STATE OF LOUISIANA
DEPARTMENT OF HEALTH
OFFICE OF PUBLIC HEALTH

School
Notice of Violations
Complaint
Permit Number
10-19-204
Permit Name
Gillis Elementary School-204
Name of Establishment
Gillis Elementary School-204
Owner Name
Address
916 TOPSY RD LAKE CHARLES, LA 70611
Date
01/17/2020
Time
09:10 AM

LAC TITLE 51 PART XVII

NON-CRITICAL ITEMS: These items should be corrected by the next regular inspection or according to the compliance schedule (see below) established by this office.
Category Code Reference Description of Violations
Housekeeping Requirements 109 15 - 109 - Building is not clean. THE CARPET IN THE SPECIAL NEEDS HALL
Housekeeping Requirements 109 16 - 109 - Building is not in good repair. OUTSIDE OPENINGS THROUGHOUT THE FACILITY CEILING TILES IN DISREPAIR

Comments:
RODENT DROPPINGS FOUND THROUGHOUT FACILITY
PEST CONTOL RECEIPT TO BE PROVIDED
SNAP TRAPS PRESENT AND REMOVED DURING INSPECTION
EXTENDED TIME PER SUPERVISOR
Number Licensed For
Number in Attendance
740
License Anniversary
02/28/2020
Sanitarian Name/Print
 Amy Courtney
Phone #
 337-721-4060
Sanitarian Signature
 
R.S. #
 1485
The above mentioned violations were called to my attention and were explained to me in detail. I hereby agree to
Correct Critical Violations by 01/21/2020  Correct Non-Critical Violations by 01/21/2020 
Name/Title 
MR. SAVOY; PRINCIPAL
Signature of Recipient