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DocuSign Envelope ID:456CB831-89E2-409B-8715-A71C362353A4 <br /> North Carolina <br /> Department of Health and Human Services <br /> Division of Aging and Adult Services <br /> This is to Certify that a Certificate is hereby granted to operate an: <br /> Adult Day Care/Day Health Center <br /> known as <br /> Florence Gray Soltys Adult Day <br /> Health Program <br /> located in the County of <br /> Orange, North Carolina. <br /> This Certificate is issued subject to the statutes of North Carolina and the Rules <br /> adopted by the North Carolina Social Services Commission, is not transferable, and <br /> shall expire January 31, 2017 unless revoked before that date. <br /> Capacity: 29 Certification Status: Full <br /> .,,,,'' ,i. STATE c;0' 4.■,‘ <br /> opyX). <br /> t‘ <br /> 1,.. ,tr ) 4. _ ,.ii. <br /> Suzanne P.Merrill,Division Director,Division of Aging&Adult <br /> Ik...t. ti Services <br /> i <br /> :I <br /> ...0 .." <br /> AI <br /> •; • I , ...:. •■•0; . ;..e, <br /> if February 1, 2016 <br /> 111 if.A...._41PRIt 12.ITS 4,. x Date Issued <br /> ‘•,, ,-7 QUAM <br /> ''—"..........,...:;.------ <br /> This Certificate Remains the Property of the State <br />