Person Centered Thinking Day 1 Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie...
Transcript of Person Centered Thinking Day 1 Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie...
Person Centered ThinkingPerson Centered Thinking Day 1Day 1
Person Centered ThinkingPerson Centered Thinking Day 1Day 1
Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Anderson, Mary Lou Bourne, Amanda George, Cherie Goss, Julie Malette, Anderson, Mary Lou Bourne, Amanda George, Cherie Goss, Julie Malette,
Michael Steinbruck, and Nolda WareMichael Steinbruck, and Nolda Ware
Not just better Not just better plans…plans…
Help people get better Help people get better liveslives
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
ServiceLife
CommunityLife
• Important for addressed
• No organized effort to address important to
• To and for present• Active circle of support• Included in community life
• To and for present
• Closest people are paid or family
• Few real connections
Moving from Service Life to Community LifeMoving from Service Life to Community Life
A Good Paid Life
Focus on connecting, building relationshipsand natural supports‘Important to’ present
‘Important to’ recognized
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
A Good Paid Life
ServiceLife
CommunityLife
Moving from Service Life to Community LifeMoving from Service Life to Community Life
• Important for addressed
• No organized effort to address important to
• To and for present• Active circle of support• Included in community life
• To and for present
• Closest people are paid or family
• Few real connections
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Good plans create a kind of mirror – they reflect how Good plans create a kind of mirror – they reflect how people want to livepeople want to live
Discontent comes from comparing what is with what Discontent comes from comparing what is with what could becould be
There are 2 kinds of discontent:There are 2 kinds of discontent:
•Optimistic Optimistic
•CynicalCynical
Discontent is the engine of changeDiscontent is the engine of change
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
A history of acting on things that can be changed A history of acting on things that can be changed immediatelyimmediately
Honesty about those things that take timeHonesty about those things that take time
Signs of progress in acting on the things that take Signs of progress in acting on the things that take timetime
Where change is new trust must be createdWhere change is new trust must be created
Optimistic discontent requires trust based on-Optimistic discontent requires trust based on-
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
One of the things that good plans do is hold a mirror One of the things that good plans do is hold a mirror up to the system and create discontent with what is. up to the system and create discontent with what is.
Without hope for change this level of discomfort Without hope for change this level of discomfort becomes intolerable.becomes intolerable.
Without hope for change you get denial, distortion, Without hope for change you get denial, distortion, or departureor departure
People say this is no different from what we have People say this is no different from what we have always been doingalways been doing
Plans are distorted to suggest that what people Plans are distorted to suggest that what people want is what is already offeredwant is what is already offered
The people who have the most passion for change The people who have the most passion for change leave (depart) when they see no hope for changeleave (depart) when they see no hope for change
Cynical discontentCynical discontent
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Level 1 change – Level 1 change –
those changes that can be made without becoming a those changes that can be made without becoming a change target – change target –
without changing core structures, responsibilities, without changing core structures, responsibilities, etc.etc.
E.G. – helping people with their morning rituals, E.G. – helping people with their morning rituals, honoring what is important that doesn’t require that honoring what is important that doesn’t require that people move or major changes in staff people move or major changes in staff responsibilities responsibilities
2 levels of change2 levels of change
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Level 2 changes –Level 2 changes –
Changes that make you a change targetChanges that make you a change target
New responsibilities, practices, structuresNew responsibilities, practices, structures
2 levels of change2 levels of change
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Supporting Dreams
Being “Mindful” & Recording Learning
Recognizing and Sorting Important To and Important For& Finding the Balance Between
Them
Defining Staff Roles and Responsibilities
Matching Staff and Those Using Services
Learning, Using and Recording
Communication
Supporting Relationships, Community Connecting
• Learning Log• The 4 Questions• Working/Not Working
Skills needed to support peopleSkills needed to support people
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Person Centered Thinking Skills - 1 & Person Centered Thinking Skills - 1 & 22
Person Centered Thinking Skills - 1 & Person Centered Thinking Skills - 1 & 22
• SkillSkill = Sorting important to = Sorting important to from important for from important for (and finding a (and finding a
better better balance between)balance between)
ToolTool = Important to/for = Important to/for sort/tablesort/table
• SkillSkill = Determining staff = Determining staff responsibilitiesresponsibilities
ToolTool = The donut = The donut
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Important to Important for
Supports wanted and
neededSkills needed
Personality Characteristics (Present/Absen
t)
Shared interests
(nice to have)
Person Centered Thinking Skills - 3Person Centered Thinking Skills - 3Person Centered Thinking Skills - 3Person Centered Thinking Skills - 3
For each person – what are the…
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Person Centered Thinking Skills - 4Learning, using, and recording communicationPerson Centered Thinking Skills - 4Learning, using, and recording communication
What is happening ______ does We think it means We should
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Person Centered Thinking Skills - 5 Person Centered Thinking Skills - 5 Three Mindful Learning ToolsThree Mindful Learning Tools
Person Centered Thinking Skills - 5 Person Centered Thinking Skills - 5 Three Mindful Learning ToolsThree Mindful Learning Tools
Tool #1:Tool #1: Analyzing situations using “What works/doesn’t work” Analyzing situations using “What works/doesn’t work” (also known as “makes sense/doesn’t make sense”)(also known as “makes sense/doesn’t make sense”)
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
What works/makes senseWhat doesn’t work/make
sense
Pers
on’s
Pers
pect
ive
Sta
ff’s
Pers
pect
ive
Person Centered Thinking Skills - 5 Person Centered Thinking Skills - 5 Three Mindful Learning ToolsThree Mindful Learning Tools
Person Centered Thinking Skills - 5 Person Centered Thinking Skills - 5 Three Mindful Learning ToolsThree Mindful Learning Tools
Tool #2:Tool #2: Using the ‘4 Questions” to focus on Using the ‘4 Questions” to focus on learning and acting on that learning and acting on that
learning –learning –
•What have we tried?What have we tried?
•What have we learned?What have we learned?
•What are we pleased about?What are we pleased about?
•What are we concerned about?What are we concerned about?
And thenAnd then
•What should we try/do based on what we What should we try/do based on what we have learned?have learned?
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
? ??
?
Person Centered Thinking Skills - 5 Person Centered Thinking Skills - 5 Three Mindful Learning ToolsThree Mindful Learning Tools
Person Centered Thinking Skills - 5 Person Centered Thinking Skills - 5 Three Mindful Learning ToolsThree Mindful Learning Tools
Tool #3Tool #3: The Learning : The Learning LogLog
•Using the learning log Using the learning log to replace typical to replace typical notesnotes
•Creating a learning Creating a learning log for the people log for the people who use serviceswho use services
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Have our own dreams and our own
journeysHave opportunities to meet new
people; try new things; change jobs; change who we live with & where we
liveHave what/who is important to us in
everyday life; people to be with; things to do, places to be
Stay healthy & safe (on our own terms)
Each of us want lives where we are supported by & contribute to our
communities
© The Learning Community for Essential Lifestyle Planning, Inc. 2006 (with apologies to Abraham Maslow)
Terminal IrritationTerminal IrritationTerminal IrritationTerminal Irritation
* Used with permission from Dave Coverly, Speedbump Comic
A Promise to listenA Promise to listen
to listen to what is being said and to what is to listen to what is being said and to what is meant by what is being saidmeant by what is being saidto keep listeningto keep listening
A Promise to act on what we hearA Promise to act on what we hear
to always find something that we can do today to always find something that we can do today or tomorrow or tomorrow to keep acting on what we hearto keep acting on what we hear
Person centered planning is a set of promisesPerson centered planning is a set of promises
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
A Promise to be honestA Promise to be honest
to let people know when what they are telling us to let people know when what they are telling us will take timewill take time
when we do not know how to help them get when we do not know how to help them get what they are asking for what they are asking for
when what the person is telling us is in conflict when what the person is telling us is in conflict with staying healthy or safe and we can’t find a with staying healthy or safe and we can’t find a good balance between important to and good balance between important to and important forimportant for
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Person centered planning is a set of promisesPerson centered planning is a set of promises
UnderstandUnderstand
What you hear depends onWhat you hear depends onwhat you are listening forwhat you are listening for
ListenListen
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
What is important to a person includes only what people are “saying”:
with their words
with their behavior
When words and behavior are in conflict, listen to the behavior.
Important to
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
What is important for people, includes only those things that we need to keep in mind regarding–
Issues of health or safety
What others see as important to help the person be a valued member of their community
Important for
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Importantto
Importantfor
Importantto
Importantfor
Health and Safety Health and Safety Dictate LifestyleDictate Lifestyle
All Choice, All Choice, No ResponsibilityNo Responsibility
Importantto
Importantfor
BalanceBalance
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
What works/makes senseWhat doesn’t work/make
sense•Shopping daily for favorite
things
•Having lots of jewelry and no one getting into them without my ok
•Having my sister Joanne in my life
•Lots of blue, red and black clothes
•Polished nails, many colors & layers
•Living with Teddy, the Yorkshire
Sleeping on my bed at night Snacks from my plate In my lap when I watch TV
•Staff don’t let me drink what I want
•Teddy leaving me during mealtimes
•Having no work to do at WAC, Inc.
•Staff not letting me buy things I want
•Favorite people doing activities with her, especially John Dandy
•Keeping Julie from falling – reminders to use her walker
•Level blood sugar - staff knowing signs of low and high blood sugar
•Joanne is active in Julie’s life
•Planning before she goes shopping
•Julie is less steady on her feet and falling more than she used to
•If you don’t make a plan with her before shopping, she will want to buy more than she has money for – Julie may get very upset which can alter her blood sugar
•Julie gives Teddy food off her plate.
Julie’s
pers
pecti
ve
Sta
ff’s
pers
pecti
ve
JulieJulie
What is important to Julie? What is important for Julie?
What else do you need to learn/know?
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Julie – Answer SlideJulie – Answer Slide
What is important to Julie? What is important for Julie?
What else do you need to learn/know?
Relationship with TeddyHaving some control –• Over what happens with Teddy• What she buys/wears• Her things Shopping a lotHer sister &John Dandy in her lifeStaying busy at the day serviceDrinking as much as she wants
Keeping diabetes under control• Monitoring blood sugar, giving insulin• Weighing her food• Controlling amount she drinks• Helping her stay calmSupporting her relationship with TeddyKeeping her from fallingPlanning in advance/budgeting in advance for shopping
• How interested/involved is Julie in her diabetes management?• What about “no work to do at WAC, Inc bothers her?•Is John Dandy really important to her?
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
If I had an hour toIf I had an hour tosave the world, I’dsave the world, I’dspend 55 minutesspend 55 minutesdefining the problem.defining the problem.
-Albert Einstein -Albert Einstein
If I had an hour toIf I had an hour tosave the world, I’dsave the world, I’dspend 55 minutesspend 55 minutesdefining the problem.defining the problem.
-Albert Einstein -Albert Einstein
USE JUDGEMENT& CREATIVITY
CORE RESPONSIBILITIES
NOT OUR PAID RESPONSIBILITY
Inside a Person’s Life
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Not our paid responsibility
Use judgmentand creativity
Core responsibilities
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
What you try! (e.g. put on my sweater, cleaning cabinet tops, etc.) Help me find a meaningful job. Help me find other ways to communicate with those that can’t communicate with me.
Don’t interfere with the private time I spend with my friends. I don’t need an interpreter. They are my friends and we communicate. Don’t interfere with how I choose to handle the love interests in my life. I will ask for any advice I want from whom I want.
Examples from Inside Libby’s Life
Support independence: Look for things she can do on her own, the last item of clothing that she puts on must be put on herself (she wants you to set it up and let her do the rest) know how she communicates and take the time to communicate with herHelp her stay healthy: Provide G-tube care and at least 1,500 ccs of fluid a day. She doesn’t feel thirsty (you keep track), an occasional glass of wine (drinks through the g-tube).
Harry #1Harry #1
What is important to Harry? What is important for Harry?
What else do you need to learn/know?
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Harry #1 – Answer SlideHarry #1 – Answer Slide
What is important to Harry? What is important for Harry?
What else do you need to learn/know?
To attract women
To spend his money as he wants
To have George’s permission
To learn what to wear with minimum pain
To learn to manage his money
What does Harry understand about –• Managing his money• Attracting women, dating• Where it is appropriate to wear what
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Harry #1 – George’s DonutHarry #1 – George’s Donut
Not our paid responsibility
Use judgmentand creativity
Core responsibilities
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Harry #1 – Answer SlideHarry #1 – Answer Slide
Not our paid responsibility
Whether or not he buys the shirt.
Use judgmentand creativity
What you do/try to help Harry makean informed choice
about –
The odds againstthe shirt being a “chick magnet”
Spending ½ his money for 2 weeks on
1 purchase
Core responsibilities
To help Harry makean informed choice –
About the shirt
About his money
Starts with asking why he wants
the shirt
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Harry #2Harry #2
What is important to Harry? What is important for Harry?
What else do you need to learn/know?
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Harry #2 – Answer SlideHarry #2 – Answer Slide
What is important to Harry? What is important for Harry?
What else do you need to learn/know?
To be around this woman, have her “recognize” that she wants him. To have control and power over her.
To know the legal consequences of stalking
To stop stalking
To understand that stalking doesn’t work to get an intimate relationship
• More about the past history of this or similar behavior?
• How dangerous is he?
• Does he get what we think he gets out of stalking?
• Has he ever had a “regular adult” relationship
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Harry #2 – Executive Director’s DonutHarry #2 – Executive Director’s Donut
Not our paid responsibility
Use judgmentand creativity
Core responsibilities
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Harry #2 – Answer SlideHarry #2 – Answer Slide
Not our paid responsibility
To help him getsex or keep him out
of jail at all costs
Use judgmentand creativity
Short term – Howyou keep the woman
safe until you can get him treatment
Longer term – howyou learn, acting on
what you learn,figuring out how he
can get what isimportant enough to
him that that hewill participate in
treatment
Core responsibilities
Short term -Keep the woman safe and in
the process keep himsafe (and out of jail)
Longer term – teachrelationship skills,
figure out why he isstalking, any pattern,
and deal with it,seeking a way for
Harry to live safelyin the community
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
BobBob
What is important to Bob? What is important for Bob?
What else do you need to learn/know?
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Bob – Answer SlideBob – Answer Slide
What is important to Bob? What is important for Bob?
What else do you need to learn/know?
To be one of the guysTo keep his friendsTo be in charge of his own lifeTo have a “typical” lifeTo stay healthy
To stay healthy –Take his medications as prescribedStay out of the hospital/not cycleTo be connected to his community
• How dangerous is it for him to go off medication and have a couple of beers?• Would it be OK for him to drink 1 or 2 beers and be on his medication?• Is there another medication where 1 or 2 beers would be OK?• How well does he understand the risks that he is taking?• Would he be willing to drink non-alcoholic beer? • What role does his girlfriend play in this?
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
BobBob
Not our paid responsibility
Use judgmentand creativity
Core responsibilities
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Bob – Answer SlideBob – Answer Slide
Not our paid responsibility
Whether or notBob drinks
What Bob’s psychiatristdoes in response to
the information
Use judgmentand creativity
What you do to meetyour core responsibilitiesaround helping him make
an informed choice –
Informing Bobof the risks
Educating yourself
Exploring alternatives
If part of the “problem”is the response of thepsychiatrist – helping
Bob find another
Core responsibilities
Helping Bob make an informed choice
Informing Bob of therisks of his behavior
Informing yourself of the actual risks and
alternatives
Making sure that Bob’s psychiatrist knows about
Bob’s drinking
Making an effort to explore with Bob
alternative ways to getwhat is important to
and important for him© The Learning Community for Essential Lifestyle Planning, Inc. 2006
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Recording learning for Charlie What we have learned about what is:
IMPORTANT TO IMPORTANT FOR
INSTRUCTIONS FOR SUPPORTORS: for a good balance between important to & important for, what other people need to know or do.
What do we need to learn or figure out?
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Recording learning for Charlie What we have learned about what is:
IMPORTANT TO IMPORTANT FOR
Water not too hot, likes it at 105 ° The lift at the pool must be available
A long soak, floating on his back To always have someone with him,supporting him in the water
Not to get rain on his face Making sure water is never over 107°
Having Aaron support him in the waterINSTRUCTIONS FOR SUPPORTORS: for a good balance between important to & important for, what other people need to know or do.
• Call ahead to make sure that the pool’s lift is available• Have a way to shield Charlie’s face when it rains • Don’t go in if water temperature is too hot (105 ° is good)• Charlie loves to ‘float’ on his back, always support him.
What do we need to learn or figure out?
How does Aaron support Charlie to float? Is it ok for others to support him?How hot is medically ‘too hot’ for Charlie? What’s a good temperature range?How long to soak? What’s too short for Charlie and what’s too long medically?
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
As the person supporting Charlie to go hot tubbing…
As the person supporting Charlie to go hot tubbing…
Not our paid responsibility
Use judgmentand creativity
Core responsibilities
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
As the person supporting Charlie to go hot tubbing…
As the person supporting Charlie to go hot tubbing…
Not our paid responsibility
Whether or not others in the tub
“connect” with Charlie
Whether or notCharlie enjoyed himself
(as long as youmade an effort)
Use judgmentand creativity
Helping Charlie meet other people who are inthe tub while Charlie is
there
How you help Charlie to enjoy himself
Core responsibilities
Calling to make surethe lift is operating, don’t go if it is not
Making sure watertemp is less than 105°
Being trained to properlySupport Charlie in the
hot tub and do it
Checking weather beforeyou go – if rain is likely,
bring an umbrella
Making an effort toensure that Charlie
enjoys himself
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
What works/makes senseWhat doesn’t work/make
sense•Shopping daily for favorite
things
•Having lots of jewelry and noone getting into them without my ok
•Having my sister Joanne in my life
•Lots of blue, red and black clothes
•Polished nails, many colors & layers
•Living with Teddy, the Yorkshire
Sleeping on my bed at night Snacks from my plate In my lap when I watch TV
•Staff don’t let me drink what I want
•Teddy leaving me during mealtimes
•Having no work to do at WAC, Inc.
•Staff not letting me buy things I want
•Favorite people doing activities with her, especially John Dandy
•Keeping Julie from falling – reminders to use her walker
•Level blood sugar - staff knowing signs of low and high blood sugar
•Joanne is active in Julie’s life
•Planning before she goes shopping
•Julie is less steady on her feet and falling more than she used to
•If you don’t make a plan with her before shopping, she will want to buy more than she has money for – Julie may get very upset which can alter her blood sugar
•Julie gives Teddy food off her plate.
Julie’s
pers
pecti
ve
Sta
ff’s
pers
pecti
ve
What works/makes senseWhat doesn’t work/make
senseP
ers
on
’sp
ers
pecti
ve
Sta
ff’s
pers
pecti
ve
USE THIS INFORMATION TO BUILD THE
AGENDA
FOR THINGS THAT ARE TO
STAY THE SAME
USE THIS INFORMATION TO BUILD THE
AGENDA
FOR THINGS THAT NEED TO
CHANGE
Disagre
emen
ts
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
What works/makes senseWhat doesn’t work/make
sense
Pers
pect
ive o
f N
ew
puppy’s
Ow
ner
Someone brings home a new puppy. Given your own experiences and those that you have heard from others, what does and does not make sense about having a new puppy in the house.
What works/makes senseWhat doesn’t work/make
sense
Pers
on’s
Pers
pect
ive
Given the medication that someone is taking…
Sta
ff’s
Pers
pect
ive
What works/makes senseWhat doesn’t work/make
sense
Pers
pecti
ve
of
Pers
on
S
up
port
ed
You
rp
ers
pecti
ve
Su
perv
isor’
sp
ers
pecti
ve
Looking at how you are doing in your work…
What works/makes senseWhat doesn’t work/make
senseK
ath
leen
’sp
ers
pecti
ve
Moth
er’
sp
ers
pecti
ve
Sta
ff’s
pers
pecti
ve
What works/makes senseWhat doesn’t work/make
senseRelationships with friendsHaving her scissors at homeCutting PatternsDressing in her own styleDoing things where she stays cleanSewing at home and making her clothes
Not getting to use HER scissorsGetting dirty & doing jobs that involve cleaningHaving to do bearingsHaving to do work that she doesn’t likeNot being listened to
Kathleen has a place to go during the daySpending time with KathleenSewing togetherKathleen is never left alone at home or workshop
Her schedule has to follow the workshop’sKathleen can’t bring her own scissors to workThere is not enough pattern work for herKathleen will open the door for anyone
Kathleen does what she is toldShe has a behavior programShe uses whatever scissors she getsShe follows the rules most of the timeThat she meets the “criteria” before being considered for enclave work
Kathleen will not follow the rules consistentlyThat Kathleen insists on using certain scissorsThat Kathleen doesn’t want to get dirtyThat Kathleen doesn’t like the other jobs that are available
Kath
leen
’sp
ers
pecti
ve
Moth
er’
sp
ers
pecti
ve
Sta
ff’s
pers
pecti
ve
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
In pairs4 minute turns for all 4 questionsListener gives good attentionThinker talks 4 minutesSwapShare ‘freshest thinking’ with the group in a roundPost 1-2 of the ‘best’ ideas per question
Adapted from Kline, Nancy. (1998). Time to Think: Listening to Ignite the Human Mind. Cassell Illustrated.
Shared TalkShared Talk
What did you learn?
What will you try based on what you learned? (what will you start on right now?)
What do you think you can accomplish?
What will your challenges/obstacles be?
What did you learn?
What will you try based on what you learned? (what will you start on right now?)
What do you think you can accomplish?
What will your challenges/obstacles be?
4 Questions4 Questions
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
www.elpnet.newww.elpnet.nett
for more information go to:for more information go to:
Michael Smull
410-626-2707
3245 Harness Creek Rd
Annapolis, MD 21403
or contact: