STATE OF WASHINGTONDEPARTMENT OF SOCIAL AND HEALTH SERVICES

AGING AND LONG-TERM SUPPORT ADMINISTRATION316 W Boone Ave., Suite 170, Spokane, WA 99201

May 2, 2016

RE: ALLEN ADULT FAMILY HOME License #159200

Dear Provider:

On April 20, 2016 the Department completed a review of communication and / ordocuments from you indicating that you have corrected the deficiency or deficienciescited in the report/s dated March 31, 2016.

Based on the review of this information the Department finds the deficiency ordeficiencies have been corrected. Your home meets the adult family home licensingrequirements.

The Department staff who did the off-site verification:

Ronald J AllenSusan M AllenALLEN ADULT FAMILY HOME3511 N ELTON RDSPOKANE, WA 99212

Colleen Daniels, Licensor

Sincerely,

Susan Bergeron, Field ManagerRegion 1, Unit BResidential Care Services

If you have any questions please, contact me at (509) 323-7324.