Facility Evaluation Report

Licensing Program Analyst (LPA) Jesse Gardner made an unannounced visit to follow up on information reported to the Department in relation to R1 and S1.

LPA met with Caretaker Dennis Pontawe and toured the facility. Present in the facility during time of visit were 6 residents. At the time of visit, LPA interviewed R1, R2, R3, R4, R5, and R6. LPA also interviewed S2, S3, S4, S5 and S6. LPA reviewed R1's file and obtained copies of pertinent documents.

An exit interview was conducted and a copy of this report was reviewed with and provided to Administrator Hall along with copies of the LIC811, and LIC811-C.