Facility Evaluation Report

An office meeting was conducted today in the Santa Rosa Regional Office with Licensing Program Manager (LPM) Victoria Bertozzi, Licensing Program Analyst (LPA) Elias Magdaleno, Licensing Program Analyst (LPA) Anthony Loera, Licensee/Administrator Rosie Skillman, Administrator Judy Johnson, and Administrator Troy Skillman regarding the passing of Licensee Clark Skillman.

CCL requested the following documents to be brought for two licensed homes (Clark-Ro Home 480102469 and Clark-Ro Residential Care II 486800164 ):

During today's meeting we received five of five documents and reviewed financial documents. Parties discussed potential Change of Ownership options under which a new license could be issued. Licensee will discuss their options and let CCL know once a decision is made as to the avenue they choose for potential future licensure. Licensee also submitted documents to update Administrator to Troy Skillman.

No deficiencies cited. Exit interview conducted with Troy Skillman, whose signature on form confirms receipt.