Facility Evaluation Report

Licensing Program Analyst (LPA) Carmen Lopez conducted a Case Management visit to deliver an Amended Report for a visit conducted on 10/29/2024 and to conduct a health and safety check. LPA Lopez met with Samantha Martin, Facility Manager and informed them of the purpose of her visit.

During today’s visit, LPA obtained Facility Manager’s signature on the amended report LIC 9099 dated (10/29/2024) and conducted client and staff interviews.

An exit interview was conducted and a copy of this report along with the Licensee’s Rights (LIC 9058 03/22) was provided to Facility Manager Samantha Martin at the conclusion of the visit. The signature on this form confirms receipt of these documents.