Facility Evaluation Report

LPA Lusby arrived on Wednesday October 13, 2021 to conduct the prelicensing inspection. Prior to the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 mask.

LPA completed the prelicensing inspection domain with Administrator Shelby. LPA toured the facility.

Component III was conducted with Administrator. LPA will notify CAB that the facility is ready for licensure.

Exit interview conducted. A copy of this report was left at the facility.