Maryland Department of Human Resources

Office of Licensing and Monitoring

311 W. Saratoga Street

Baltimore, Maryland 21201

Office: 410.767.7871 Fax: 410.333.8408

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Child Placement Agency Report
Provider Organization: /

MENTOR Maryland

Licensing Agency: / DHR / Contracting Agency(s): / DHR, DJS
Name of Chief Administrator: / Colette Walker-Thomas / Email: /
License Type: / Treatment Foster Care,
Independent Living Program / Type of Inspection: / Quarterly
Name and Address of CPA Office / License Capacity / DHR Contract Limit / Census by Placing Agency / License#/ Exp. date / Date of site Inspection
Lanham Children’s Services
4501 Forbes Rd., Suite 140
Lanham, MD 20706 / Unlimited / SED 150 / DHR 37
CFSA 1 / #00148 / 6/30/16 / 3/12/15
Baltimore Teens in Transition TFC/ILP
1540 Caton Center Dr.,
Baltimore, MD 21227 / Unlimited / TFC 55
ILP 20 / BTIT DHR 18
DJS 13
ILP DHR 8
DJS 4 / #00272 / 6/30/16
#00408 / 6/30/16 / 3/11/15
Salisbury Teens in Transition
TFC/ILP
821 Eastern Shore Blvd Salisbury, MD 21804 / Unlimited / TFC 55
ILP 20 / ECS DHR 22
DJS 13
STIT DHR 4
DJS 22
ILP DJS 2 / #00318 / 6/30/16
#00409 / 6/30/16 / 3/10/15
Baltimore Children’s Services TFC/ Baltimore Medical Program TFC
5720 Executive Drive
Baltimore, MD 21228-1757 / Unlimited / SED 150
MF 100 / BCS DHR 113
BMP DHR 80 / #00147 / 6/30/16 / 3/16/15

Inspection Summary

Number of Records Reviewed: / Youth / 7 / Staff / 4 / Foster Parent / 23 / Adoptive Parent / N/A
Number of Interviews: / Youth / 0 / Staff / 10 / Foster Parent / 0
CPA Office Inspection: / Approved
Number of ILP Apartments Inspected: / 0 / Number of Foster Homes Inspected: / 0
COMAR Violation: / Yes / X / No
If Yes, list Cited Violation(s) below:
Violation(s) / Findings
07.05.02.17 (7) / 1/7 client records didn’t document physical exam;1/7 didn’t document dental exam
07.02.21.10 D (3) / 2/7 client records didn’t document foster parent progress notes
07.02.21.08 A (1) / 1/7 client record didn’t document timely 30 day treatment plan
07.02.21.08 A (2) / 1/7 client records didn’t document 90 day treatment plans
07.05.02.17 A (3) / 1/7 client records didn’t document immunization
Corrective Action Plan: / Yes / X / No / If yes, date of CAP: / 3/16/15
Complaint Outcome: / Complaint documentation will follow separately
Current Status of License: / Continued
Licensing
Coordinator: / Lisa Beeman / Date: / 3/19/2015 / Email: /
Program Manager: / Richard Berger / Date / 3/19/2015 / Email: /

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