Leap Care Services Llc
What is an RCFE with Memory Care?
A Residential Care Facility for the Elderly (RCFE) is a non-medical residential care home licensed by California CDSS under Health & Safety Code §1560. Residents receive help with daily living activities such as bathing, dressing, and medication management. An RCFE with a Memory Care designation is additionally required by California Title 22 (§87705 and §87706) to provide specialized staff training in dementia care, individualized care plans for residents with cognitive impairment, and appropriate supervision protocols — requirements that go beyond a standard RCFE license.
4336 East Avenue · Livermore, 94550
Record last updated April 20, 2026.
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Quick facts
Memory care context
Leap Care Services Llc is a California-licensed Residential Care Facility for the Elderly (RCFE) with 6 beds. The operator advertises memory care services, though this designation is not formally recorded in CDSS licensing data. California Title 22 requires all RCFEs serving dementia residents to comply with §87705 and §87706, which govern individualized care plans, staff dementia training, and resident supervision standards. State records show 7 inspection reports on file with 22 total deficiencies — 6 Type A citations (actual harm) and 16 Type B citations (potential for harm). No dementia-specific citations under §87705 or §87706 appear in the data. The most recent inspection occurred on May 6, 2025. For a 6-bed facility, the volume of deficiencies, particularly Type A citations, warrants careful review during any tour.
Questions to ask on your tour
Based on Leap Care Services Llc's state inspection record.
State records show 6 Type A deficiencies — citations indicating actual harm to residents — what were the specific circumstances of each, and what corrective actions were implemented?
With 22 total deficiencies across 7 inspections at a 6-bed facility, what systemic changes has Leap Care Services Llc made since the most recent May 2025 inspection to address recurring compliance issues?
The operator advertises memory care but CDSS does not record a formal memory care designation — what specific dementia training have your caregivers completed, and how do you document compliance with Title 22 §87705 requirements?
For a facility with 6 residents and this deficiency history, how many caregivers are on duty during overnight hours, and what is the supervision protocol if a single caregiver must attend to an emergency?
Which Title 22 sections were cited in the 16 Type B deficiencies, and can you show documentation that each deficiency has been fully corrected?
State records
California CDSS · Community Care Licensing Division- License number
- 019201280
- License type
- RESIDENTIAL CARE ELDERLY
- License status
- LICENSED
- License expires
- Not yet indexed
- Licensed beds
- 6
- Operator
- Leap Care Services Llc
Inspections & citations
7
reports on file
22
total deficiencies
6
Type A (actual harm)
Other visitMay 6, 2025Type A7 deficiencies
Inspector notes
On 2/26/2026 at 9:30AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Catherine Ibanez and explained the purpose of the visit. Administrator, Marivel Calambro arrived 30 minutes later. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full. One week of nonperishable and 2-day of perishable food supplies were available. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned. First Aid kit is complete. LPA reviewed 5 residents and 3 staff files starting at 10:15AM. Staff are fingerprint cleared and associated to the facility. LPA reviewed a sample of resident's medication during inspection. At 10:30AM, LPA observed R2 does not have medical assessment and TB test results on file. At 11:00AM, LPA measured hot water at 132.7 degrees F in the hallway bathroom. Staff lowered hot water and was re-measured at 114.8 degrees F. At 11:15AM, LPA observed unlocked medications in the refrigerator. Staff locked up the medications during inspection. At 11:20AM, LPA observed facility had a baby monitor in R1's room and the receiver is on the kitchen counter. Staff removed the baby monitor during inspection. (Continue LIC809C...) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 At 11:45AM, LPA observed S3 does not have initial training completed. At 12:45PM, LPA observed 4 residents (R2, R3, R4, R5) does not have doctor's orders for bed rails. At 1:20PM, LPA observed R4 did not have medication Senna available. Additionally, R4 has a doctor's order for Milk of Magnesium; however, the facility has MiraLAX power instead. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct deficiencies may result in civil penalties. Exit interview conducted. A copy of this report, civil penalty, and appeal rights was provided.
(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C).
Based on observation, the licensee did not comply with the section cited above by having hot water at 132.7 degrees F in the hallway bathroom which poses an immediate health and safety risk to persons in care. POC Due Date: 02/27/2026 Plan of Correction 1 2 3 4 Staff lowered hot water and was re-measured at 114.8 degrees F. Deficiency cleared.
(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.
Based on observation, the licensee did not comply with the section cited above by having unlocked medications in the refrigerator which poses an immediate health and safety risk to persons in care. POC Due Date: 02/27/2026 Plan of Correction 1 2 3 4 Staff locked up the medications during inspection. Deficiency cleared.
(1) The department shall adopt regulations to require staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training. This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, …
Based on record review, the licensee did not comply with the section cited above by not having initial training completed for S3 which poses a potential health and safety risk to persons in care. POC Due Date: 03/20/2026 Plan of Correction 1 2 3 4 Administrator has agreed to obtain initial training for S3 and submit completion document to CCLD by POC date.
(4) The licensee shall assist residents with self-administered medications as needed.
Based on observation and record review, the licensee did not comply with the section cited above by not having medications available for R4 which poses a potential health and safety risk to persons in care. POC Due Date: 03/20/2026 Plan of Correction 1 2 3 4 Administrator has agreed to obtain an updated doctor's order for discontinue Senna and updated MiraLAX powder. Administrator will submit updated doctor's order to CCLD by POC date.
(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record.
Based on record review, the licensee did not comply with the section cited above by not having medical assesssment and TB test for R2 which poses a potential health and safety risk to persons in care. POC Due Date: 03/20/2026 Plan of Correction 1 2 3 4 Administrator has agreed to obtain R2 medical assessment and TB test and submit a copy to CCLD by POC date. Civil penalty of $250 is being assessed for a repeat violation.
(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions: (3) A written order from a physicia…
Based on record review, the licensee did not comply with the section cited above by not having doctor's order for residents' bed rails which poses a potential health and safety risk to persons in care. POC Due Date: 03/20/2026 Plan of Correction 1 2 3 4 Administrator has agreed to obtain residents (R2, R3, R4, R5) doctor's orders for bed rails and submit a copy to CCLD by POC date.
(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:
Based on observation, the licensee did not comply with the section cited above by having baby monitors in R1's room which poses a potential personal rights risk to persons in care. POC Due Date: 02/27/2026 Plan of Correction 1 2 3 4 Staff have removed the baby monitors in R1's room during inspection. Deficiency cleared.
Other visitApril 9, 2025No deficiencies
Inspector notes
On 5/6/2025 at 1:45PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a POC (proof of correction) inspection. LPA met with caregiver, Julie Ann Arcosa and informed her the reason for the visit. Administrator, Marivel Calambro was not able to be at the facility and authorized caregiver to sign CCLD reports. The following deficiencies were cleared by visit : - 1569.625(b)(2); LPA observed staff have annual training documents in file. - 1569.69(a)2); LPA observed staff have initial training documents in file. - 87465(d)(3); LPA observed staff completed medication training and certificates were sent via email. - 87458(a); LPA observed R2 has medical assessment on file. - 87467(a)(3); LPA observed residents have reappraisals on file. - 87507(d); LPA observed R1 and R3 have signed admission agreements. No deficiencies are being cited on this date. Exit interview conducted with Julie. A copy of this report and POC letters provided.
InspectionFebruary 14, 2025Type B6 deficiencies
Inspector notes
On 4/9/2025 at 10:15AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management - Annual Continuation. LPA met with caregiver, Julie Ann Arcosa and explained the purpose of the visit. Administrator, Marivel Calambro was not able to be at the facility and authorized caregiver to sign CCLD reports. During visit, LPA reviewed 5 residents and 3 staff files. LPA observed staff are fingerprint cleared and associated to the facility. LPA reviewed a sample of resident's medications at around 3:00PM. At 11:30AM, LPA observed R1 and R3 did not have admission agreement on file. At 11:35AM, LPA observed the five residents (R1, R2, R3, R4, R5) did not have reappraisal/ needs & service plan on file. At 11:40AM, LPA observed R2 did not have medical assessment on file. At 1:00PM, LPA observed all staff does not have initial and annual training on file. At 3:30PM, LPA observed facility did not have MAR (Medication Administration Records) completed for March and April of 2025. MARs for April was missing for all residents and MARs for March was incomplete. LPA observed staff did not mark down when medications were given and PRN medications were not documented on the MARs. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted with Julie Ann Arcosa. A copy of this report and appeal rights were provided.
(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivisi…
Based on record review, the licensee did not comply with the section cited above by not having staff annual training completed which poses a potential health and safety risk to persons in care. POC Due Date: 04/30/2025 Plan of Correction 1 2 3 4 Administrator has agreed to complete annual training for staff and submit annual training documents to CCLD by POC date.
(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours o…
Based on record review, the licensee did not comply with the section cited above by not having staff initial training completed which poses a potential health and safety risk to persons in care. POC Due Date: 04/30/2025 Plan of Correction 1 2 3 4 Administrator has agreed to complete initial training for staff and submit annual training documents to CCLD by POC date.
(d) If the resident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable to communicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (3) The date and …
Based on record review, the licensee did not comply with the section cited above by not completing the MARs for residents which poses a potential health and safety risk to persons in care. POC Due Date: 04/30/2025 Plan of Correction 1 2 3 4 Facility has agreed to conduct training for staff on completing documentation/MARs for residents when administering medications. Facility will submit staff sign in sheet and training materials to CCLD by POC date.
(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record.
Based on record review, the licensee did not comply with the section cited above by not having medical assessment completed for R2 which poses a potential health and safety risk to persons in care. POC Due Date: 04/30/2025 Plan of Correction 1 2 3 4 Facility has agreed to obtain R2's medical assessment and submit a copy to CCLD by POC date.
(a) Prior to, or within two weeks of the resident's admission, the licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, and any other appropriate parties, to prepare a written record of the care the resident will rece…
Based on record review, the licensee did not comply with the section cited above by not having reappraisals completed for all residents which poses a potential health and safety risk to persons in care. POC Due Date: 04/30/2025 Plan of Correction 1 2 3 4 Facility has agreed to obtain reappraisals for all residents and submit a copy to CCLD by POC date.
(d) The licensee shall retain in the resident's file the original signed and dated admission agreement and all subsequent signed and dated modifications. This does not apply to rate increases which have specific notification requirements as specified in Health and Safety Code section 1569.655.
Based on record review, the licensee did not comply with the section cited above by not having admission agreements completed for R1 and R3 which poses a potential health and safety risk to persons in care. POC Due Date: 04/30/2025 Plan of Correction 1 2 3 4 Facility has agreed to obtain admission agreements for R1 and R3. Facility will submit copies of R1 and R3's admission agreements to CCLD by POC date.
Other visitFebruary 7, 2024Type A9 deficiencies
Inspector: Grace Luk
Inspector notes
On 2/14/2025 at 11:00AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Catherine Ibanez and explained the purpose of the visit. Administrator, Marivel Calambro arrived 30 minutes later. The facility’s fire clearance was approved for 6 residents of which 4 residents maybe non-ambulatory and 2 residents maybe under hospice care. LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full. One week of nonperishable and 2-day of perishable food supplies were available. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned. First Aid kit is complete. LPA reviewed 5 residents and 3 staff files starting at 11:30AM. At 12:15PM, LPA observed unlocked medications in the refrigerator. Staff locked up the medications during inspection. At 12:20PM, LPA observed unlocked knives and scissors in the kitchen. There was unlocked cleaning supplies in the bathroom and unlocked tools in the backyard. Staff locked up the items during inspection. At 12:25PM, LPA measured hot water temperature at 130.5 degrees F in the hallway bathroom. Staff lowered hot water temperature and LPA re-measured hot water at 118.1 degree F. At 12:45PM, LPA observed R1's physician's report dated 7/19/2024 states R1 has a dementia diagnosis which requires R1 to be in a non-ambulatory room. However, R1 is occupying room 5 which is ambulatory only. Civil penalty of $500 is being assessed. (continue on LIC809C...) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 At 1:00PM, LPA observed R1, R2, and R4 does not have TB test on file. At 1:10PM, LPA observed resident files were incomplete. At 2:00PM, LPA observed S3 does not have health screening and TB test on file. At 2:10PM, LPA observed S1, S2, and S3 does not have current first aid training on file. At 2:30PM, LPA observed facility did not conduct fire drill every three months. LPA will return at a later time to complete annual inspection. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct deficiencies may result in civil penalties. Exit interview conducted. A copy of this report, civil penalty, and appeal rights was provided.
(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degre…
Based on observation, the licensee did not comply with the section cited above by having hot water at 130.5 degrees F which poses an immediate health and safety risk to persons in care. POC Due Date: 02/15/2025 Plan of Correction 1 2 3 4 Administrator lowered hot water and LPA re-measured hot water at 118.1 degrees F in the hallway bathroom. Deficiency cleared.
(b) Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate nonambulatory residents. Residents whose condition becomes nonambulatory shall not remain in rooms restricted to ambulatory residents.
Based on record review, the licensee did not comply with the section cited above by having a non-ambulatory resident in an ambulatory room which poses an immediate health and safety risk to persons in care. POC Due Date: 02/15/2025 Plan of Correction 1 2 3 4 Administrator has agreed to submit LIC200 and updated sketch to CCLD by POC date. Civil Penalty of $500 is being assessed.
(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. (1) Disinfectants, cleaning solutio…
Based on observation, the licensee did not comply with the section cited above by having unlocked knives, scissors, cleaning supplies, and tools at the facility which poses an immediate health and safety risk to persons in care. POC Due Date: 02/15/2025 Plan of Correction 1 2 3 4 Staff locked up the items during inspection. Deficiency cleared.
(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.
Based on observation, the licensee did not comply with the section cited above by having unlocked medications in the refrigerator which poses an immediate health and safety risk to persons in care. POC Due Date: 02/15/2025 Plan of Correction 1 2 3 4 Staff locked up the medications during inspection. Deficiency cleared.
(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after e…
Based on record review, the licensee did not comply with the section cited above by not having health screening and TB test completed for S3 which poses a potential health and safety risk to persons in care. POC Due Date: 03/07/2025 Plan of Correction 1 2 3 4 Administrator has agreed to obtain health screening and TB test for S3. Administrator will submit a copy to CCLD by POC date.
(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A) Communicable tuberculosis.
Based on record review, the licensee did not comply with the section cited above by not having TB test on file for R1, R2, and R4 which poses a potential health and safety risk to persons in care. POC Due Date: 03/07/2025 Plan of Correction 1 2 3 4 Administrator has agreed to obtain TB test for R1, R2, R4 and submit copies to CCLD by POC date.
(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill,…
Based on record review, the licensee did not comply with the section cited above by not conducting disaster drill every three months which poses a potential health and safety risk to persons in care. POC Due Date: 03/07/2025 Plan of Correction 1 2 3 4 Administrator has agreed to conduct a disaster drill and submit document to CCLD by POC date.
(c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross.
Based on record review, the licensee did not comply with the section cited above by not having current first aid training for 3 staff which poses a potential health and safety risk to persons in care. POC Due Date: 03/07/2025 Plan of Correction 1 2 3 4 Administrator has agreed to obtain current first aid training for S1, S2, S3 and submit copies to CCLD by POC date.
(d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements:
Based on record review, the licensee did not comply with the section cited above by having incomplete resident files which poses a potential health and safety risk to persons in care. POC Due Date: 03/07/2025 Plan of Correction 1 2 3 4 Administrator has agreed to review resident files and make sure all files are complete. Administrator will submit self-certification to CCLD by POC date.
Other visitJanuary 30, 2024No deficiencies
Inspector: Grace Luk
Inspector notes
On 1/30/2024 at 11:45AM, Licensing Program Analyst (LPA) G. Luk conducted a face to face Component III presentation. LPA met with Licensee/Applicant, Carl Arcosa. LPA presented Component III power point and discussed the regulations embodied in the presentation. LPA observed Licensee/Applicant gained knowledge about running and maintaining the facility in accordance with Title 22 regulations. LPA concluded Component III. Exit interview conducted and a copy of this report provided.
Other visitJanuary 30, 2024No deficiencies
Inspector: Grace Luk
Inspector notes
On 2/7/2024 at 9:10AM, Licensing Program Analyst (LPA) G. Luk conducted a Pre-licensing Inspection to verify corrections were made. LPA met with Licensee/Applicant, Carl Arcosa. The facility's fire clearance was approved for 2 ambulatory and 4 non-ambulatory residents. LPA toured facility including but not limited to resident's bedrooms, bathrooms, living room, kitchen, and outdoor area. LPA observed fire extinguishers to be full and purchase receipt attached dated 1/30/2024. Smoke detectors were observed in operating condition. Hallway bathrooms has night lights and bathrooms have paper towel holders installed. LPA observed bedroom #1 and #5 have chest of drawers for each residents. LPA observed beds have mattress pads. LPA measured hot water at 119.2 degrees F in the hallway bathroom sink. Licensee provided a copy of the updated dementia plan to address behaviors such as ingestion of toxic chemicals and wandering behaviors. The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB): LPA observed a portion of the back fence is leaning away from the facility. Licensee stated the contractor will be at the facility today to assess the fence. Licensee will submit pictures of fence repair to CCLD. Licensee/Applicant will submit proof of corrections to CCLD on/before 2/20/2024. Exit interview conducted and a copy of this report provided.
Other visitDecember 15, 2023No deficiencies
Inspector: Grace Luk
Inspector notes
On 1/30/2024 at 9:10AM, Licensing Program Analyst (LPA) G. Luk conducted a Pre-licensing Inspection. LPA met with Licensee/Applicant, Carl Arcosa. LPA toured facility including but not limited to resident's bedrooms, bathrooms, living room, dining area, kitchen, garage, and outdoor area. LPA observed lighting in all rooms. LPA observed facility had some non-perishable food supply. Licensee will purchase additional food supplies once facility is licensed. Carbon monoxide detector was observed in operating condition. First aid kit was complete. Emergency disaster plan was complete. The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB): 1. Fire extinguisher was observed to be full, but unknown when it was last purchased or serviced. Licensee agreed to either provide a copy of the purchase receipt or have it serviced. 2. Hot water was measured at 131 degrees F in the hallway bathroom sink. Licensee lowered hot water and re-measured hot water at 129.4 degrees F. 3. LPA observed facility's smoke detector was beeping during inspection. 4. LPA observed two bathrooms does not have paper towel holders. 5. LPA observed bedroom #1 and #5 does not have chest of drawers. (Continue on LI809C...) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 6. LPA observed facility does not have mattress pads for all resident beds. 7. LPA observed common bathrooms does not have night lights available. 8. LPA reviewed dementia plan and observed the plan does not address behaviors such as ingestion of toxic chemicals and wandering behaviors. Licensee/Applicant will submit proof of corrections to CCLD on/before 2/2/2024. Exit interview conducted and a copy of this report provided.
Federal summary
CMS Care CompareNot a CMS-certified facility
California RCFEs (residential care facilities for the elderly) are licensed by the state, not by CMS. CMS data only applies to skilled nursing facilities or to CCRCs that operate a licensed SNF wing.
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