Facility Evaluation Report

Announced office visit was conducted, via Teams Meeting, with the following representatives for the purpose of conducting an Informal Conference:

The purpose of this informal conference was to discuss the current situation and status of this facility license moving forward. It was learned that this facility license was granted to La Hacienda Care Manteca, LLC to which 50% ownership was granted to Liliana Bello and the other 50% granted to Anabelen Vallarta.

It was discussed that the LLC was going to be dissolved and would no longer be recognized through the Secretary of State to be able to conduct business in this state.

As a result, since the licensed entity, La Hacienda Care Manteca, LLC, was going to no longer be in existence then this facility license would be deemed forfeited at this time.

The following will need to be completed by the co-Licensee(s) in order to move forward in this process:

Complete and submit a new application for an RCFE into CCL by COB 03/14/2025

Complete and submit all notifications for the residents, and their responsible parties, in regards to the change of ownership into CCL by COB 03/14/2025

Complete and submit all forms and documents related to the hiring of Jennifer Whiteley into CCL by COB 03/04/2025

Complete and submit all POCs due from prior complaint visit conducted on 01/27/2025 into CCL by COB 03/07/2025

There were no deficiencies cited during today's office visit.

A copy of this report will be scanned and emailed to both of the co-Licensee(s) at this time. Exit Interview