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November 12, 2025 Natalie Graf, Authorized Agent Dungarvin Minnesota LLC 1440 Northland Drive, Suite 100 Mendota Heights, MN 55120 RE: Report No. 202507157 Dungarvin Minnesota LLC License No. 1120791/1070806 Dear Natalie Graf: CORRECTION ORDER An investigation of Dungarvin Minnesota LLC was completed regarding report number 202507157, which alleged violation of Minnesota Statutes, section 626.557, and Minnesota Statutes, Chapter 245D. This maltreatment allegation concerned neglect and emotional abuse. The disposition of the investigation report is inconclusive. Three violations were noted. VIOLATIONS AND CORRECTION ORDERS The following violations of state and (or) federal laws and rules were observed. Corrective action for each violation is required by Minnesota Statutes, section 245A.06, and is hereby ordered by the Commissioner of Human Services. Failure to correct the violations within the prescribed amount of time may result in fines and/or action against your license, as provided for in Minnesota Statutes, sections 245A.06 and 245A.07. 1. Citation: Minnesota Statutes 245D.05, subdivision 1, paragraph (b) Violation: For one client whose record was reviewed (C1), the license holder did not document health needs as required. The license holder was assigned responsibility of medication administration for C1. The license holder did not maintain documentation on how C1’s health needs would be met, including a description of the procedures the license holder would follow in order to provide medication administration, including administration of C1’s pro re nata (PRN) psychotropic medication. Corrective Action Ordered: Immediately update C1’s support plan addendum and maintain compliance on an ongoing basis as required in this subdivision. 2. Citation: Minnesota Statutes 245D.05, subdivision 2, paragraph (c), clause (6) Violation: For one client whose record was reviewed (C1), the license holder did not document in the medication administration record (MAR) as required. The license holder administered C1’s psychotropic PRN six times in July and August 2025; however, the license holder did not document a notation of these administrations in C1’s MAR. Corrective Action Ordered: Maintain compliance on an ongoing basis as required in this subdivision. 3. Citation: Minnesota Statutes 245D.051, subdivision 1, paragraph (b) Violation: For one client whose record was reviewed (C1), the license holder did not develop and maintain documentation regarding psychotropic medications as required. The license holder did not to document a description of the target symptoms that C1’s psychotropic PRN medication was to alleviate. Corrective Action Ordered: Immediately update C1’s support plan addendum and maintain compliance on an ongoing basis as required in this subdivision. If you believe any of the citations are in error, you may ask the Commissioner of Human Services to reconsider the parts of the correction order that you believe to be in error. If you choose to exercise this right, your request for reconsideration must be in writing and received by the Commissioner within 20 calendar days after receipt of this letter. Your request for reconsideration must be sent to: Commissioner Minnesota Department of Human Services c/o Licensing Division PO Box 64242 St. Paul, MN 55164-0242 You must include any and all information, documentation, or other evidence you have to support your request for reconsideration. Please note that a request for reconsideration does not stay any provisions of the correction order. If you have any questions regarding the investigation, contact me immediately. If you have any questions regarding compliance with this Correction Order or applicable rules, contact your licensor, Robert Romani at 651-431-3685 and Robert.R.Romani@state.mn.us. Sincerely,
Beth Virden, Senior Investigator Office of Inspector General Licensing Division 651-431-6572 beth.virden@state.mn.us Enclosure
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