1',l11N TV ,.IBM AN ,~RVlr~,
COMPANY
D
: COVERAGES '':. ............?........ .... ............. ......................... ..... ..... .....i/.........::............
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REaUIREMENT. TERM OR CONDI:rION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE IPOUCY EXPIRATION I
DATE {MMIODIVYI DATE {MMIODIYYI
I GENERAL AGGREGATE
12/18/96 12/18/97 PRODUCTS. COMP/OP AGG
CO
LTR
UMrrs
PERSONAL 3. ADV INJURY
EACH OCCURRENCE
1$1,000,000
Is1,000,000
sl,OOO,OOO
sl,OOO,OOO
Is 100,000
$ 50,000
GENERAL UABIUTY
A Xl COMMERCIAL GENERAL UABIUTY
. · .,. I CLAIMS MADE W OCCUR
OWNER'S III CONTRACTOR'S PROT
-
95-7152
-
FIRE DAMAGE (Anyone fire)
HI EO EXP (Anyone person)
AUTOMOBILE LIABIUTY
-
A _ ANY AUTO
96-7152
12/18/96
12/18/97
COMBINED SINGLE UMIT
$1,000,000
-
AL!. OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per personl
I $
-
~ HIRED AUTOS
n NON.OWNED AUTOS
H
ORAGE UAB1LITY
R ANY AUTO
RCESS UABILITY
UMBRELLA FORM
I OTHER THAN UMBRElLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' UABILITY
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
A PROFESSIONAL
A IMPROPER SEX. CT.
96-7152
AUTO ONLY. EA ACCIDENT $
OTHER THAN AUTO ONLY: I :..............
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
AGGREGATE $
$
I WC STATU- I 10TH-
TO-RY liMITS ER .
a EACH ACCIDENT $
El DISEASE. POUCY UMIT $
a DISEASE. EA EMPLOYEE $
12/18/95 12/18/97 LIABILITY 1,000,000
12/18/96 12/18/97 250,000
I
THE PROPRIETORI
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
RINCL
exCL
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
***CERTIFICATE HOLDER ADDED AS ADDITIONAL INSURED***
SCOTTCO
..................::....:.... .. ........
.........................:..
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCEllED BEFORE THE
EXPIRATlON DATE THEREOF. THE ISSUING COMPANY WlU ENDEAVOR TO MAIL
.l:..Q...- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
BITr rAILURE TO MAIL SUCH NOTICE SHAU IMPOSE NO OBUGATION DR UABILITY
OF ANY KIND UPON THE COMPANY. rrs AGENTS OR REPRESENTATIVES.
A~~ZED REPRESENTATIVE /?~-+-
7ncv~ f.A. .V':?'na.,,~
. .. ........-. ~ ACORD CORPORATION 1988
.
CERTIFICATE
......
SCOTT COUNTY HUMAN SERVICES
ATTN: JODI HOLIN
COURTHOUSE 300
428 HOLMES ST. SO.
SHAKOPEE MN 55379-1375
ACORD 25-S (1/951
..
. .
GROUP HOMES
,
~~I
EXHIBIT F
-- .~_._-,_. ._--~.
~':l~
._~ I f\: 1
-----; j: ~ !
I. "
i!; :"
, 1997 II .: ,.
c:.; - 3 lillJ:
I
r
.
7/94
Rule 8
9545 .1400 STATUTORY AUTHORITY.
The authority of the Department of Human Services, Licensing Division, to
prescribe and publish minimum standards for the approval and licensing of group
homes is contained under Minnesota Statutes, chapter 245A. Standards
prescribed, and contained herein, shall be in force until revoked or revised by
authority of the department.
The commissioner of human services is delegated responsibility by the state
legislature to see that the minimum requirements as herein prescribed are met
and maintained by county welfare departments, licensed child-placing agencies,
licensed children's institutions, foster family group homes, and independent
operators of group homes.
STAT AUTH: MS s 245A.09
HIST: L 1984 c 654 art 5 s 58; 13 SR 1448
9545.1410 PURPOSE OF GROUP HOMES.
In our day, we are greatly concerned about all children in society and their
need for proper care. We have the responsibility to see that proper resources
are established and maintained. With. our growing child and youth population
and expansion of needs, we find that there are gaps between the service needed .
and the variety of resources available to provide the service.
In recent years, in an attempt to meet diverse needs, new resources for care
have been established. One of these new resources is the group home. Group
homes provide a type of care that is not available through traditional foster
families or institutions. Group homes are not meant to replace either of these
types of care but present a unique opportunity to combine different aspects of
treatment from both resources. Group homes can provide adult guidance and
professional services to the child placed out of the child's own home and yet
keep the child in community living. The facility is community based, and the
program is community oriented.
The group home represents a resource that has tremendous flexibility in giving
care to children of all ages with varying needs. Group home care should be
used on a selective basis as a treatment of choice. The group home should not
be considered a panacea of care for children. It is a distinct resource in its own
right that is part of the whole broad spectrum of "resources available to children.
STAT AUTH: MS s 245A.09
HIST: 17 SR 1279
9545.1420 DEFINITIONS.
Subpart 1. Agency. "Agency" means the party responsible for providing
social service, administration, and the direction and control of the program. This
party can be a county welfare department, licensed child-placing agency,
licensed children's institution, or independent operator.
Subp. 2. Children. "Children" means persons under the age of 18 years of
age or persons over 1 6 years of age if for reasons of mental retardation they still
require the protection needed by persons under 16 years of age (Minnesota
Statutes, section 245A.02, subdivision 4).
Subp. 3. Group home. "Group home" means a specialized facility that
provides care on a 24-hour-a-day basis for a selected group of not more than ten
children. The facility can be owned, rented, or leased by a county welfare
department, licensed child-placing agency, licensed children's institution, or
independent operator, or subsidized by any of the above. The specialized care
will be a planned treatment program under the direction and control of an
agency, institution, or independent operator. Natural children of the group home
parents under 21 years of age, if present in the home, are included in the total
number of children living in the home.
Subp.4. Group home parent. "Group home parent" means a person who
carries out the continuing daily living program and provides care to the children.
This may be a member of the agency staff or a person subsidized for the care he
or she provides. It may be a married couple, a single person, or single persons
working on a shift basis.
STAT AUTH: MS s 245A.09
HIST: 13 SR 1448
9545 .1430 ORGANIZATION AND ADMINISTRATION.
Subpart 1. Philosophy, purpose, and function of home. The philosophy,
purpose, and function of the group home shall be clearly defined in writing and
maintained as part of the group home file in the agency.
2
z-~ -.-- - -
Subp. 2. Written description. The agency shall similarly define, in writing,
and file a statement of the geographic area to be served, ages and kind of
children to be accepted for care, and the specific extent, limitations, and scope
of service for which the group home is established.
Subp. 3. Written agreement. The agency shall have on file a written
agreement between itself and the group home parents. The agreement shall
contain the following items:
A. admissions and discharge policy for t~e residents;
B. program plans for residents;
C. terms of the agreement as they affect length of time to be in effect and
what conditions necessitate the formulation of a new agreement;
D. the roles, responsibility, and authority of the agency and its personnel
and group home parents;
E. the per diem or monthly care rate paid to the group home parents; and
F. the maximum number of children to be cared for in the group home.
Subp. 4. Finance plan. The agency shall have a sound plan of financing that
will give assurance of sufficient funds to enable it to carry out its defined
purposes and to provide proper care for children.
Subp. 5. Repealed, 18 SR 2748
Subp. 6. Coordination with community services. The agency shall coordinate
its services and program with appropriate persons, agencies, and organizations
in the community. This shall include schools, vocational training centers, mental
health centers, job placements, day activity centers, parent organizations, and
churches.
Subp. 7. Needs of children. Clothing, personal allowance, spending money,
and medical expenses for the children in the group home shall be worked out by
the agencies involved.
Subp. a.Discrimination prohibited. All licensed individuals, agencies, or
organizations shall operate on a nondiscriminatory basis, according equal
treatment and access to their services to all persons.
Subp. 9. Repealed, 18 SR 2748
3
STAT AUTH: MS s 245A.09; 245A. 16
HIST: l1984 c 654 art 5 s 58; 18 SA 2748
9545.1440 PERSONNEl.
Subpart 1. Director. The dir~ctor of the agency will be the chief administrator
of the group home. The chief administrator may direct the total operation of the
group home or may delegate this duty.
Subp. 2. Employee qualifications. All employees shall be persons of good
character, good physical and emotional health, and appropriate age and maturity
and shall possess sufficient ability and education to carry out adequately the
duties assigned to them.
Subp. 3. Adequate staff. There shall be sufficient staff to carry out the group
home program.
Subp. 4. Social service staff. The agency shall provide qualified social
service staff for the group home either from within its own structure or through
contractual arrangements.
It is recommended that not more than two persons provide continuing social
service to any group home. (Recommended.)
Subp. 5. Group home parents. Each group home shall have full-time group
home parents. If a married couple is employed in this position, at least one of
them shall be on a full-time basis. A group home parent shall be on duty at all
times.
Subp. 6. Substitute parents. Adequate arrangements shall be made for
substitute group parents to serve in emergency situations, vacation, illness, and
when the regular group parents have their time off.
It is recommended that the full-time group home parents receive two weeks
vacation per year and that they be allowed one full day off per week.
(Recommended. )
Subp. 7. Medical and dental staff. The agency shall provide medical and
dental staff for the care of the group home residents either from within its own
structure or through contractual arrangements.
Subp. 8. Additional staff to carry out the group home program. Additional
staff to carry out the group home program:
4
- - - ~
.....
A. Psychiatric consultation: to provide consultation on a case basis as well
as overall treatment goals for the group.
B. Psychological consultation: to provide testing for assessment purposes
at the time of admission as well as to measure gains throughout the stay or at
the time of dismissal. The psychologist may also be used to set up and carry
out a research project to evaluate the program and its impact on the children.
C. Service personnel: a cook, a housekeeper, or maintenance personnel
may be hired to perform specific duties. This could relieve the group home
parents of these functions and allow them more time with the children in
carrying out the program.
D. Volunteer services: to augment and assist other personnel in carrying
out the program. Volunteers shall be aware of, and interested in, the needs of
children. They shall be oriented to the program, staff, and children of the group
home.
E. Trained group worker: to carry out direct group treatment services,
consult about overall group programs, and provide training in group process to
the group home parents. (Recommended.)
Subp. 9. Repealed, 18 SR 2748
5ubp. 10. Repealed, 18 SR 2748
5ubp. 11. Staff-to-children ratio. It is recommended that the staff ratio in a
group home be one staff member for every five children. (Recommended.)
STAT AUTH: M5 s 245A.09; 245A.16
HIST: 18 5R 2748
9545.1450 PROGRAM.
Subpart 1. In general. The program shall be a composite of the services
offered in the group home, community, and agency supervising and directing the
operation of the group home. (Recommended.)
The program shall be based on the purpose of the group home, with plans for
the individual children as well as the total group.
5ubp. 2. Individual program plans. A program plan for each child shall be
formulated by the agency in conjunction with the group home staff, community
5
resources, and auxiliary services at the time of intake. This plan shall be
reevaluated at least every six months, with changes implemented according to
the needs of the child.
Subp. 3. School for children. All school age children shall be referred to the
local school district, for educational planning and placement. "Local school
district" means the district in which the group home is located:
It is recommended that this referral to the local school take place prior to
placement in the group home to ensure that the child is eligible for service and
that the local school has an appropriate program.
Subp. 4. Goal of group living. Group living shall be used in planful and
purposeful ways to help the children develop constructive relationships to adults
and to other children and constructive patterns of handling time, money, and
care of belongings and property.
Subp. 5. Community experiences. Community living experiences shall be
used in conjunction with plans for education and training, recreational and social
pursuits, job placements, and attendance at religious services.
Subp. 6. Social service. Social service shall be a clearly defined and
. identifiable phase of the total care, treatment, and training program. Social
service shall be provided on both an individual and a group basis. It is
recommended that social service be extended to the families of the residents
whenever feasible and in accordance with the planning of the child.
(Recommended. )
Subp. 7. Recreation. Leisure time .activities shall be planned to allow for
constructive activities that enhance social and physical skills. Time shall also be .
available for completion of academic assignments and to allow for individual
pursuits.
Subp. 8. Health examinations. All children shall have medical and dental
examinations yearly, or more often if necessary.
It is recommended that each child be given a medical and dental examination
prior to admittance into the group home.
Subp. 9. Religious practice. Each child shall have the opportunity to practice
the child's religious preference.
STAT AUTH: MS s 245A.09
HIST: 17 SR 1279
6
-- -- '" *
9545.1460 RECORDS.
Subpart 1. Group home records. The supervising agency shall maintain a
record on each group home. The record shall contain a copy of each of the
following items:
A. the philosophy, purpose, and function of the group home;
B. the statement of the geographic area to be served, ages and kind of
children to be accepted for care, and the specific extent, limitations, and scope
of service for which the group home is established;
c. the agreement between the agency and the group home parents;
D. the intake policy and procedure;
E. the arrangements for the provision of social services;
F. the arrangements for the provision of medical and dental services;
G. personnel policies;
H. criteria for s~lection of group home parents. (The criteria outlined in
parts 9545.0030to 9545.0080 for foster parents may be used in the
development of the criteria for the selection of group home parents.
Recommended.) ;
I. names of group home parents and substitute group home parents;
J. the state fire marshal report; and
K. a floor plan of the group home, the designated room dimensions.
Subp. 2. Financial records. The financial record of the group home shall be
maintained in the agency.
Subp. 3. Individual records. The agency shall maintain a r~cord on each
individual resident in the group home. The record shall contain a copy of each
of the following items:
A. admission information;
B. objectives of individual planning;
7
C. reports on progress toward the accomplishment of these objectives; and
D. dismissal summary.
Subp. 4. Medical records. The group home parents shall maintain medical
records on each child.
Subp. 5. Children's progress reports. The agency shall send the referring
agency a record of the child's progress at least every six months.
Subp. 6. Repealed, 18 SR 2748
Subp. 7. Confidentiality. Information on record pertaining to an individual or
the family shall be held confidential and released only to authorized persons or
agencies.
STAT AUTH: MS s 245A.09; 245A.1 6
HIST: 17 SR 1279; 18 SR 2748
9545.1470 PHYSICAL FACILITY.
Subpart 1. Location. The location of the group home shall be related to the
program it offers. It shall be accessible to religious, school, training, and
recreation facilities and other appropriate community resources.
It is recommended that the home be located in a residential area and be
undifferentiated from other residences. It is helpful to locate in a neighborhood
where there are other children and the neighborhood accepts children and their
behavior. (Recommended.)
Subp. 2. Grounds. The grounds shall provide adequate outdoor space for
recreational pursuits.
Subp. 3. Compliance with codes. The group home shall meet the regulations
of the local health authorities as well as local zoning and building codes.
Consultation with the state Department of Health is available if desired.
The group home shall meet the requirements set forth by the state fire
marshal. The state fire marshal shall inspect all facilities.
Subp. 4. Building. Building:
8
A. There shall be living and recreation space of 35 square feet of floor
space per child. This may include living room, dining room, and recreation room
but excludes bathrooms, halls, laundry room, bedrooms, furnace room, and
kitchen.
B. The dining area shall be large enough to comfortably accommodate all
the children, the group home parents, and guests at a meal. The room shall be
cheerful, well ventilated, and convenient to the kitchen.
C. Every sleeping room for the accommodation of one child shall contain 80
square feet of floor space, with a minimum horizontal dimension of eight feet.
D. Every sleeping room for the accommodation of more than one child shall
contain 60 square feet of floor space per child, with a minimum horizontal
dimension of eight feet. Each child shall have an individual bed. Individual beds
shall be at least three feet apart.
E. No bedroom shall accommodate more than four children.
It is recommended that there be no more than two children per bedroom. It
may also be helpful to have single occupancy rooms. (Recommended.)
F. Each resident shall have a set of dresser drawers to accommodate
personal articles and clothing.
G. Each resident shall have an individual storage closet or locker for
day-to-day clothing, and other storage space for clothing not currently used.
H. There shall be one toilet for every five children, one lavatory with hot and
cold water for every five children, and one tub or shower for every five children.
The toilet facilities shall be maintained in a sanitary condition equ.al to the local
health regulations. All group homes that house children of both sexes shall have
separate toilet and bath facilities for each sex.
I. The heating plant shall be of a size and capacity to maintain a temperature
of 70 degrees Fahrenheit in all rooms.
J. Provisions shall be made. for laundry facilities adequate in space and
equipment to meet the needs of the children, the group home parents, and the
home.
K. A flashlight and a first aid kit shall be available in everY group home for
emergency use.
9
L. All medications for the children in the group home, as well as household
poisons, shall be kept in a safe and secure place.
STAT AUTH: MS s 245A.09; 245A.1 6
HIST: 18 SR 2748
9545. 1 480 PROCEDURE FOR LICENSING.
Subpart 1. Repealed, 18 SR 2748
Subp. 2. Repealed, 18 SR 2748
Subp. 3. Repealed, 18 SR 2748
Subp. 4. Repealed, 18 SR 2748
Subp. 5. Repealed, 18 SR 2748
Subp.6. Repealed, 18 SR 2748
Subp.7. Repealed, 18 SR 2748
Subp. 8. Repealed, 18 SR 2748
Subp. 9. license required. Group homes must be licensed under parts
9543.1000 to 9543.1060. -
STAT AUTH: MS s 245A.09; 245A. 16
HIST: L 1984 c 654 art 5 s 58; 18 SR 2748
9545. 1 490 Repealed, 18 SR 2748
9545.1500 Repealed, 18 SR 2748
10
EXHIBIT G
JAN 2 1998
SAFE lIAVEN SHELTER FOR YOUTH
December 31, 1997
Town Meeting Regarding Safe Haven For Youth Group Home
Informational Meeting Tuesday, January 6, 6:30 p.m. City Council Chambers,
at New Fire Station.
The intent of this meeting is to:
1) Inform neighbors of Safe Haven' s structured programming and staffing.
2) Answer questions regarding typical Safe Haven residents.
3) Give history of Safe Haven and its current group home operating in Prior Lake.
4) Address other questions and concerns.
Various Safe Haven staff including the Program Director, Peggy Howell will be on
hand to answer your questions. If you have questions related to this issue, we hope you
will attend. If you can't attend but still have question, please feel free to call me at
440-5379 or Peggy at 226-1488. Although this meeting was suggested by the City
Planning staff, it is not a City facilitated meeting.
~7}JJJ
Dan Saad
cc: Jenny Tovar, City Planner
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Jan. 3 '98 18:44
1000 PROPERTY MRNRGE
TEL 6124398482
City of .Prior Lake
16%00 Eagle Creek Ave. S.E.
Prior Lake, MN. ~5372
Attn: Planuing. Jenny Tovar
1/3/98
Memben of Priur LAke Planning Commission,
P. 1
EXHIBIT I
I bave just ~ved notice of the Planning Commission meeting to be held 1/12/98. I was neyer
informed ofth"e put meeting that tbe discussion is continued from of 12/8/97. I awn two pieces of
property within the radius of the proposed rezoning (Gateway Center & Northgate Center). 1 do
oppose tbe rezoning of the property in question. only due to It being the last of the retail land In the
smail area of ~tail aod I believe tbat only further retail development in mill area wiD help the already
existing busioC3'es. I also believe that tbe proposed new building tbat Safe hayen would construct
would also not conform with the collstruction and look of the other properties cnrrently & proposed
j e area.
S' erely, J / --
~~..v
Gateway & NorthgJltc Centen
(612)430-0163 fax (439-1432
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Planning Case File No. ~
Property Identification No.
'. City of Prior Lake ;;.S- - CJ&;' ~ "\ -0
ILAND USE APPLICATION -~
16200 Eagle Creek Avenue S.E. fPrior Lake, Minnesota 55372-1714/ Phone (612) 447-4230, Fax (612) 447-4245
Type of Application:
.0 Rezoning, from (present zonin~)
to (proposed zonin~)
o Amendment to City Code, Compo Plan or City Ordinance
o Subdivision of Land
o Administrative Subdivision
121' Conditional Use Permit
o Variance
o Other:
Brief description of proposed project (attach additional
sheets/n~tive i~ desired) A- I '~ens~& (Str;tz oJ! JIlIN)
lleSi&vd., 'oJ f'v 'fT/t1'n Se rill hj
10 A.PKonS. fi.,'5,. will be'- a flJ.L "6
I .
(;;ro"'-~ Mo~ hi{. YtJ""'<(J.. ~ya 1-1K .
J<7&4- to>YI Q&w,s e. o.~)\.fit ~(.d- a",d an...J~
h~ co...~t ord.u'eti. .
~~
Applicable Ordinance Section(s): Sf. S~~
;; YS/J./I "j1.l~J. 3
Applicant(s): SA-FE 4-AI/EnJ ~-#,€'LrE~ ;:;Jt.."?olAv'll~ -' 'bAttJ~-Presj'&!.#n.J-
Address: J (" 7hc. VIA-to, j~ "R na& PrI'Oll.. Lok-tL J IH/IJ S--S-3"1 ').
Home Phone: ~n)'" 1./0 -t::;, "J 7 "1 Work Phone: l/qD -~ ?'7'1
Property Owner(s) [If different from Applicants]: [3/'/1 d- :I& ;/ eeh Sc. "'}intO ktd
Address: '-Ilff ~re1,/hWI;OLQ. ~ . ,
Home Phone: ~/2,) '1 LJ7- '11'5' ) Work Phone{ 4-1'2.-} '-196- r,3~S-
Type of Ownership: Fee _ Contract for Deed _ Purchase Agreement ~ .
Legal Description of Property (Attach a copy if there is not enough space on Ithis sheet):
~ $o~~ ;.v/." ,cee.-t- rt ft..t, &s,f- :J..uo ~+. t')~ Sw Yy ~ tOf. ft..L ~WYy}
&~~to", ?Jin . 1115"". I!. ).).. S;>-,,>I+ u,.> 5";:..)4!" I&,:)~ s+.)
To the beSt o'f my kDowledge ~he information provided in this application and other material submitted is correct. In
addition, I have read the relevant sections of the Prior Lake Ordinance and procedural guidelines, and understand that
applic ions will no be pr essed until deemed complete by the Planning Director or assignee.
111/;7/9?
Da" /~fr-
Date
THIS SPACE TO BE FILLED IN BY THE PLANNING DIRECTOR OR DESIGNEE
PLANNING COMMISSION
CITY COUNCIL
APPROVED
APPROVED
DENIED
DENIED
DATE OF HEARING
DATE OF HEARING
CONDITIONS:
SignatUre of Planning Director or Designee
lu-app2.doc
Date
NOTICE OF HEARING FOR CONDITIONAL USE PERMIT
You are hereby notified that the Prior Lake Planning Commission will hold a hearing at Prior Lake
Fire Station #1, located at 16776 Fish Point Road, SE (Southwest of the intersection of CR. 21
and Fish Point Road), on Mondav. December 8. 1997. at 6:30 C.m. or as soon thereafter as
possible.
APPLICANT:
Safe Haven Shelter for Youth
Dan Saad
16706 Dublin Road
Prior Lake, MN 55372
SUBJECT SITE:
5240 160th Street
This property is located east of Franklin Trail, on the north side of 160th
Street.
LEGAL
DESCRIPTION:
The South 241.7 feet of the East 200 feet of the Southwest Quarter of the
Southwest Quarter of Section 36, Township 115, Range 22, Scott County
Minnesota.
REQUEST:
The applicant is proposing to construct a state licensed residential facility
serving 10 persons at the above location, zoned R-3 (Multiple Family
Residential). The Prior Lake Zoning Ordinance requires a conditional use
permit for state licensed residential facilities serving 7-16 persons in the
R-3 district.
If you are interested in this issue, you should attend this hearing. The Planning Commission will
accept oral and/or written comments. Questions related to this hearing should be directed to the
Prior Lake Planning Department by calling 447-4230 between the hours of 8:00 a.m. and 4:30
p.m.
Jennifer Tovar
Planner
City of Prior Lake
TO BE PUBLISHED IN THE PRIOR LAKE AMERICAN ON NOVEMBER 22, 1997 AND
nOVEMBER 29, 1997.
1:\97files\97cup\97 -117\97117pn.doc
16200 Eagle Creek Ave. S.E., Prior Lake. Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245
i'\N EQCAl OPPORTCNITY E:<IPLOYER
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'.
NOTICE OF HEARING FOR CONDITIONAL USE PERMIT
You are hereby notified that the Prior Lake Planning Commission will hold a hearing at Prior Lake
Fire Station #1, located at 16776 Fish Point Road, SE (Southwest of the intersection of CR. 21
and Fish Point Road), on Mondav. Januarv 12. 1998. at 6:30 C.m. or as soon thereafter as
possible.
APPLICANT:
Safe Haven Shelter for Youth
Dan Saad
16706 Dublin Road
Prior Lake, MN 55372
SUBJECT SITE:
5240 160th Street
This property is located east of Franklin Trail, on the north side of 160th
Street.
LEGAL
DESCRIPTION:
The South 241..7 feet of the East 200 feet of the Southwest Quarter of the
Southwest Quarter of Section 36, Township 115. Range 22, Scott County
Minnesota.
REQUEST:
The applicant is proposing to construct a state licensed residential facility
serving 10 persons at the above location, zoned R-3 (Multiple Family
Residential). The Prior Lake Zoning Ordinance requires a conditional use
permit for state licensed residential facilities serving 7-16 persons in the
R-3 district.
This is a continued hearing from December 8, 1997. If you are interested in this issue, you
should attend this hearing. The Planning Commission will accept oral and/or written comments.
Questions related to this hearing should be directed to the Prior Lake Planning Department by
calling 447-4230 between the hours of 8:00 a.m. and 4:30 p.m.
Jennifer Tovar
Planner
City of Prior Lake
1:\97files\97cup\97-117\97117pn2.doc
16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fa,< (612) 447-4245
AN EQLiAL OPPORTUNITY E;'4PLOVSQ
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DRAFT
D. Case #97-117 Consider a Conditional Use Permit to construct a State Licensed
residential facility servicing 10 persons at the property located at 5240 160th Street.
Jenni Tovar explained proposal. One of the conditions is that use is consistent with
Comprehensive Plan. Property currently zoned R-3, but is designated for Community
Commercial on 2010 Comprehensive Land Use Plan Map. The City Attorney has
advised us to continue this item due to the upcoming zoning ordinance which may have
an effect on this property.
Dan Saad, 14750 West Burnsville Parkway, Burnsville, operate group home located on
Dublin Road in Prior Lake, and is coach at Prior Lake High School. Asking to resolve
inconsistency between Comp plan and zoning ordinance, by changing Comp Plan to R-
RD.
Explained his current operation of group home. Have had no problems in community.
Home is located on Dublin Road, in residential area. Has been a great success. Take
boys in middle and high school, and let them play football. Are looking for property in
R-3 district to allow 7-16 residents in group home. Have chosen this piece of property
near high school. Has been residential, but was designated Commercial on Comp Plan in
1996. Surrounding property is R-4, high school, commercial. The justification for change
is as follows: property is rather small, changing to R-4 would make it consistent with
surrounding area. Are also a business, so have employees. Home would fit in nicely
with area. Looking for feedback from Planning Commissioners. Have done extensive
work on this property, and have several letters of support. Prior Lake Rotary, $5,000,
Edina Realty, $7,500, Lions Club, $1,000, Optimists Club, $1,000. Other businesses
have donated products. This inconsistency came up late in the process. Asking to amend
the Comprehensive Plan to High Density Residential.
Stamson- Staff has asked to table indefinitely to work out legalities.
Tovar- Look at this zoning map with discussion of new zoning ordinance. House
cleaning Comp Plan amendments would have to be done as a result of new zoning map.
Would be done after new zoning ordinance is amended.
Open Public Hearing:
Doug Boyle, 5140 150th Street, asked is facility. Tovar explained Safe Haven Youth is a
state licensed facility for court ordered juveniles ages 8-17, order to live in group home
facility. Has some experience with group homes, in Sioux City, Iowa, doesn't want a
facility a block away from him. Moved to Prior Lake to get away from gangs and
criminals. Has no problem with helping kids.
Tovar explained children are there with emotional or behavioral disorders. Police report
for existing house, shows seven calls, three for runaways, two harassing phone calls to
house, noncriminal activities.
L:\97FILES\97PLCOMM\PCMIN\MN120897.DOC 12
DRAFT
Larry , representing mother who owns adjoining property. Concerned about how many
residents would be allowed in R-4. Is there a buffer required between R-l and R-4.
Kansier Explained bufferyard requirements.
Alex ?, represents mother who owns adjacent residents. Facility is across the street form
an elderly home. Have already voiced concerns about safety of children. Also concerned
about security. If it is included, can there be request for a security fence. Is not
advantageous to area. Has developer talked to neighboring people to get
recommendations. She was not notified until found in the newspaper.
Dan Saad, incidents at existing house very minor. Runaways went home, but ended up
back at house. Facility is set up to be a step up from a foster home. The kids are already
in school. We offer a 1:5 ratio of staff to kids at facility. State requires a 1:10. Staffis
all BA or MA certified. Kids are supervised when they are in the community. Intend on
going to neighbors to answer any questions. Want to work with communities. Stamson
asked ifkids are coming from social services rather than criminal courts. Yes. Goal is to
get kids back to their homes whenever possible.
Kuykendall- How is program funded. Saad explained funded by a per diem from Scott
County, which covers administration. Also do some fund raising to cover costs. Host
county contract is with Scott County. Other counties abide by same contract as Scott
County. Saad explained they have looked at several sites in Chaska, but could not offer
the security he can offer now. Other locations in Scott County, have looked for over a
year. Found a rental home on Dublin. Is looking in Prior Lake because of support
received in Prior Lake.
Bill Schmokel, 4151 Grainwood Circle, owner of property. Would like to speak to
process, This process was designated Commercial in June, 1996. Have had numerous
meetings with staff over past years about this property. Mr. Saad checked with staff prior
to application. When you have a conflict between Comp Plan and Zoning Ordinance,
City has 9 months to resolve issue. City has already exceeded this by 5 months. Leaves
City opened to liability. Quite dismayed that this type of application can get this far.
Kuykendall asked staff to rephrase how this got here. Tovar explained criteria number 6
states use must be consistent with Comp Plan. Right now attempting to change ordinance
to be consistent with Comp Plan. Zoning Ordinance is catching up, applicant caught in
middle.
MOTION BY VONHOFF TO CONTINUE PUBLIC HEARING INDEFINITELY.
SECOND BY CRAMER. MOTION CARRIED 5-0.
Tovar explained new notices will be sent.
5. Old Business: 9:20 p.m.
L:\97FILES\97PLCOMM\PCMIN\MN120897.DOC 13
~~@:@~O~[g ~~
01
I~ JAN 1 21998 '"
January 12, 1998
City of Prior Lake
16200 Eagle Creek Ave.
Prior Lake MN 55372
Attention: Jenny Tovar, Planning Department
RE: Safe Haven for Youth
Conditional Use Application
Members of the Prior Lake Planning Commission:
I am unable to be at the hearing for Safe Haven for Youth Conditional Use tonight
due to previous commitments. I would like to make the following comment.
I believe that the request is a reasonable one and fits in with the use of the area. I
also think that the proposal to amend the Comprehensive Plan for the parcel is a
reasonable solution to the problem at hand. Therefore, I would encourage you to approve
both requests.