St Charles Retirement Community

Last evaluation

December 3, 2025

Evaluations on record

2

Investigations substantiated

2 kept 7 years

Inconclusive

0 kept 4 years

Unsubstantiated

3 kept 3 years

Most recent evaluation (December 3, 2025, state report EZH711)

MDH: “On December 1, 2025, through December 3, 2025, the Minnesota Department of Health conducted a change of ownership (CHOW) survey at the above provider.”

Survey completed December 3, 2025: 11 correction orders

• Tag 480: 144G.41 Subdivision 1 Subd. 1a (a-b) Minimum requirements; required food services Level 2, widespread scope, scope/level letter F · correction period: Please refer to the FBEIR for any compliance dates
  Details

  Summary: MDH found the licensee failed to ensure food was prepared and served according to the Minnesota Food Code.

  MDH’s finding, as written: “Based on observation, interview, and record review, the licensee failed to ensure food was prepared and served according to the Minnesota Food Code. This practice resulted in a level two violation (a violation that did not harm a resident's health or safety but had the potential to have harmed a resident's health or safety, but was not likely to cause serious injury, impairment, or death), and is issued at a widespread scope (when problems are pervasive or represent a systemic failure that has [...]”

  Rule cited: “(a) Except as provided in paragraph (b), food must be prepared and served according to the Minnesota Food Code, Minnesota Rules, chapter 4626. [...]”

• Tag 730: 144G.43 Subd. 3 Contents of resident record Level 2, widespread scope, scope/level letter F
  Details

  Summary: MDH found the licensee failed to ensure the resident record included a discharge summary with the required content for one of one discharged resident (R4).

  MDH’s finding, as written: “Based on interview and record review, the licensee failed to ensure the resident record included a discharge summary with the required content for one of one discharged resident (R4). [...]”

  Rule cited: “Contents of a resident record include the following for each resident: (1) identifying information, including the resident's name, date of birth, address, and telephone number; (2) the name, address, and telephone number of the resident's emergency contact, [...]”

• Tag 775: 144G.45 Subd. 2. (a) Fire protection and physical environment Level 2, scope/level letter F · correction period: Seven (7) days
  Details

  Summary: MDH found the licensee failed to ensure the physical environment of the facility was maintained in compliance with the requirements of Minnesota Statute 144G.

  MDH’s finding, as written: “Based on observation, interview, and record review, the licensee failed to ensure the physical environment of the facility was maintained in compliance with the requirements of Minnesota Statute 144G. This practice resulted in a Level 2 Widespread: The findings include: Please refer to the document titled, Physical Environment Inspection Report (PEIR) dated December 3, 2025, for the specific violations related the physical environment under Minnesota Statute 144G.”

  Rule cited: “Each assisted living facility must comply with the State Fire Code in Minnesota Rules, chapter 7511, and:”

• Tag 790: 144G.45 Subd. 2 (a) (2-3) Fire protection and physical environment Level 2, scope/level letter F · correction period: Seven (7)
  Details

  Summary: MDH found the licensee failed to ensure the physical environment of the facility was maintained in compliance with the requirements of Minnesota Statute 144G.

  MDH’s finding, as written: “Based on observation, interview, and record review, the licensee failed to ensure the physical environment of the facility was maintained in compliance with the requirements of Minnesota Statute 144G. This practice resulted in a Level 2 Widespread: The findings include: Please refer to the document titled, Physical Environment Inspection Report (PEIR) dated December 3, 2025, for the specific violations related the physical environment under Minnesota Statute 144G. days.”

  Rule cited: “(2) install and maintain portable fire extinguishers in accordance with the State Fire Code; (3) install portable fire extinguishers having a minimum 2-A:10-B:C rating within Group R-3 occupancies, as defined by the State Fire Code, located so that the travel [...]”

• Tag 810: 144G.45 Subd. 2 (b-f) Fire protection and physical environment Level 3, scope/level letter I · correction period: Seven (7) days
  Details

  Summary: MDH found the licensee failed to ensure the physical environment of the facility was maintained in compliance with the requirements of Minnesota Statute 144G.

  MDH’s finding, as written: “Based on observation, interview, and record review, the licensee failed to ensure the physical environment of the facility was maintained in compliance with the requirements of Minnesota Statute 144G. This practice resulted in a Level 3 Widespread: The findings include: Please refer to the document titled, Physical Environment Inspection Report (PEIR) dated December 3, 2025, for the specific violations related the physical environment under Minnesota Statute 144G.”

  Rule cited: “(b) Each assisted living facility shall develop and maintain fire safety and evacuation plans. [...]”

From MDH’s letter: the letter says the facility is in substantial compliance.

Food and beverage inspection (included in this report): Food and beverage inspection report included

Total fines assessed, as printed in the letter: $1,500.00.

Substantiated investigations (state reports)

• March 24, 2025 · report HL397769442M · MDH finding: Substantiated, facility responsibility
  Details

  Allegation, as written: “The facility neglected the resident when the resident's clozapine (an antipsychotic medication, which required blood level monitoring) psychotropic medication was not refilled and not administered to the resident.”

  “The Minnesota Department of Health determined neglect was substantiated.”

  “The facility was responsible for the maltreatment.”

  Summary: MDH looked into an allegation and found: neglect substantiated (facility responsibility).

  MDH’s conclusion, as written: “The Minnesota Department of Health determined neglect was substantiated. The facility was responsible for the maltreatment. The facility ran out of the resident's clozapine and did not administer it for more than a month.”

  Action taken by facility: “Once the facility was made aware of the missed doses of medication they completed a report in the Minnesota Adult Abuse Reporting Center.”

  Action taken by MDH: “The facility was found to be in noncompliance.”

  Survey completed February 25, 2025: 2 correction orders

  • Tag 1760: 144G.71 Subd. 8 Documentation of administration of medication Level 3, isolated scope, scope/level letter G · correction period: Seven (7) days
    Details

    Summary: MDH found the licensee failed to ensure medications were administered as prescribed for one of one resident (R1) with records reviewed.

    MDH’s finding, as written: “Based on interview and record review, the licensee failed to ensure medications were administered as prescribed for one of one resident (R1) with records reviewed. Facility licensed staff had been unaware the medication had not been filled or administered to R1 for thirty-two days. R1 was at risk for harm with the omission of the numerous doses of the critical medication. [...]”

    Rule cited: “Each medication administered by the assisted living facility staff must be documented in the resident's record. The documentation must include the signature and title of the person who administered the medication. [...]”

  • Tag 2360: 144G.91 Subd. 8 Freedom from maltreatment
    Details

    Summary: MDH found the facility failed to ensure one of one resident(s) reviewed (R1) was free from maltreatment.

    MDH’s finding, as written: “The facility failed to ensure one of one resident(s) reviewed (R1) was free from maltreatment. The Minnesota Department of Health (MDH) issued a determination maltreatment occurred, and the facility was responsible for the maltreatment, in connection with incidents which occurred at the facility. Please refer to the public maltreatment report for details.”

    Rule cited: “Residents have the right to be free from physical, sexual, and emotional abuse; neglect; financial exploitation; and all forms of maltreatment covered under the Vulnerable Adults Act.”

• May 3, 2024 · report HL397769385M · MDH finding: Substantiated, individual responsibility
  Details

  Allegation, as written: “The alleged perpetrator (AP) financially exploited the multiple residents when the AP signed out narcotic pain medications for three residents on hospice but failed to administer the medications.”

  “The Minnesota Department of Health determined financial exploitation was substantiated.”

  “The AP was responsible for the maltreatment.”

  Summary: MDH looked into an allegation and found: financial exploitation substantiated (individual responsibility).

  MDH’s conclusion, as written: “The Minnesota Department of Health determined financial exploitation was substantiated. The AP was responsible for the maltreatment. The AP, who was an unlicensed caregiver, was observed setting up medications at a medication cart she was not assigned to and was asked to stop. Afterwards, narcotic medications from three residents signed out by the AP were found to be missing.”

  Action taken by facility: “The facility called law enforcement. Facility purchased new medication carts. Only the delegated medication person has a set of keys on their person during the shift and the second set of keys is with the facility administration person. The AP is no longer employed at the facility”

  Action taken by MDH: “The facility was issued a correction order regarding the vulnerable adult's right to be free from maltreatment.”

  Survey completed April 9, 2024: 1 correction order

  • Tag 2360: 144G.91 Subd. 8 Freedom from maltreatment
    Details

    Summary: MDH found the facility failed to ensure three of three resident(s) reviewed (R1) was free from maltreatment.

    MDH’s finding, as written: “The facility failed to ensure three of three resident(s) reviewed (R1) was free from maltreatment. Findings include: The Minnesota Department of Health (MDH) issued a determination maltreatment occurred, and an individual person was responsible for the maltreatment, in connection with incidents which occurred at the facility. Please refer to the public maltreatment report for details.”

    Rule cited: “Residents have the right to be free from physical, sexual, and emotional abuse; neglect; financial exploitation; and all forms of maltreatment covered under the Vulnerable Adults Act.”

Summaries are ours and are marked “Summary”; quoted text is MDH’s own, shortened where marked [...]. Read the full reports at the links above or search every report on MDH’s site.

MDH keeps investigation results for seven years when allegations are substantiated, four years when inconclusive, and three years when unsubstantiated, so the counts cover different periods. This community is licensed for 42 residents; larger communities are evaluated and reported on more often, so read counts with size in mind. Source: Minnesota Department of Health, Health Regulation Division, data as of September 28, 2026. Always visit in person and ask the community about anything listed here.