Facility Evaluation Report

On 5/22/2026, Licensing Program Manager (LPM) Robyn Clark conducted an in-person office meeting with Administrator (ADM) Gloria Pascua to grant an Emergency Approval to Operate the facility in response to the death of the Facility licensee, Josefina I. Hulsey (LIC).

On 5/20/2026, LPM conducted a virtual office meeting with the LIC's next of kin, who produced verification of death, LIC's notarized Trust, as well as a grant deed indicating that LIC's next of kin held legal ownership of the property occupied by the facility, which was being operated by Administrator Pascua. A new control of property (rental lease agreement) was executed and produced to the Department on 5/21/2026, showing Pascua's legal right to occupy the premises to operate the Residential Care Facility for the Elderly.

During the meeting, LPM provided Pascua with an LIC 9117, Certificate of Emergency Approval to Operate and explained the terms and conditions of the approval. The certificate is valid for 60 days, and will expire upon the issuance of a provisional license, or denial of application for licensure. LPM Reviewed the LIC 200 and application documents and advised that Pascua must submit a completed application for licensure including payment to the Department's Centralized Applications Bureau (CAB) within 20 days of LICs death. Pascua must also comply with all applicable laws and regulations, and ensure that the needs of all residents are met.

Report discussed and provided along with the LIC 9117 to Administrator Pascua, whose signature below confirms receipt.