Facility Evaluation Report

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted by, identified herself to and discussed the purpose of the visit to Staff David Di Mauro. The facility's license shows a maximum capacity of four (4) ambulatory clients. During today’s inspection there were four (4) clients in care.

During today's visit, LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. Due to time constraints, the annual inspection could not be completed and a return visit on a subsequent day is needed.

No deficiencies were cited on today's date. An exit interview was conducted with Staff Di Mauro, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).