HomeMy WebLinkAboutMisc Inspection 2400203 Tamarack Ave. HEALTH INSPECTION RESIDENTIAL AND DAY FACILITIES
CERTIFICATION
8-1-08
STATE OF CONNECTICUT
DEPARTMENT OF CHILDREN AND FAMILIES
DIVISION OF ADMINISTRATIVE LAW AND POLICY
505 Hudson Street,Hartford,Connecticut 06106
Unit or Cottage Name: +( �Q h s^Q)awj i o� a
Facility Name:
Address: Z��� TU�a/�c,k rQCV�P . ,� �i 4-e- Z'03
WATER SUPPLY:
1. Description of drinking water source: Public Well
2. If supplied by well water,has the supply been analyzed and found safe?
If so,When? Please attach lab results to this form.
SEWAGE DISPOSAL:
1. Private on-site septic system. Public Sewers
2. Date system was last serviced/pumped
TOILET FACILITIES:
1.Number of toilets for females Z, for males 5 ar Urinals Sinks
2. Toilets clean ✓' in good working order ,/ in good repair ✓
3.Adequate lighting__Z Ventilation ✓ Screening ✓
SLEEPING QUARTERS(N/A for Day Programs and Clinics): _
1. Is distance between beds proper?(3 ft. For single,4 1/2 for double deck beds)?
Check for cleanliness:walls floor mattresses bedding
KITCHEN AND DINING ROOM:
1.Are dishes, silverware,etc.In good condition and clean? %A t S
2. Is there sufficient hot water available for washing dishes? `1 R-.Z
3. Is the home equipped with a dishwasher? r� If so is it functioning properly?
4. Check for cleanliness: floors ✓walls V tables / counters ✓ sinks ✓
ventilation and air conditioning systems��appliances ✓
5. Is refrigerator clean? - Is food adequately refrigerated and properly stored? ✓
6. Is food protected from dust? ✓ flies? ✓ vermin? ✓
7. Is kitchen screened? A)1 Is dining room screened? N A
8. Are covered containers provided for garbage?
9. Are food preparation&serving areas in compliance with Health Department requirements? L/
GENERAL:
1. Are all stairways free from obstruction? ✓
2. Is the building apparently in good repair? ,/
3.Are surrounding grounds kept clean? 1/
4.Is housekeeping satisfactory?
5.Are floor coverings safe and clean?
5.Are laundry facilities adequate?-41J�c Clean? In good repair?
LEAD INSPECTION(Child Caring Facilities Only): Ali A
Has the facility had a comprehensive lead inspection? (ATTACH RESULTS)
Date of Inspection: Not applicable if house built since 1978:
FLOOR PLANS:
Please attach floor plans for all buildings used for sleeping or treatment purposes.
The attached floor plans have been reviewed and the maximum number of beds for children in each area meets with my
approval. The maximum capacity for sleeping or treatment purposes by floor is :
1st: _�/ 2nd: 3rd:
THIS FACILITY HAS BEEN INSPECTED BY ME AND
[41DOES [ ] DOES NOT
MEET ALL APPLICABLE HEALTH DEPARTMENT REQUIREMENTS
I
HEALTH INSPECTOR(Print or type name)
Signature: 4r l
Address: U S✓1� �h)-P . �� LO�V '/, V\ Date:_(0
Continents and Recommendations(use separate sheet if necessary)
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HEALTH INSPECTION
Z
CONSULT 2 INURSE OBSERVATION CONSULT I
7
STATION ROOM
230 5.f. too s.f. 100 51 100 5.f. MULTIPURPOSE TREATMENT I TREATMENT 2
300 5.f. 19G 5.f. 225 5.f.
1
LOCKERS
FEC
5TAFF ROOM E
I I S SOILED RMEDICSLECORDSTOILET M.G.
60 5.f.
EIEC TOM
e
CLEAN I DINING
ROOM
LION 327 af.
DINING 217 5.L
WAITING
237 5.f,
FEC — 211 e.E D.W.
570R j
2
STAR.
Walden Behavioral Care
at Evergmen Walk -.Building 2
240p.KiRmaraol�A,nc.:a�a
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