Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown contacted the facility via telephone to commence

an announced Office visit on 3/8/22 at 1:00pm. This meeting will be held using “Microsoft Teams”. Present in the meeting were Regional Manager (RM) Krystall Moore, Licensing Program Manager (LPM) Stephenie Doub, LPA Victoria Brown, LPA Christina Valerio, LPA Jamie Ivey Canady, representatives of 5M Care LLC and Mariolyn Care LLC: Annie Lyn J Rodriguez, and Monalisa Legaspi.

Krystall Moore discussed the purpose and elements of this type of call. It is to review the stipulation adopted on 2/22/2022 and the next steps. This Stipulation shall be posted in a conspicuous place at the facility for the duration of the probationary period of 3 years.

The Stipulation was reviewed with representatives of 5M Care LLC who expressed their understanding.

Items discussed at the meeting included, but not limited to:

· Revocations/Denial/Exclusion: STAYED with Probation

· Future Application for License, Registration, Certification or Approval

· Trustline and Home Care Aide Registries