Facility Evaluation Report

LPA conducted Component III with Licensee/ Administrator. LPA presented Component III Power Point and discussed the regulations embodied in the presentation.

No issues noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Centralized Application Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required.

Exit interview conducted and a copy of this report will be provided.