The Secretary may impose a civil money penalty if a deficiency or an ongoing pattern of deficiencies exists in a center. In determining whether a civil money penalty is to be imposed, the Secretary shall consider the following factors: The number, nature, and seriousness of the deficiencies; The extent to which the deficiency or deficiencies are part of an ongoing pattern during the preceding 24 months; The degree of risk to the health, life, or safety of the participants of the center that is caused by the deficiency or deficiencies; The efforts made by, and the ability of, the center to correct the deficiency or deficiencies; and A center's prior history of compliance. If the Department determines that a deficiency or an ongoing pattern of deficiencies exists, the Department shall notify the center of the deficiency or deficiencies and may: Impose a per day civil money penalty until sustained compliance has been achieved; Permit the center the opportunity to correct the deficiencies by a specific date; or Impose a per instance civil money penalty for each instance of violation. If the Department permits a center the opportunity to correct the deficiencies by a specific date, and the center fails to comply with this requirement, the Department may impose a per day civil money penalty for each day of violation until correction of the deficiency or deficiencies has been verified and sustained compliance has been maintained. If the Department proposes to impose a civil money penalty, the Secretary shall issue an order which shall state the: Deficiency or deficiencies on which the order is based; Amount of civil money penalties to be imposed; and Manner in which the amount of civil money penalties imposed was calculated. An order issued pursuant to this regulation shall be void unless issued within 60 days of the inspection or re-inspection at which the deficiency is identified.