Facility-requested visit·November 8, 2021

Licensing Program Analyst (LPA) Jacob Williams arrived at the facility at 10:00 AM and met with Licensee Aurica Pop, to conduct an inspection proceeding the closure of the facility. A Notice of Facility Closure was received by the Regional Office with a facility closure date of 11/08/2021. At the time, the facility had zero (0) RCFE clients, but the facility is operating as a room and board with four (4) tenants. License was forfeited to LPA at the time of visit. LPA informed Licensee that facility will be closed in the department's system effective 11/08/2021. Exit interview was conducted with Licensee and a copy of this report was provided to the facility. The signature of Licensee on this form acknowledges receipt of this report.