Follow-up on corrections·September 18, 2025

Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced case management visit to cite deficiencies. LPA identified herself to, was greeted by, and explained the purpose of the visit to House Manager Milagros Bucatcat. Review of the Department’s Active Administrator List dated 9/16/2025 revealed that Virgil P. Bucatcat, who is the currently listed Administrator for the facility, did not have an active or pending renewal for an Administrator Certificate, and their latest Administrator Certificate expired in 2013. Additionally, Staff 1, [House Manager was provided with an LIC811 Confidential Names List to identify individuals] who was acting as a facility manager did not have active or pending renewal for Administrator Certificate. Review of an Administrator Certificate for Staff 2 revealed that S2 had an active Administrator Certificate for residential care facilities for the elderly, however, interviews confirmed that facility management had not submitted a Change of Administrator request to the Department. Additionally, Staff 1 stated during multiple conversations that only Residents 1 and 2 were receiving hospice services and Residents 3, 4, 5, 6, and 7 were not receiving hospice services. Staff 1 only provided LPA Borunda with hospice records for R1 and R2. However, interviews with outside sources and review of facility records revealed that Residents 1-7 were under the care of a hospice provider and were receiving hospice services. Residents 1-6 were all admitted to the facility at the same time, which placed the facility over their approved and pending hospice waiver requests. In 2013, the facility was originally approved to admit 2 hospice residents, however in 2022, the facility applied for a hospice waiver increase from 2 to 4 residents. Continued on LIC809-C page... Following a visit from the Department on 7/23/2025, S1 submitted a hospice waiver increase to 6 residents, which is still pending with the Department. Therefore the following deficiencies for lack of active Administrator, false claims, and over capacity for hospice residents are being cited per California Code of Regulations Title 22 and noted on the attached LIC809-D pages. An exit interview was conducted with House Manager Milagros Bucatcat, whose signature below confirms receipt of a copy of this report, the LIC811, and the Licensee Appeal Rights (LIC9058 3/22).