ABW DCH Violations June 2008

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Georgia Department of Human Resources,Office of Regulatory Services State

Statement of Deficienciesand Plan of Correction

Inspection begin date

Inspection end date:

6/4/2008

6/20/2008

Name of Provider or Supplier

ADOPTION BLESSINGS WORLDWIDE, INC

Street Address, City, State Zip Code

3405 VINEVILLE AVENUE LOWER LEVEL

MACON, GA 31204

Inspection Results

As of: Thursday, July 17, 20

therefore did not believe s/he had to also report the incident.

P 0319 290-9-2-.03(9)(a) Composition of the Board.

SS=D

Composition of the Board. ...The Board shall be composed of at least five (5) members.

This Requirement is not met as evidenced by:

Based on staff interview and review of relevant agency documents, the agency failed to ensurethat the board was composed of at least five (5) members.

Findings include:

A review on 06/17/2008 of minutes for the Board of Directors (BOD) meetings for 12/17/2005,04/14/2006, 06/06/2006, 08/06/2006, 11/02/2006, 12/02/2006, and 03/16/2007 revealed that only fou(4) members were present during each meeting. The minutes did not indicate the absence of anymembers.

A review on 06/17/2008 of all BOD documents available revealed that the agency did not retain acopy of a complete list of BOD members for the time period of 12/17/2005 through 03/16/2007.Therefore, the surveyor was unable to review the current list of board members for additionalmembers.

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More Information Return to Facility Location and Information Guide Return to Inspection Scre
http://167.193.144.170:7001/ORSINV/facsum.jsp?varFACID=CPA001016http://www.ors.dhr.state.ga.us/facsearch.asphttp://167.193.144.170:7001/ORSINV/information.jsp?facid=CPA001016&eventid=ZPK711


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An interview on 06/17/2008 at 12:20 PM with staff B revealed that there was another member onthe BOD in 2005; however, that member became employed by the agency in October 2005 as theagency's Social Work Supervisor. According to staff B, the member left the paid position with thagency and once again joined the BOD in September 2007.

P 0320 290-9-2-.03(9)(b) Composition of the Board.

SS=D

At least one of the Board members shall be a bona fide resident of Georgia.


Based on staff interview and review of relevant agency documents, the agency failed to ensurethat at least one of the Board members was a bona fide resident of Georgia.

Findings include:

A review on 06/17/2008 of minutes for Board of Directors (BOD) meetings for 12/17/2005,04/14/2006, 06/06/2006, 08/06/2006, 11/02/2006, 12/02/2006, and 03/16/2007 revealed that only fou(4) members were present during each meeting. The minutes did not indicate the absence of anymembers.

A review on 06/17/2008 of a "Board of Directors" list provided by the agency revealed that the

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four (4) members present during the seven (7) BOD meetings conducted from 12/17/2005 throug03/16/2007 were all residents of the state of Florida.

A review on 06/17/ 2008 of all BOD documents available revealed that the agency did not retain acopy of a complete list of BOD members for the time period of 12/17/2005 through 03/16/2007.Therefore, the surveyor was unable to review the current list of board members for additionalmembers.

An interview on 06/17/2008 at 12:20 PM with staff B revealed there is currently a BOD memberfrom Georgia on the board. According to staff B, the member was also on the BOD in 2005;however, the member became employed by the agency in October 2005 as the agency's SocialWork Supervisor, and therefore could no longer serve on the BOD. Additionally, staff B statedthat the BOD member from Georgia left his/her paid position with the agency and once againoined the BOD in September 2007.

P 0336 290-9-2-.03(11)(d) Financing.

SS=G

The Agency shall: ...(d) Provide bond for Board members and staff responsible for handling substantial amounts of funds; ...


****Based on a review of email communications and staff interview, the agency failed to providbond for board members and staff responsible for handling substantial amounts of funds.

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Findings include:

A review on 06/19/2008 of an email message received from staff B on 06/19/2008 at 12:46 PMrevealed that the agency does not have bonding for Board of Director's members and staff whohandles substantial amounts of agency funds. According to the email from staff B, staff Acontends that the agency was not aware that bond insurance was a rule requirement.

A telephone interview on 06/20/2008 at 12:09 PM with staff B revealed staff B had began toactively research companies to provide bonding to employees handling agency funds.

P 0337 290-9-2-.03(11)(e) Financing.

SS=G

The Agency shall: ...(e) Not require gratuities such as money or other things of value or services from applicants or theirrepresentatives beyond the established fee; ...


****Based on a record review and staff interview, the agency failed to ensure that additional feebeyond the established fees were not required of applicants. This deficiency is associated withintakes #53972 and #54637.

Findings include:

A review on 06/04/2008 of receipts for funds paid by AH #1 to Adoption Blessings Worldwide(ABW) revealed three (3) payments of $500.00, $300 .00 and $500.00, for "Humanitarian Aid fees

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paid in September 2005, February 2006, and September 2006 respectively. AH #1 has initiatedthree (3) adoptions through ABW.

Additionally, a review on 06/17/2008 of an email message dated 09/15/2005 at 2:55 PM from ABWstaff to AH #1 with the subject line "Wiring Instructions for Country Fee" revealed a statementfrom ABW that in addition to the country fee and foster care fee, AH #1 "also would wire $500humanitarian aide fee to Adoption Blessings Worldwide account" .

A review on 06/04/2008 of receipts for funds paid by AH #2 to ABW revealed two (2) $500payments for "Humanitarian Aid fees" paid in May 2006 and July 2007, respectively . AH #2 hasinitiated two (2) adoptions through ABW.

A review on 06/04/2008 of AH #1 and AH #2's records revealed that the files did not contain anydocumentation related to "Humanitarian Aid fees" that was provided to AH #1 and AH #2 at thetime of application, during orientation, or within the signed contracts.

An interview on 06/04/2008 at 2:10 PM with staff B revealed that the "Humanitarian Aid fee" iscurrently $500.00 and is for agency representatives to travel to agency approved countries to

bring humanitarian aid such as clothing and diapers to the country. Staff B indicated that the"Humanitarian Aid fee" is in addition to the "Agency fee" and the agency did not have writtendocumentation concerning the fee.

A telephone interview on 06/20/2008 at 12:09 PM with staff B revealed that all families are "askedand not required to contribute to humanitarian aid. In addition, although staff B could not recallan incident where a family did not pay the fee, staff B contends that the fee can be waived basedon the circumstances of the family.

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P 0339 290-9-2-.03(11)(g) Financing.

SS=D

The Agency shall: ...(g) Establish a fee for placement services based on the cost of recruitment, placement, postplacement, legal,medical and other services rendered to the birth parent, adoptive family, foster parents, and child as documentedand justi


Based on a review of relevant agency documents and staff interview, the agency failed toensure there was written documentation that the Board reviewed the agency's fee schedule at

least annually.

Findings include:

A review on 06/17/2008 of minutes for all Board of Directors ( BOD ) meetings documentedfrom December 2005 through October 2007 revealed that the minutes did not contain anydocumentation that the BOD discussed and approved the agency's established fee schedule.

A telephone interview on 06/20/2008 at 2:19 PM with staff B revealed that staff B is not actively

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involved with BOD meetings; however, staff B contends that s/he is sure that the BOD wouldhave discussed and approved the fees.

P 0340 290-9-2-.03(11)(h) Financing.

SS=G

The Agency shall: ...(h) Collect fees only as services are provided; ...


****Based on record review and staff interview, the agency failed to ensure that fees were onlycollected as services were provided. This deficiency is associated with intake #53972.

Findings include:

A review on 06/16/2008 of an email dated 09/15/2005 at 2:55 PM from an Adoption BlessingsWorldwide (ABW ) staff to AH #1 with the subject line "Wiring Instructions for Country Fee"revealed that AH #1 was instructed to wire the Guatemalan attorney $10,700 with $700 of thosefund s wired for foster care fees at $350 per month for AH #1's referred child.

A review on 06/16/2008 of an "Outgoing Wire Transfer" from AH #1's bank revealed that $10,700was transferred to the Guatemalan attorney's account on 09/16/2005.

A review on 06/19/2008 of an email message dated 08/31/2006 at 4:49 PM from staff D to AH #1with the subject line "Travel Information" revealed that adoptive parents were reminded in theemail that "foster care fees of $350 per month will be due for each month longer than 4 monthsfrom the time of referral acceptance."

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A review on 06/13/2008 of an unsigned/undated "Financial Guide and Agreement" from theGuatemalan attorney provided to AH #1 by ABW staff on 09/15/2005, revealed that AH #1 wasscheduled to pay an initial $10,000 of the attorney's $20,000 fee upon referral of a child.According to the guide, the attorney's fee included "Four months of childcare" and indicated thachildcare would cost the adoptive parent "$300.00 per month thereafter". Therefore, according tdocuments provided to AH #1 by ABW, fees for foster care services should not have beencollected prior to January 2006 which is four (4) months from AH #1's payment of funds to the

attorney.

A telephone interview on 06/19/2008 at 5:15 PM with staff B revealed staff B's understanding ofthe upfront foster care fees is that families who were not "paper ready" were required to pay two(2) months foster care in advance. Additionally, staff B indicated that s/he was not involved withthe early stages of AH #1's case.

Cross reference Tag 525

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P 0467 290-9-2-.04(14)(f) Agency Personnel.

SS=D

There shall be a personnel file on each employee which shall include: ...(f) Current job description; ...


Based on record review and staff interview, the agency failed to ensure that 1 of 7 personnelrecords reviewed included a current job description.

Findings include:

An interview on 06/17/2008 at 2:10 PM with staff B revealed that staff B is the GeorgiaDirector/Guatemala Program Coordinator. According to staff B, s/he has held this position sinceMay 1, 2006.

A review on 06/17/2008 of staff B's personnel record revealed that the file did not contain acurrent job description for staff B's position as Georgia Director. The file did include two (2) job

descriptions with the job titles "Dossier Specialist" and "International Program Director".

An interview on 06/17/2008 at 2:15 PM with staff B confirmed the finding.

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P 0468 290-9-2-.04(14)(g) Agency Personnel.

SS=D

There shall be a personnel file on each employee which shall include: ...(g) Annual performance evaluation reports and any records of discipline involving the inappropriate use ofbehavior management techniques or emergency safety interventions signed a


Based on record review and staff interview, the agency failed to ensure that 1 of 7 staff memberhad an annual performance evaluation signed and dated by the supervisor.

Findings include:

A review on 06/17/2008 of staff A's personnel record revealed that the file contained a performacevaluation report completed, signed and dated by staff B on 10/01/2007. The performanceevaluation report was not signed and dated by staff A's supervisor and Staff B is not in asupervisory role over Staff A.

A review on 06/17/ 2008 of staff A's record revealed that staff A is the Executive Director and aninterview on 06/17/2008 at 2:10 PM with staff B revealed that staff B is the Georgia Director/Guatemala Program Coordinator and is supervised by staff A.

A review on 06/17/2008 of an Adoption Blessings Worldwide (ABW) Organizational Chart revealethat the Executive Director is supervised by the Board of Directors .

An interview on 06/17/2008 at 2:15 PM with staff B revealed that staff B contends that becausestaff B knew staff A's strengths and weaknesses, staff B thought that s/he could complete staff

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A's performance evaluation.

P 0522 290-9-2-.05(4) Agency Policies and Procedures for Services.

SS=G

Prior to accepting a child from another state or prior to placing a child outside Georgia for temporary care or foradoption, the Agency's procedures shall comply with the applicable state laws and with the provisions of theInterstate Compact on the Plac


****Based on record review, staff interview and review of Florida Department of Children andFamilies' (DCF) documents, the agency failed to comply with Florida state laws. This deficiencis associated with intakes #54637 and #55795.

Findings include:

A review on 06/17/2008 of a list of prospective adoptive parents submitted by the agency on06/17/2008 revealed twelve (12) finalized adoptions in 2005 involving families residing in Florida

three (3) finalized adoptions in 2006 involving families residing in Florida; and six (6) finalizedadoptions in 2007 involving families residing in Florida .

A review on 06/05/2007 of Florida State Statutes revealed that Florida Statutes 63.202(2) and63.032(3) state respectively :"No agency shall place a minor for adoption unless such agency is licensed by the Departmentexcept a child caring agency registered under Florida Statutes 409.176."

"An "adoption entity" means the department, an agency, a child caring agency registered under

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Florida Statutes 409.176, an intermediary, or a child placing agency licensed in another state,which is qualified by the Department to place children in the state of Florida."

A review on 06/16/2008 of a Cease and Desist letter dated 05/23/2008 issued to staff A by theState of Florida Department of Children and Families (DCF) revealed that Adoption BlessingsWorldwide (ABW) does not possess a Florida Child Placing license nor is the agency qualified bFlorida DCF to place children in the state of Florida.

A telephone interview conducted on 06/04/2008 at 12:25 PM with staff A revealed that staff Acontends that s/he was told at the time of the agency's initial Georgia ORS licensure that theagency's Georgia license could be used to place children in all fifty (50) states.

P 0525 290-9-2-.05(7) Agency Policies and Procedures for Services.

SS=G

Agency practices shall conform to the written policies.


Based on record review and staff interview, the agency failed to ensure that agency practicesconformed to written policies. This failure resulted in a prospective adoptive parent being askedby an agency representative to pay established fees early to assist in payment of funds to a

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child's relative in order to obtain the relative's cooperation with the adoption process. Thisdeficiency is associated with intake #53972.

Findings include:

A review on 06/19/2008 of an Adoption Blessings Worldwide (ABW) "Prohibition on Child BuyiPolicy" revealed that ABW's policy "prohibits its employees and agents from giving money or

other forms of compensation, directly or indirectly to a child's parent(s), or other individual(s), oan entity as payment for the child or as an inducement to release the child".

A review on 06/13/2008 of an email message from staff D to AP #1A dated 04/18/2007 at 1:15 PMrevealed that a relative of AH #1's referred child wanted to be compensated $2,000 to cooperatewith required interviews to complete the adoption of AH #1's referred child. The email furtherstates that the attorney asked for AP #1A to pay $1,000 of the country fee early in order to pay thexpense to the relative.

A review on 06/13/2008 of an email message from staff D to AP #1A dated 04/21/2007 at 7:02 AMrevealed that the relative of AH #1's referred child informed the attorney that "if they would give

him/her $2,000 to pay him/her for his/her time and trouble, he/she would come" to completerequired interviews. According to the email, the attorney was only able to pay $1,000 andtherefore asked if AP #1A would pay $1,000 of the final attorney fee early in order to help pay the$2,000 to the relative.

A review on 06/16/2008 of an email message from staff D to AP #1A dated 04/24/2007 at 2:15 PMrevealed that the person requesting the $2,000 from the attorney was not the referred child'sblood-related relative, but instead was the the referred child's blood-related relative's newspouse. According to the email, the child's blood-related relative's new spouse did not have to binterviewed for the adoption, but was "the one calling the shots" as to whether or not theblood-related relative and the birthparent could be interviewed.

A review on 06/16/2008 of an email message from staff D to AP #1A dated 04/28/2007 at 6:01 PMwith the subject line "Re: is everything ok?" revealed that staff D was told that the attorneyneeded the $1,000 for the child's blood-related relative's new spouse and for foster care fees byMay 2007 or the attorney "would no longer go forward" with the adoption.

A review on 06/19/2008 of an email message from staff A to AP #1A dated 04/28/2007 at 6:22 PMwith the subject line "Re: is everything ok?" revealed that staff A expressed to AP #1A that if sta

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A was AP #1A, staff A would "do what they ask". Staff A also expressed in the email that theattorney is "not even asking for additional money".

An interview on 06/20/2008 at 2:19 PM with staff B revealed that the agency's "Prohibited ChildBuying Policy" had not been developed at the time of the request to AP #1A. Staff Backnowledged that s/he could not provide any documentation reflecting exactly when the policywas developed. Additionally, staff B stated that the agency was only relaying the information

from the attorney to AP #1A and that AP #1A never paid the money to the attorney.

P 0605 290-9-2-.06(2) Adoption Services.

SS=D

Additional Orientation for Applicants. Once an application has been submitted by prospective adoptive parent(s)and prior to approval of the application, additional orientation information shall be supplied for the applicant(s),including but not limite

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Based on record review and staff interview, the agency failed to ensure that adoptive parentsreceived information on the agency's grievance procedures. This deficiency is associated withintake #53972.

Findings include:

A review on 06/04/2008 of AH #1's record revealed that the file did not contain documentation thAH #1 received information concerning the agency's grievance procedure.

A review on 06/18/2008 of an email message from staff staff A to AP #1A dated 04/02/2008 at 9:0PM with the subject line "Re: Agreement/Foster care" revealed a statement from staff A indicatinthat at the time that AP #1A and AP #1B signed the contract with the agency, there was nogrievance procedure distributed to families.

An interview on 06/04/2008 at 2:05 PM with staff B revealed that the agency now has a form that provided to families that includes the agency's grievance procedure.

P 0649 290-9-2-.06(3)(d)11. Adoption Services. Home Study.

SS=D

The [home] study shall include at least the following information concerning the prospective adoptive family: ...11. A minimum of three character references:(i) At least one reference must be from an extended family member not residing with the pr


Based on record review and staff interview, the agency failed to ensure that a home study for 1 2 adoptive home records reviewed, included at least one (1) reference from an extended familymember. This deficiency is associated with intake #53972.

Findings include:

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A review on 06/17/2008 of AH #1's home study report completed 04/04/2008 revealed that thereport included three (3) character references; however, neither of the references was from anextended family member of AP #1A or AP #1B.

An interview on 06/17/2008 at 3:13 PM with staff B confirmed the finding.

P 0757 290-9-2-.06(9)(a) Adoption Services. Maintenance of Records.

SS=D

Maintenance of Adoption Records. The Agency shall maintain a record for each applicant for adoption services, contain the application and other information collected by the Agency pertaining to the applicant including but nolimited to:1. The home


Based on record review and staff interview, the agency failed to maintain all legal documentspertaining to the adoption of a child in 1 of 2 adoptive home records. This deficiency isassociated with intake #54637.

Findings include:

A review on 06/04/2008 of AH #2's record revealed that the file did not contain the DNA results foAH #2's second intercountry adoptive child and biological mother.

An interview on 06/04/2008 at 3:40 PM with staff B confirmed the finding. Staff B forwarded acopy of the DNA results via email on 06/11/2008 at 2:31 PM.

P 0763 290-9-2-.06(9)(c) Adoption Services. Maintenance of Records.

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SS=D

For adoptions finalized after the effective date of these rules, the adoption records shall be converted to non-papformat, such as microfilm or computer format, within six months from the date of finalization of the adoption. Theformat type and date m


Based on observation and staff interview, the agency failed to ensure that adoption records werconverted into a non-paper format within six (6) months from the date of finalization of anadoption.

Findings include:

An observation on 06/17/2008 of the agency's file room revealed that the file room included four(4) black single drawer fireproof file cabinets each filled with agency adoption records.

An interview on 06/17/2008 at 4:05 PM with staff A revealed that the agency had not convertedany of the finalized adoption records to a non-paper format. Additionally, staff A stated that with

the exception of scanning each individual sheet, the agency has not developed a plan forconverting the records.

P 1001 290-9-2-.08(2) Agency Records and Reports.

SS=D

Each Agency shall maintain a permanent listing with identifying information of all children accepted for service orplacement.


Based on a request for information and staff interview, the agency failed to maintain a permanenlisting of children accepted for service or placement.

Findings include:

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A request on 06/04/2008 to staff B for a listing of all adoptive families currently being serviced bthe agency revealed that the agency did not have a list onsite.

An interview on 06/04/2008 at 12:38 PM with staff B revealed that staff B could create ahandwritten copy of the adoptive family information but did not have a permanent list available. copy of a list of adoptive families and children was provided while onsite on 06/17/2008.


SS=D

Records and files shall be kept current and be available for review by the Department.


Based on record review and staff interview, the agency failed to ensure that records were keptcurrent and were available for review.

Findings include:

A review on 06/16/2008 of an "Income Statement" form for year ending June 30, 2007 provided bthe agency on 06/04/2008 revealed an unknown line item labeled "coordinat . fee" which includesignificant revenues.

A review on 06/04/2008 and 06/16/2008 of a fee schedule provided in the contract and inorientation information to adoptive parents revealed that there was no mention of a"coordinat.fee".

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An interview on 06/17/2008 at 11:38 AM with staff B revealed that staff B was unable to provide aexplanation of the "coordinat.fee" and had to contact staff C for clarification. Further discussionwith staff B revealed that staff B was informed by staff C that the "Income Statement" for yearending June 30, 2007 was an estimation of revenues and expenditures and the the agency's taxreturns can be reviewed for accurate information. Additionally, staff B indicated that staff B courequest a copy of an updated "Income Statement" form from staff C; however it should be notedthat at the time of the request, staff C, who resides in Florida, was at his/her other place of

employment.

A review on 06/05/2008 of a letter also provided by email on 06/05/2008 at 12:34 PM revealed thathe agency's part-time bookkeeper (staff C ) does Adoption Blessings Worldwide (ABW) workfrom home and "has to be there" to access the agency's financial information.

An interview on 06/17/2008 at 12:06 PM with staff B revealed that with the exception of theagency's tax returns and the "Income Statement" provided, there were no additional financialrecords readily available at the ABW Georgia office.


SS=D

The Agency shall submit on a timely basis such financial, statistical reports, and Board minutes and otherinformation as may be required by the Department.

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Based on a request for information, record review, and staff interview, the agency failed toprovide financial reports in a timely manner.

Findings include:

A request to staff B on 06/04/2008 at 11:54 AM :for financial ledgers reflecting all revenues andexpenditures for AH #1 and AH #2's cases revealed that financing was handled by staff C whoresides in Florida and is the agency's bookkeeper.

A request to staff A by telephone interview on 06/04/2008 at 11:57 AM, revealed that staff C was his/her other place of employment at the time of the request; however, staff A and staff C wouldprovide the required information. During the interview, the second part of ORS Rule290-9-2.03(11)(c) was relayed verbatim to staff A.

A review on 06/04/2008 of documents faxed to the Adoption Blessings Worldwide (ABW) office

while onsite between 3:00 PM-3:30 PM, revealed that the faxed documents only contained copieof receipts reflecting payments made by AH #1 and AH #2 and did not reflect all expendituresrelated to AH #1 and AH #2's cases. The document did contain an email message dated06/04/2008 at 2:58 PM from the facilitator for AH #1 to staff C confirming the attorney's receipt ofpayments paid to the attorney by AH #1. .

An additional request was made to staff A and staff B on 06/04/2008 between 3:30PM-4:00 PM foa financial ledger from the agency's accounting system reflecting all revenues and expendituresfor AH #1 and AH #2's cases. A typed list of receipts and expenditures for AH #1 and AH #2 wasprovided by staff B by email on 06/05/2008 at 12:34 PM.

A review on 06/05/2008 of a letter also provided by email on 06/05/2008 at 12:34 PM revealed thathe agency's part-time bookkeeper (staff C) had returned to his/her other place of employment athe time of the second request for information and that staff C "works from home and has to bethere" to access the agency's financial information.

A telephone interview on 06/04/2008 between 3:30 PM-4:00 PM with staff A revealed that staff Acontends that s/he did not understand the intitial request for financial information.

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P 9999 Closing Comments.

The investigation of complaints #53972, #54637 and #55795 concluded on 06/20/2008. There wereighteen (18) deficiencies identified during the investigation. An exit conference was held whileonsite on 06/04/2008 and 06/17/2008. An initial preliminary report was provided to staff B by emaon 06/07/2008. It is imperative that immediate action be taken to ensure compliance in the areasidentified in this report. A written plan of correction (POC) is due to this surveyor on or beforeJuly 10, 2008.

*Please note that an office conference will be scheduled. Details concerning the officeconference will be forwarded separately.

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ABW DCH Violations June 2008

Documents

Transcript of ABW DCH Violations June 2008