Facility Evaluation Report

Licensing Program Analyst (LPA), Tiffany Holmes, conducted an unannounced Case Management visit to issue civil penalties based on complaint report issued on February 8, 2024. LPA met with Sally Saif, Administrator and was allowed entry into the facility after identifying herself and stating the purpose of the visit.

During the visit, civil penalties assessment was discussed with the Administrator. Based on the substantiated findings from the complaint report issued on February 8th, 2024, the Department determined that the violation of fire clearance resulted in an immediate civil penalty and it is being assessed in the amount of $500.00 for the date of 02/08/2024 and listed on the LIC421IM.

An exit interview was conducted and a copy of this report, LIC421IM, and Licensee/Appeals Rights (9058 01/16) were provided to the Administrator, whose signature on this form confirms receipt of these documents.