If the Department determines that a deficiency or deficiencies exist, the Secretary may impose sanctions against the licensee. The Secretary may impose the following sanctions, as appropriate: Direct the licensee to correct the deficiencies in a specific manner or within a specific time frame, or both; Require the center to use the services of a management firm that is approved by the Department; Mandate staffing patterns that specify the number of personnel or personnel qualifications, or both; Appoint a State monitor, as described in Regulation .44 of this chapter; Restrict the number of participants that a center may admit; Impose a civil money penalty; Impose emergency suspension of license; and Deny or revoke a license. If the Secretary determines that the licensee has violated a condition or requirement of an imposed sanction the Secretary may revoke the license. Grievances. A licensee that is aggrieved by the imposition of a sanction under §B(4)—(8) or C of this regulation may appeal the Secretary's action by filing a request for a hearing in accordance with Regulation .53 of this chapter. A licensee that is aggrieved by the imposition of a sanction under §B(2) and (3) of this regulation may request a show cause hearing before the Director of the Office of Health Care Quality to show cause why these remedies should not be enforced.