Facility Evaluation Report

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced collateral visit to the facility to conduct staff interviews. LPA Lopez identified herself and was granted entry by Joseph Baker, Program Manager. LPA Lopez stated the purpose of the visit with Shanta Haines, Administrator.

During the visit, LPA Lopez interviewed staff members, and requested and obtained relevant records. No deficiencies were observed during today's visit.

An exit interview was conducted, and a copy of this report along with Licensee/Appeal Rights (LIC9058 03/22) wereprovided to Administrator Haines, at the conclusion of the visit. The signature below confirms the receipt of the documents.