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Date issued: September 17, 2025 CERTIFIED MAIL Date reissued: January 27, 2026 Natalie Lynn Graf, Authorized Agent Dungarvin Minnesota LLC 1440 Northland Drive, Suite 100 Mendota Heights, Minnesota 55120 License Number: 1120847 CRS AMENDED ORDER OF CONDITIONAL LICENSE NOTICE: This Amended Order of Conditional License supersedes the Order of Conditional License dated September 17, 2025. This document is amended to reflect a one-year conditional license rather than two-years based upon the conditional license reconsideration decision. The original Order of Conditional License must be destroyed. Dear Natalie Lynn Graf: Based on the recommendation from Sherburne County, the Department of Human Services (DHS) is placing your license to provide CRS services at 2056 47th Street Southeast, Saint Cloud, Minnesota 56304 on conditional status for one year, beginning January 13, 2026. This means you must meet certain conditions to maintain your license, detailed below. This order applies to the service site detailed in the “Applicability of Conditional License” section below. This order is based on your noncompliance with CRS licensing requirements. This order is based on your level of noncompliance with CRS licensing requirements. Our next steps and your options are also provided below. REASON FOR THE CONDITIONAL LICENSE 1. Commissioner’s evaluation of program In determining whether a licensing action is warranted, DHS evaluated the facts, conditions, and circumstances concerning your program’s operation. This includes consideration of the well-being of persons served in your program, available evaluations from consumers of your program, and information about the qualifications of staff persons working in your program. DHS has determined that it is appropriate to place your license on conditional status based on the violations identified below and the program evaluation. This CRS has been licensed since September 1, 2023. You are also licensed by DHS to provide home and community-based services (HCBS) at your CRS program. Sherburne County has provided five correction orders addressing repeat concerns at your CRS from July 2024 through February 4, 2025. Due to your inability to comply with Statute requirements, Sherburne County has recommended a conditional license for your CRS. Legal Authority: Minnesota Statutes, section 245A.04, subdivision 6. To protect the health and safety of persons served, DHS is putting your license on a conditional status for one year. 2. Failure to comply with licensing laws and rules As a result of previous licensing visits, Sherburne County determined that your program did not comply with the laws and rules for licensed CRS. DHS has considered the nature, chronicity, and severity of these violations, which are provided below. Legal Authority: Minnesota Statutes, section 245A.06, subdivision 1. Nature, history and severity of violations Previous licensing actions The following violations summarize the nature of your previous licensing violations. Because these violations are now conclusive, the individual violations are not within the scope of your appeal rights. Please refer to the previously issued correction orders for further details on these violations. If you do not have copies of these orders, contact your Sherburne County licensor for assistance. DHS also considered this history as a factor when it determined that a Conditional License is appropriate. July 8, 2024 Correction Order, which cited one violation for the facility Sanitation and Health, General Maintenance, under Minnesota Statute, 245D.22, Subdivision 1. · November 20, 2024 Correction Order, which cited three violations, one of which was a repeat violation. Violations of concern include: o Facility Sanitation and Health, General Maintenance, under Minnesota Statute, 245D.22. Subdivision 1; o Community Residential Settings; Physical Plant and Environment, Bedrooms, under Minnesota Statute 245D.24, Subdivision 3, paragraph d; and o Community Residential Settings; Food and Water, Food Safety, under Minnesota Statute 245D.25, subdivision 3. · December 4, 2024 Correction Order, which cited one violation, which was a repeat violation. Violation of concern: o Facility Sanitation and Health, General Maintenance, under Minnesota Statute, 245D.22. Subdivision 1. · January 27, 2025 Correction Order, which cited one violation, one of which was a repeat violation. Violation of concern: o Facility Sanitation and Health, General Maintenance, under Minnesota Statute, 245D.22. Subdivision 1. · February 14, 2025 Correction Order, which cited one violation, which was a repeat violation. Violation of concern: o Facility Sanitation and Health, General Maintenance, under Minnesota Statute, 245D.22. Subdivision 1. Severity of violations The violations relate to the health and safety of persons served. DHS also considered the severity of these violations when it determined that a Conditional License is appropriate. Due to the serious and chronic nature of these violations, and the conditions in the program, which impact the health and safety of persons served in your care, your license to provide CRS is placed on a conditional status. Applicability of Conditional License This Order of Conditional License applies to service site operated as the community residential setting (CRS) located at 2056 47th Street Southeast, Saint Cloud, Minnesota 56304 because this CRS is not being operated in substantial compliance with applicable law and rules and has a history of violations documented above. You did not maintain the interior of the community residential setting in sanitary condition. You did not consistently correct the health and sanitation concerns, including the home being dirty, food being left out, and multiple areas infested by cockroaches including areas where food is stored and prepared. These violations involved license 1120847 (CRS) and were serious in nature, therefore, this conditional order applies to this license. Legal Authority: Minnesota Statutes, section 245A.06, subdivision 1a, paragraph (a). Conditional License Terms In addition to the licensing Rules and Statutes for CRS, you are required to comply with the following terms: 1. Dungarvin must create a daily cleaning checklist that includes: a. Staff clean countertops, appliances, and cupboards daily with disinfectant. b. Staff check inside of kitchen and bathroom cupboards daily for dead insects. If any are found, they must be removed and the area disinfected. c. Staff must ensure trash is collected and taken out to the dumpster at least daily. d. Staff must ensure there are not dirty dishes and open food containers sitting out around the home, including bedrooms. e. Staff must ensure that all dishes are cleaned promptly after use or put into the dishwasher. Dishwasher should be run and emptied at least daily. f. Staff must ensure that the home is free of excess dirt, debris, and clutter. 2. Dungarvin must train all staff on the cleaning checklist and monitor that items are checked off daily.
Ongoing Monitoring Your Sherburne County licensor will monitor your compliance with these terms and with all of the CRS rules and laws. This will include unannounced visits. If you fail to demonstrate substantial compliance with CRS requirements or with the terms of your conditional license that are provided above, DHS may take an additional licensing sanction, including a revocation of your license. NO RIGHT TO REQUEST RECONSIDERATION You requested reconsideration of the original Order of Conditional License, and the order has been amended to decrease the length of the conditional license from two years to one year based on that reconsideration determination. You do not have additional reconsideration rights. Conditional license stayed pending reconsideration Because you requested a reconsideration of the original Order of Conditional License, the terms of the conditional license were stayed until the Commissioner issued a decision on the request for reconsideration. On January 13, 2026, the license holder’s attorney received the Commissioner’s reconsideration decision. For the above reasons, the terms of the Amended Order of Conditional License begin on January 13, 2026, and runs for one year from that date. You continue to be required to comply with all CRS laws and rules. Questions If you have any further questions regarding this matter, you may contact Tawnya Arueya, Supervisor, at 651-201-5571. Sincerely,
Christala Culhane, Unit Manager Licensing Division Office of Inspector General cc: Kerry Goshorn, Sherburne County
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