Facility Evaluation Report

An informal meeting was conducted today in the Santa Rosa Regional Office. Present in the meeting were Regional Manager Carla Nuti-Martinez, Licensing Program Manager Victoria Bertozzi, Licensing Program Analysts Marisol Cuadra, Christi Coppo, Robert Frank and Co-licensees of the facility, Nicanor Aquino and Tiffany Dizon, other representatives Justice Dizon and Jasmin Dizon, via phone Nikki Aquino.

The purpose of the informal conference is to address concerns regarding further operation and management for this facility and the Licensee's other facility, Mc Hugh Care Home 490108000 in which Tiffany Dizon is the identified Administrator. Also, areas of concern regarding medication management, hospice care/responsibilities related to hospice care and recurrent bed bugs’ issue.

During today’s meeting it was discussed with Co-Licensees the possible options that they can choose to continue the operation of both facilities due to Co-Licensee’s Angelita Aquino health challenges. Based on records review, LIC309 Administrative Organization form indicates that this facility is in a limited liability company (LLC) where Angelita Aquino, Nicanor Aquino and Tiffany Aquino Dizon own ten percent (10%) or more interest in LLC of this facility. The current options discussed are the following:

- Submit a change within a corporate structure application to the Centralized Application Bureau (CAB).