Residential Care Services Investigation Summary Report

Provider/Facility: Lorraines Garden Adult Family Home(930682)

Intake ID(s): 3610715

License/Cert. #: AF753002Investigator: Hook, Marjean Region/Unit: RCS Region 2/Unit A Investigation

Date(s):02/19/201902/19/2019

through

Complainant Contact Date(s):Allegations:AFH is overdue on their licensing fees. Oldest due date: 12/15/2018 amount: $1350.00

Investigation Methods:Sample: no sample Observations: Ample food supply and

resident supplies.Residents were clean.

Interviews: Residents said they likedthe food and got enoughto eat.

Record Reviews: Record review showedannual fee was not paid

Allegation Summary:Statement of deficiencies was written as annual fee had not been paid.

Unalleged Violation(s):Statement of deficiencies was written a annual fee had not been paid.

Yes No

Conclusion /Action:

Failed Provider Practice Identified /Citation(s) Written

Failed Provider Practice Not Identified /No Citation Written

Statement of deficiencies was written as annual fee had not been paid.

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