Evaluation Tool: MHPs/RCAs Program
STANDARD 1:
Regulatory
Foundation
Ordinances
November, 2011 Version
Evaluation Criteria
Comments
Rating
(0-2)
O
a. Has the Board passed ordinances
referring to statutes and rules, as listed
in the SCOPE of the Delegation
Agreement?
b. Have ordinances been revised as
needed to be consistent with current
statutes and rules?
c. If applicable ordinances were changed
since the previous program evaluation,
were they were sent to MDH for review
prior to their passage?
d. Do ordinances define MHP/RCA
license categories and inspection
frequency according to rule?
e. Do ordinances describe enforcement
tools and procedures, and grant
authority for enforcement?
f. Do ordinances reference plan review
requirements?
g. (MDH only) Has MDH reviewed and
responded in writing to its delegated
partners regarding proposed ordinances
or language changes to existing
ordinances, within 30 days of receipt of
those changes?
Y
Y
Y
Y
Y
Y
Source Materials
STANDARD 2:
Trained
Regulatory Staff
Evaluation Criteria
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Comments
YELLOW: Required Program Elements required by the Delegation Agreement
1
Rating
(0-2)
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: MHPs/RCAs Program
1. Inspection
Staff
2. Agreements
with Other
Qualified Parties
3. Additional
Training
4. Staffing
Transition Plan
November, 2011 Version
O
a. Does the Board employ qualified
inspection staff as defined in the
Delegation Agreement?
b. Are any less qualified staff (as
described in the Delegation Agreement)
limited to performing inspections that
are not mandated by the Delegation
Agreement?
If the Board has entered into agreements
with other qualified persons to carry out
its regular, delegated duties, did the
Board obtain MDH’s written approval
before entering into such an agreement?
a. Describe the percentage of staff that
have taken ICS classes (minimum of
ICS 100 & 200.)
b. Describe other training that staff have
received (e.g., MNTrac courses
completed).
a. Does the Board have a written plan
that is submitted annually to MDH, to
assure adequate program coverage and
to address staffing transition in the event
of unexpected staffing changes?
b. Has that written plan has worked
effectively during staffing transitions
within the evaluation period?
c. Has the Board notified MDH within
10 business days of staff departures,
when staffing is insufficient to perform
the obligations of the Delegation
Agreement?
Y
Y
W
W
Y
W
Y
Source Materials
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
YELLOW: Required Program Elements required by the Delegation Agreement
2
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: MHPs/RCAs Program
STANDARD 3:
Risk-Based
Inspection
Program
1. Inspection
Forms
2. Risk
Assessment
3. Inspection
Frequency
4. Written &
Implemented
Policies
November, 2011 Version
Evaluation Criteria
Comments
Y
Do the Board’s inspection documents
identify health and safety hazards and
interventions?
Are MHPs/RCAs are categorized as
‘Category A’ or ‘Category B’ in
accordance with MN rules?
Is the inspection frequency based on
MN Rule 4630.2210 being met?
a. Has the Board developed a
documented procedure to address
corrective action?
b. Has the Board developed a
documented procedure that requires
discussion of options for long-term
control of health and safety hazards?
c. Has the Board developed a
documented procedure that requires
follow-up activities on health and safety
violations?
d. Has the Board developed a
documented, implemented procedure on
variance requests related to health and
safety hazards, and interventions?
e. Has the Board submitted to MDH any
copies of variances granted, within 30
days of issuance?
f. Does the Board’s inspection report
indicate number and type of sites at each
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Rating
(0-2)
Y
O
Y
W
Y
Y
Y
Y
YELLOW: Required Program Elements required by the Delegation Agreement
3
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: MHPs/RCAs Program
November, 2011 Version
facility (e.g. – MHP; RCA dependent or
independent)?
Source Materials
STANDARD 4:
Uniform
Inspection
Program
1. Plan Review
Evaluation Criteria
Comments
Y
a. Does the Board conduct and
adequately document plan review for
each new construction, renovation, or
conversion of licensed establishments,
as required in Chapter 327.16-327.28?
b. Does the Board license only those
establishments for which plan review is
complete and approved?
c. Is documentation maintained in the
Board’s files for: 1) all new sites added
to MHP/RCA; 2) when sites are
changed from dependent to independent,
indicating zoning approval if needed; 3)
when plans for new sites were
submitted; 4) when storm shelters are
added; 5) when plans were approved,
new sites were inspected and approved,
and other pertinent information?
d. Does the Board maintain adequate
documentation throughout the plan
review process, in each MHP file, for
storm shelter or evacuation plan as
required by M.S. 327.20C, subd. 1?
e. Is documentation maintained for
water and sewer system approval as
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Rating
(0-2)
Y
Y
W
W
YELLOW: Required Program Elements required by the Delegation Agreement
4
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: MHPs/RCAs Program
2. Licensing &
Data
Management
3. Inspections &
Written Reports
November, 2011 Version
reviewed by the appropriate authority?
a. Is the Board required by policy to
license establishments on an annual
basis?
b. Does the Board maintain a current list
of establishments (including
establishment name, address and risk
category)?
a. Are inspections conducted by
qualified inspection staff, as described
in the Delegation Agreement?
b. Does the Board incorporate education
into the inspection process?
c. Are written reports complete and
accurate, and do they describe
compliance activities?
d. Are statutes, rules and ordinances
interpreted accurately and consistently?
Y
Y
O
Y
Y
Y
Source Materials
STANDARD 5:
Illness & Injury
Investigation &
Response
1. Protocol for
Investigating
Complaints
2. Complaints
Evaluation Criteria
Comments
Y
Does the Board utilize a procedure to
investigate, respond to, and document
MHP/RCA complaints or injury?
a. Does the Board maintain a log or
database for all complaints alleging
injury, or health and safety hazards?
b. Does the Board follow-up on all
injury, or health and safety hazard
complaints within one business day?
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Rating
(0-2)
W
W
YELLOW: Required Program Elements required by the Delegation Agreement
5
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: MHPs/RCAs Program
3. Program
Coverage
November, 2011 Version
W
c. Are investigation reports filed or
linked to the records of the
establishment?
d. (MDH only) Does MDH refer to its
delegated partners any complaints that
MDH receives concerning matters under
their jurisdiction?
Does the Board have qualified staff
available for emergency coverage on a
24-hour a day basis and have they
provided an after-hours contact number
to MDH?
Y
Y
Source Materials
STANDARD 6:
Compliance &
Enforcement
Compliance &
Enforcement
Evaluation Criteria
Comments
Rating
(0-2)
O
a. Does the Board identify and
document violations according to
statute, rule and ordinance?
b. Does the Board address the identified
risk factors and health and safety
hazards by: (1) following up or using
appropriate enforcement tools, including
revocation or suspension, and (2) by
maintaining adequate documentation
throughout the enforcement process?
c. Does the Board resolve identified
violations within a reasonable time?
d. Does the Board maintain records
according to its records retention
policy?
O
Y
Y
Source Materials
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
YELLOW: Required Program Elements required by the Delegation Agreement
6
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: MHPs/RCAs Program
STANDARD 7:
Industry &
Community
Relations
1. Work Groups
2. Educational
Outreach
November, 2011 Version
Evaluation Criteria
Comments
Rating
(0-2)
Y
Does the Board participate in
workgroups, advisory boards, task
forces or committees that work to
identify, correct, and prevent risk factors
and health and safety hazards in licensed
establishments?
a. Does the Board lead or participate in
activities that increase awareness of risk
factors, health and safety hazards, and
control methods to prevent illness or
injury?
b. (MDH only) Has MDH been
available to advise its delegated partners
regarding issues covered under the
Delegation Agreement.
W
Y
Source Materials
STANDARD 8:
Program
Resources
1. Inspection
Ratio (sufficient
staffing)
Evaluation Criteria
Comments
W
a. Describe the current ratio of qualified
inspection staff to the number of
licensed establishments.
b. (MDH only) Does MDH evaluate its
delegated partners’ compliance with the
Delegation Agreement to ensure that
their programs are adequate to assure
compliance by regulated parties to
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
Rating
(0-2)
Y
YELLOW: Required Program Elements required by the Delegation Agreement
7
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions
Evaluation Tool: MHPs/RCAs Program
2. Inspection
Equipment
3. Funding
4. Data Sharing
5. Professional
Development
6. Staff Safety
November, 2011 Version
requirements in statutes and rules?
Does the Board provide the appropriate
inspection equipment to its qualified
inspection staff?
Describe the source(s) of funding for
this program. (Fees, General Fund, etc.)
Does the Board maintain all licensing
and inspection information in an
electronic format and make it available
to MDH upon request?
Is funding provided for staff training,
conference attendance, and other
professional development activities?
Does the Board provide staff with
appropriate safety training and
equipment?
W
Y
W
W
Source Materials
ORANGE: Essential Program Elements defined in statute and/or rule and in the Delegation
Agreement
YELLOW: Required Program Elements required by the Delegation Agreement
8
WHITE: Value-Added Program Elements - not required
by law or the Delegation Agreement, but can help support core
functions