- Treatment Foster Care ii Performance Report SFY 2015 Quarter 1 5001618 MENTOR Maryland, Inc. 11/10/2014 5001380 MENTOR Maryland, Inc. Version: 2 ProvProg: MENTOR Maryland - Lanham Street: 4501 Forbes City, Lanham Indicators Score State: MD Staff Security: Yes 30 Zip: 20705 Maltreatment: No 20 Juris: Prince George.s License Sanction: No 20 55? ?Ot'isti ?0 1? Treatment Foster Care SSA F'sca' AUd't: 100% 10 Compliance: Male Beds: 0 Female Beds, 0 Your Total Score: 99 Total Beds, 0 Minimum Score: 80 Your Status: MET Version History: Was SCYFIC 3716 5001625 MENTOR Maryland, Inc. Version: 2 ProvProg: MENTOR Maryland - 5720 Executive Street: 5720 Executive City, Baltimore Indicators Score State: Staff Security: Yes 30 Zip: 21223 Maltreatment: No 20 Juris: Baltimore County License Sandiom N0 20 55A ?0 1? Treatment Foster Care SSA F'scal AUd't: 100% 10 Compliance: Male Beds: 0 Female Beds_ 0 Your Total Score: 100 Total Beds. 0 Minimum Score: 80 Your Status: MET Version History. Terms: MDCHESSIE Organization ID MDCHESSIE Provider ID Program Name DHR Contract Number Contract Type SCYFISID: Provider Indicators: Staff Security: (30 Pts) Timely submission of Staff roster and background checks prior to hire employee hire date during report quarter Maltreatment: (20Pts) No indicated ?ndings of child maltreatment by RCC staff member during quarter prior to report quarter License Sanctions No license sanction for agency program during report quart SSA Hotlist (5Pts) RCC not placed on SSA Hot List during report qua SSA Fiscal Audit (15Pts) On-time submission=100% of points; Less than 1 month 1 month submission=50%; No submission=0% CANS Compliance (10Pts) Percent of expected CANS assessments actually completed during quarter prior to report quarter. If no eligible children served then these points are excluded from performance report RCC Incentive Points: (20 Pts) Good Placement Changes Percent of exits to less restrictive placement setting or to good exit from foster care (reuni?cation, guardianship, adoption) - Treatment Foster Care ii Performance Report SFY 2015 Quarter 1 5001618 MENTOR Maryland, Inc. 11/10/2014 5001525 MENTOR Maryland, Inc. Version: 2 ProvProg: MENTOR Maryland - 5720 Executive Street: 5720 Executive I CW Baltimore Indicators Score State: Staff Security: Yes 30 Zip: 21228 Maltreatment: Yes 0 Juris: Baltimore County License sanction: No 20 55? H?t"5t= N0 10 Medically Fragile TFC SSA F'scal AUd't: 100% 10 compliance: Male Beds: 0 Female Beds. 0 Your Total Score: 80 Total Beds_ 0 Minimum Score: 80 Your Status: MET Version History: 5001625 MENTOR Maryland, Inc. Version: 2 ProvProg: MENTOR Maryland - 5720 Executive Street: 5720 Executive City, Baltim ore Indicators Score State: MD Staff Security: Yes 30 Zip: 21228 Maltreatment: No 20 Juris: Baltimore County License Sandion: N0 20 55? Hows": ?0 1? Teens in Transition SSA F'sca' AUd't: 100% 10 Compliance: Male Beds: 0 Female Beds: 0 Your Total Score. 93 Total Beds. 0 Minimum Score: 80 Your Status: MET Version History: Terms: MDCHESSIE Organization ID MDCHESSIE Provider ID Program Name DHR Contract Number Contract Type SCYFISID: scyr s Prower Indicators: Staff Security: (30 Pts) Timely submissmn of Staff roster and background checks prior to hire employee hire date during report quarter Maltreatment: (20Pts) No indicated ?ndings of child maltreatment by RCC staff member during quarter prior to report quarter License Sanctions (20Pts) No license sanction for agency program during report quart SSA Hotlist (5Pts) RCC not placed on SSA Hot List during report qua SSA Fiscal Audit (15Pts) On?time submiss:on=100% of points; Less than 1 month 1 month submission=50%; No submission=0% CANS Compliance (10Pts) Percent of expected CANS assessments actually completed during quarter prior to report quarter. If no eligible children served then these points are excluded from performance report RCC Incentive Points. (20 Pts) Good Placement Changes Percent of exits to less restrictive placement setting or to good exit from foster care (reunification, guardianship, adoption) - Treatment Foster Care ii Performance Report SFY 2015 Quarter 1 5001618 MENTOR Maryland, Inc. 11/10/2014 5011198 MENTOR Maryland, Inc. Version: 2 ProvProg: MENTOR Maryland Caton Center Street: Caton Center DR City. Baltimore Indicators Score State: MD Staff Security: Yes 30 Zip. 21277 Maltreatment: No 20 Juris: License Sanction: No 20 55A ?Ot'lst? ?0 10 Teens in Transition SSA F'scal AUd't: 100% 10 compliance: Male Beds: 0 Female Beds_ 0 Your Total Score: 93 Total Beds. 0 Minimum Score: 80 Your Status: MET Version History: 5020914 MENTOR Maryland, Inc. Version: 2 ProvProg: MENTOR Maryland - Salisbury Street: 620 Naylor Mill City, Salisbury Indicators Score State: Staff Security: Yes 30 Maltreatment: NO Juris: Wicomico License Sanction: No 20 55A ?Ot'isti N0 10 Medically Fragile TFC SSA F'sca' AUd't: 100% 10 Compliance: Male Beds: 0 Female Beds. 0 Your Total Score: 99 Total Beds. 0 Minimum Score: 80 Your Status: MET Version History: Was SCYFIS 3762 Terms: MDCHESSIE Organization ID MDCHESSIE Provider ID PrOVProg: Program Name DHR Contract Number COMTVPEZ Contract Type SCYFISID: SCYFIS Provider ID Indicators: Staff Security (30 Pts) Timely submission of Staff roster and background checks prior to hire employee hire date during report quarter Maltreatment.- (20Pts) No indicated findings of child maltreatment by RCC staff member during quarter prior to report quarter License Sanctions (20Pts) No license sanction for agency program during report quart SSA Hotlist (SPts) RCC not placed on SSA Hot List during report qua SSA Fiscal Audit (15Pts) On-time submission=100% of points; Less than 1 month 1 month submi55ion==50%; No submission=0% CANS Compliance (10Pts) Percent of expected CANS assessments actually completed during quarter prior to report quarter. If no eligible children served then these points are excluded from performance report RCC Incentive Points: (20 Pts) Good Placement Changes Percent of exits to less restrictive placement setting or to good exit from foster care. (reunification, guardianship, adoption) . Treatment Foster Care ii Performance Report SFY 2015 Quarter 1 5001618 MENTOR Maryland, Inc. 11/10/2014 5020914 MENTOR Maryland, Inc. Version: 2 ProvProg: MENTOR Maryland - Salisbury Street: 620 Naylor Mill City. Salisbury Indicators Score State: MD Staff Security: Yes 30 Maltreatment: NO 20 Juris: Wicomico License Sanction: NO 20 55? ?Wis? ?0 1? Treatment Foster Care 55A F'sca' AUd't: 100% 10 3761 CANS Compliance: 100% 10 Male Beds: 0 Female Beds. 0 Your Total Score: 100 Total Beds_ 0 Minimum Score: 80 Your Status: MET Version History: 5020914 MENTOR Maryland, Inc. Version: 2 ProvProg: MENTOR Maryland - Salisbury Street: 620 Naylor Mill City_ Salisbury Indicators Score State: Staff Security: Yes 30 Zip: 21801 Maltreatment: No 20 Juris: Wicomico License Sanction: No 20 55? N0 10 Teens in Transition 55A ?593' AUd't: 100% 10 4340 CANS Compliance: 100% 10 Male Beds: 0 Female Beds. 0 Your Total Score: 100 Total Beds_ 0 Minimum Score: 80 Your Status: MET Version History: Was SCYFIS 3764 Terms: MDCHESSIE Organization ID MDCHESSIE Prowder ID Program Name DHR Contract Number Contract Type SCYFIS Provider ID Indicators: Staff Security: (30 Pts) Timely submission of Staff roster and background checks prior to hire employee hire date during report quarter Maltreatment (20Pts) No indicated findings of child maltreatment by RCC staff member during quarter prior to report quarter License Sanctions (20Pts) No license sanction for agency program during report quart SSA Hotlist (SPts) RCC not placed on SSA Hot List during report qua SSA Fiscal Audit (15Pts) On-time submission=100% of points; Less than 1 month 1 month submission=50%; No submission=0% CANS Compliance (10Pts) Percent of expected CANS assessments actually completed during quarter prior to report quarter. If no eligible children served then these points are excluded from performance report RCC Incentive Points: (20 Pts) Good Placement Changes Percent of exits to less restrictive placement setting or to good exit from foster care (reunification, guardianship, adoption)