Board of Health

City of Nashua Division of Public Health & Community Services 18 Mulberry Street, Nashua, NH 03060 BOARD OF HEALTH MEETING May 14, 2014 12:30 PM AGENDA 1. Call to Order 2. Introduction by Mayor Donnalee Lozeau 3. Board of Health Orientation 4. Approve minutes from April 2014 5. Public Comments 6. Adjourn – Next Meeting - June 11, 2014 - 12:30 pm – 1:30 pm  City of Nashua Division of Public Health & Community Services 18 Mulberry Street, Nashua, NH 03060 BOARD OF HEALTH MEETING May 14, 2014 12:30 PM 18 Mulberry Street, 2nd floor Nashua, NH 03060 MEETING MINUTES BOH Members Present: Dr. Anthony Storace Dr. Thomas Astolfi Dr. Chuck Cappetta Board members were given an agenda and copies of the department reports, as well as an orientation binder. Mayor Donnalee Lozeau attended to offer a few words of thanks and support to the new Board members. Meeting was called to order at 12:35 pm. Minutes: Dr. Astolfi made a motion to accept the April 2014 minutes. Dr. Storace seconded the motion. The Motion passed. Orientation Orientation led by Kerran. Department Managers and Program Coordinators summarized their departments’ roles and responsibilities within the division. Dr. Astolfi posed the question of whether Environmental Health conducts water testing to Heidi Peek. Water testing kits are available for home testing, but are submitted by the resident to NH DHHS. The Environmental Health Department does not conduct drinking water tests. 1 Dr. Cappetta asked about ticks and differentiation between types. Members of the public are able to bring in ticks for species determination and information. Dr. Storace asked Beverly Doolan what is the percentage of grant funding versus city funding for the Division. Kerran replied that she believed it was 47%. After seeing the Tree Streets PlaceMaps, Dr. Cappetta suggested sharing them with the local PTAs. In response to the Healthy Homes presentation, Dr. Cappetta proposed to speak with pediatricians at Dartmouth Hitchcock to increase lead screening rates among two-year-olds. Sue Myers gave a brief update on MERS: two cases in the United States (FL and IN). No sustained person-to-person transmission thus far. The Division has held a webinar and conference call with its medical partners for educational and planning purposes, as well as having provided a FAQ for them. Public Comments None Dr. Astolfi made a motion to adjourn. Dr. Cappetta seconded the motion. The Motion passed. Meeting adjourned at 1:35 pm. In accordance with the 2014 Board of Health Meeting Schedule, the next meeting will be on Wednesday, June 11, 2014 12:30-1:30 pm. 2  City of Nashua Division of Public Health & Community Services 18 Mulberry Street, Nashua, NH 03060 BOARD OF HEALTH MEETING April 9, 2014 12:30 PM 18 Mulberry Street, 2nd floor Nashua, NH 03060 MEETING MINUTES BOH Members Present: Dr. Anthony Storace Dr. Thomas Astolfi Board members were given an agenda and copies of the department reports. Meeting was called to order at 12:40 pm. Minutes: Dr. Astolfi made a motion to accept the March 2014 minutes. Dr. Storace seconded the motion. The Motion passed. Department Reports Department Managers and Program Coordinators summarized their monthly reports. Ald. Wilshire mentioned the Board of Alderman had passed Welfare’s guidelines the previous evening at the April 8th meeting. Epidemiologist, Ashley Conley, reported outstanding attendance to recent focus groups; key issues included: obesity, access, and behavioral health. Dr. Astolfi posed the question regarding the requirements of glove use in food establishments (no bare- hand contact, changing tasks, and washing hands in-between) to Health Officer, Heidi Peek. 1 Community Health Manager, Sue Myers, described several of the van’s appearances as part of Public Health Week (Adult Learning Center, Railroad Square); also discussed future expansion of clinic hours/days. Public Comments Ward 4 Alderwoman, (Tree Streets), State Representative, and Chair of the Lyme Disease Subcommittee, Pamela Brown, informed the Board that May is Lyme Disease Awareness Month. Alderwoman Brown has a group of volunteers and wants to hold an awareness event; left a DVD, Under Our Skin, and wants to show it at the library next month. Dr. Astolfi made a motion to adjourn. Dr. Storace seconded the motion. The Motion passed. Meeting adjourned at 1:35 pm. In accordance with the 2014 Board of Health Meeting Schedule, the next meeting will be on Wednesday, May 14, 2014 12:30-1:30 pm. 2  City of Nashua Division of Public Health & Community Services 18 Mulberry Street, Nashua, NH 03060 603-589-4560 Memorandum To: Honorable Donnalee Lozeau, Mayor Board of Aldermen John Griffin, Chief Financial Officer Kerran Vigroux, Director of Public Health & Community Services From: Robert Mack, Welfare Officer Date: May 6, 2014 RE: Welfare Statistics – April 2014 [FY2014] The following is a summary for the month of April 2014 in the City Welfare Department. Voucher figures for April 2013 as compared to issued amounts for April 2014: Type of April 2013 April 2014 Assistance FY2013 FY2014 Shelter: $46,882.83 $27,776.02 Medical: $3,880.95 $5,472.27 Utilities: $3,333.39 $1,957.98 Food: $1,447.94 $221.96 Maintenance: - $118.15 Transportation: - $1,000.00 Total expense: $56,484.11 $36,546.38 Statistics for April 2013 as compared to April 2014: April 2013 April 2014 FY2013 FY2014 Number of Contacts: 764 637 Number of New Applications: 162 125 Number of Interviews: 259 174 Number of Cases: 143 92 Number who received Assistance: 172 100 Percentage who received aid: 66% 57% Number of vouchers issued during the calendar month: Voucher Type April 2013 April 2014 FY2013 FY2014 Shelter: 101 59 Medical: 50 33 Utilities: 24 13 Food: 13 5 Maintenance: 15 4 Burial: 1 2 Travel: 1 0 Total vouchers: 205 116 The Nashua Welfare Department assisted 3 families and 2 individuals in emergency shelter placements, and referred 5 families and 4 individuals to public shelters and/or homeless outreach during the month of April. The Welfare Department has expended $498,632.54 for General Assistance in FY2014. The Welfare Department continues to provide assistance in accordance with RSA165 and the City of Nashua Welfare Guidelines to those who are in need and unable to support themselves.  City of Nashua, NH - Board of Health Public Health Network Services (PHNS) April 2014 2014 Community Health Assessment (CHA): The eight focus groups that were scheduled in March and April have been completed! The information from these focus groups will be put together into a final report and the information will be included in the 2014 CHA. There were over 70 people that attended the focus groups to provide their input and comment on the health status of residents in the greater Nashua area. New Hampshire Public Health Association (NHPHA): The Epidemiologist and PHNS Program Assistant attended the NHPHA Annual Meeting on April 16th and the strategic planning session for Board members on April 17th. Public Health Emergency Preparedness (PHEP) Highlights 2014 Preparedness Summit: The Epidemiologist and Public Health Network Services Coordinator attended this conference from March 31st to April 3rd. The Epidemiologist presented on “Disaster Epidemiology 101” and led a town hall session to discuss the use of disaster epidemiology in recent events. Low-Flow Oxygen and Medical Surge Exercises: On May 2nd the region will conduct two exercises. The first part will include the set-up of oxygen at an Alternate Care Site (ACS) and the second part will include the throughput of actors (fake patients) through the Neighborhood Emergency Help Center (NEHC) and the ACS. A NEHC and an ACS can be set-up during a public health emergency when the healthcare system is overwhelmed and there are limited hospital beds and limited appointments at provider offices. The NEHC is a triage center and the ACS is a limited in-patient facility.  NEHC/ACS Facility Walk Through: The Healthcare Emergency Response Coalition conducted a walk through at Nashua High School South to prepare for the Low-Flow Oxygen Functional Exercise. The group discussed the set-up and logistics of using oxygen for patients at an Alternate Care Site. The regional plans estimate that 75 beds at the ACS will need to provide oxygen to patients.  Warehouse and Trailer Preparations: Staff went to the warehouse where the supplies are stored for public health emergencies and stocked the trailer with the necessary supplies to conduct the exercise. Regional Disaster Epidemiology Training by CDC: The Epidemiologist attended a two day training in Burlington, VT on tools used to conduct disaster epidemiology. The Epidemiologist learned about the Assessment for Chemical Exposures (ACE) toolkit and the Emergency Responder Health Monitoring System (ERHMS) toolkit. This information will be included in the regions preparedness plans. Greater Nashua Infection Prevention and Control Coalition: Dr. Alexander Granok presented on Vectorborne Diseases including West Nile Virus, Eastern Equine Encephalitis Virus and Lyme Disease on April 22nd. There were about 15 people in attendance from the coalition and the Division. WebEOC Training: The State of New Hampshire, Department of Safety, Division of Homeland Security and Emergency Management (HSEM) maintains a crisis-disaster management system, WebEOC, to manage large scale events, disasters and support or increase public safety information sharing – providing real-time situational awareness. One of the primary objectives of WebEOC is to provide incident commanders, community leaders and command level personnel one common operating picture of public safety operations, sensitive information and infrastructure problems and/or disruptions upon which to make informed, effective decisions in response, recovery and mitigation efforts. NH Homeland Security Emergency Management (HSEM) held a series of webinars, the first being held on April 29th, to train users on several significant changes that were made to WebEOC to make it more user-friendly. It is important to ensure all users are aware of the changes before there is a need to utilize it during an incident/emergency, therefore, all DPHCS employees with WebEOC accounts were asked to participate in one of the webinars and provide confirmation of participation to the Public Health Network Services Coordinator. Five staff participated in the first webinar. Incident Response Team: The Public Health Incident Response Team at the Division held a meeting to discuss health education for vectorborne diseases including Lyme Disease for the City of Nashua, prepared for the medical surge exercise and discussed action items for the next three months. State Mass Care Capability Summit 2014: On April 7th the Public Health Network Services Coordinator attended the State Mass Care Capability Summit 2014. This meeting provided an update on the current State Mass Care activities and discussed proposed activities and possible projects related to mass care for Budget Period 3 (July 1, 2014 - June 30, 2015) of the federal Health and Human Services’ Hospital Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) Cooperative Agreements.  Functions included under the PHEP Mass Care Capability include: o Determine public health role in mass care operations o Determine mass care needs of the impacted population o Coordinate public health, medical, and mental/behavioral health services o Monitor mass care population health NH DHHS/HSEM Information Sharing Workgroup: As a member of the DHHS/HSEM Information Sharing Workgroup, the Public Health Network Services Coordinator attended a meeting on April 15th to discuss proposed activities and projects related to Information Sharing and Emergency Public Information and Warning for Budget Period 3 (July 1, 2014 - June 30, 2015) of the federal Health and Human Services’ Hospital Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) Cooperative Agreements.  Functions included under the PHEP Information Sharing Capability include: o Identify stakeholders to be incorporated into information flow o Identify and develop rules and data elements for sharing o Exchange information to determine a common operating picture  Functions included under the PHEP Emergency Public Information and Warning Capability include: o Activate the emergency public information system o Determine the need for a joint public information system o Establish and participate in information system operations o Establish avenues for public interaction and information exchange o Issue public information, alerts, warnings, and notifications  Substance Misuse Program (SMP) Highlights Town Hall Meeting– Pelham: On April 10th, the SMP Coordinator attended the First Local Town Hall Meeting on Underage Drinking Prevention coordinated by the Pelham Community Coalition, the town’s substance misuse prevention coalition. This event had two primary goals:  To communicate the risks and seriousness of underage drinking. We will provide age appropriate interventions that will help students make healthy and informed choices regarding alcohol abuse.  To share our new community-wide intervention program entitled SAFE HOMES. “Safe Homes” empowers parents and community members to set and enforce clear rules against underage drinking. This was the first of four Town Halls scheduled to be hosted by local prevention coalitions within the Greater Nashua Public Health Region. These Town Halls are sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). SMAHSA is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities. Bi-Monthly Substance Misuse Prevention Coordinators’ Meeting: The SMP attended the MP Coordinators’ meeting held on April 16 th. Attendance at this meeting, facilitated by the Bureau of Drug and Alcohol Services, is required under the scope of the Public Health Network Services grant. Life of an Athlete: The SMP Coordinator attended Life of an Athlete training at Hollis Brookline HS on April 9th. PWITS Training: The SMP Coordinator attended PWITS April 23rd. PWITS is the reporting system used by the NH Bureau of Drug and Alcohol Services. National Drug Take Back: The National Prescription Drug Take Back was held on April 26th. Town Total Weight Town Total Weight Amherst 225.5 Merrimack 149.1 Brookline 95.1 Milford 64.8 Hollis 117.1 Nashua 340.4 Hudson 64.4 Pelham 23.4 Mason 29.4 Substance Misuse Program Leadership Team Meeting: The SMP Coordinator planned the first meeting of the Substance Misuse Leadership Team meeting of 2014 which is being held on May 5th. In addition to the existing Beyond Influence Leadership Team members, potential new members were identified and invited. Guidance from the NH Bureau of Drug and Alcohol Service states that leadership teams should include representatives from the 6 Sector Model of Community Substance Misuse Prevention. The 6 sectors include: Community and Family Support, Government, Safety, Health, Education and Business. As of this date, representatives from each sector are attending the meeting. In addition, each of the five local coalitions have been asked to designate a representative to the Leadership Team, which was not previously requested.  Board of Health • April 2014 Division of Public Health and Community Services Melissa Whalen, Community Health Educator Communications/Marketing  Coordination of printed promotional items for regional distribution of marketing materials for the STD/HIV/HCV program  Promotion of Lyme Disease Awareness posted onto the city and regional websites  Revised the City of Nashua Division of Public Health and Community Services Brochure to include more recent pictures, our new Substance Misuse Prevention program, Blood Pressure Clinics, and the “Dare to Begin” logo  Promotion of Annual Conference on May 29th  Developed the 3rd issue of the Greater Nashua Public Health Update – distributed on May 6th  Wrote and distributed press release for National Public Health Week, pick up by Nashua Telegraph, Union Leader and Rumbo  Worked with Access Nashua to film a 3 minute Public Service Announcement, highlighting the scheduled events for National Public Health Week  Wrote and distributed press release of Public Health Emergency Preparedness Functional Exercise on May 2nd, picked up by Nashua Telegraph, Union Leader, and Nashua Patch Events/Community Partners  Organized National Public Health Week, April 7th – 13th  Hosted a table at the Women’s Expo, April, 24th  Attended the first Healthy Living Advisory Group (HLAG) at the YMCA of Greater Nashua to help inform their plans to roll out the Diabetes Prevention Program, April 23rd Community Health Assessment  Attended Regional Focus Groups in Merrimack (4/2), Milford (4/3) and Hudson (4/22). In attendance were residents, key leaders and medical providers  Assisting with the planning and promotion of the Greater Nashua Public Health Annual Conference on May 29th Accreditation  Working intermittently to gather documents to inform where the division currently stands regarding Domain 3 “Inform and Educate about Public Health Issues and Functions” New Hampshire Public Health Association (NHPHA)  Helped to coordinate and attended the NHPHA Annual meeting on April 15th as a member of their Board of Directors and co-chair of the Communications Committee  Attended a NHPHA strategic planning workshop to help inform the future goals and plans for the association on April 16th  As co-chair of the Communications Committee, helped develop the NHPHA Annual Report 2013  Board of Health April 2014 Program Coordination Public Health & Community Services Report from Beverly Doolan, Program Coordinator Community Health Improvement Plan  Presented at 4/9 HEAL community networking meeting about Nashua’s trail efforts to promote healthy eating and active living  Assisted Nashua Regional Planning Commission to organize and participated in National Public Health Week April 11 “Walk or Bike Event”  Conducted a Heritage Rail Trail count to determine trail usage on 4/12  Attended the 4/23 We Can! parent education night for early childhood pilot site and conducted parent evaluation. Worked with Obesity Prevention intern Alicia Triantos to prepare final report of the pilot.  Participated in Nashua North Community Health Assessment resident focus group  Attended Amherst Street School “Ed”ies award review. School has been selected 2014 recipient.  Joined Nashua Fall Festival planning team  Researched new opportunities for Turn a New Leaf restaurant initiative Grants  Along with the new obesity prevention coordinator, Stacy Nelson, attended the 3/22 HEAL Active Transportation Training . HEAL has provided $5K in funding for a feasibility study to provide improved trail connection between Mine Falls and Heritage Rail Trails  Worked with Community Health in preparing for 2015/16 Combined Services grant funding requirements  Assisted with final report review for Healthy Smiles Healthy Growth 3 rd Grade Survey Accreditation  Participated in senior staff presentation of mid-point results in the UNH MPH core competencies project  April 2014 Board of Health Report Greater Nashua Healthy Homes Program Amy Moutenot, Program Coordinator The Healthy Homes Program addresses multiple diseases and injuries in the home. The program takes a comprehensive approach to these actives by focusing on housing- related hazards in a coordinated fashion, rather than addressing a single hazard at a time. This program is grant funded through the U.S. Department of Housing and Urban Development Program and will be funded for the next three years. This month we’ve continued to monitor the blood lead levels of children in the Greater Nashua area. Currently there are twelve cases of elevated blood lead levels in the Greater Nashua region. Also, we’re currently working with the Community Health manager to create a screening program for children enrolled in WIC. Our National Public Health week events were a huge success. On April 9 th we gave a Healthy Homes presentation at the adult Learning Center. We have over 65 attendees. Most of the group are renters living in the older tree streets neighborhood. They asked a lot of questions and were very engaged. There were also two screening events in the city using the mobile unit. All were very well attended. This month will begin our big push for outreach events as the Summer Fun season is approaching. Our strategic planning meetings are held at 9:30 on the second Tuesday of the month at 18 Mulberry Street. All are invited to attend.  New Hampshire Department of Health and Human Services Community Health Department Board of Health Report Community Health Department Program Statistics April 2014 PROGRAM April April April FY YTD 2012 2013 2014 2013 FY 2014 Communicable Disease Surveillance & Investigation Communicable Disease 19 10 16 62 78 Investigations Tuberculosis High-risk Latent TB Infection 4 1 0 18 15 Latent TB infection 4 7 6 34 62 Active Cases Reported 0 0 0 3 1 Suspect Active Case Reported 0 0 1 0 7 Ongoing Case Investigated 1 14 12 20 25 (High-risk +Active) Skin Test performed 37 30 3 201 151 STD/HIV Clinic Number of Client Visits 2 0 14 112 255 Recorded HIV/STD Dual Test Performed 0 0 0 12 47 STD Only Test Performed 0 0 3 19 57 Hepatitis A/B Vaccines 0 0 0 1 6 Administered Positive Chlamydia Tests 0 0 0 5 10 Reported Positive Syphilis Tests 0 0 0 2 2 Positive Hepatitis C Tests 0 0 0 15 15 Reported Clinic + Outreach Reactive HIV Tests Reported 0 0 0 0 1 Clinic + Outreach Positive Gonorrhea Tests 0 0 0 0 2 Reported Clinic HIV Tests 0 0 6 33 79 High Risk/Targeted Clients 0 0 3/2 31 62/6 Immunization Children 39 57 19 283 270 Adults 69 56 51 415 401 Seasonal Flu Vaccine 0 0 4 73 121 (Children) Seasonal Flu Vaccine (Adults) 0 0 15 1,108 1071 Children vaccinated with Flu 0 0 0 1,385 1,055 Vaccine in schools Childhood Lead Poisoning Prevention New Cases Reported 0 0 0 7 8 Ongoing Case Management 3 8 10 8 16 Screening Completed Using 53 3 0 56 18 LeadCare Analyzer HIV Prevention/Outreach HCV Tests Performed 0 0 0 34 23 Van/Street Outreach Contacts 40 0 9 182 153 HIV Tests Performed 7 0 0 77 40 Communicable Disease Program Highlights Reportable Diseases, Nashua, NH January 2014 REPORTABLE DISEASE April 2013: April 2014: April 2014 CATEGORY Number of Number of Number of Cases Reportable Reportable Investigated Diseases Diseases (Including Confirmed, (Confirmed, Probable, (Confirmed, Probable, Probable, Suspect and Suspect) Suspect) “Not a Case”) Foodborne/Waterborne 5 4 4 Latent Tuberculosis Infection 6 6 Tuberculosis Disease (active 1(suspect) 1(suspect) case) Vaccine Preventable 2 5 8 Vectorborne 0 0 0 Other (Strep A/B, HUS, HIV) 3 4 4 STD/HIV Program Highlights The Community Health Department has initiated the marketing campaign to promote an awareness of STD/HIV clinical services. Posters are in place in front of the Transit Station and three others are on bus shelters throughout the city. A Webinar was viewed on 4/22 entitled Skill Building and Clinical Pearls: Challenging Cases in STI Diagnosis and Treatment of Young Adults The annual inspection of the Outreach Van was conducted by the NH DHHS Clinical Laboratory Coordinator. No deficiencies were identified. The Collection Station license for the mobile van has been received and posted. Submitted by: Betty Wendt, PHN Lead/Healthy Homes Program Highlights Theresa Calope and Susan Myers had the opportunity to attend the Lead and Healthy Homes Case Management meeting on April 22nd at the Manchester Health Department. The case managers are working on updating and revising the existing case management protocols. Submitted by: Theresa Calope-Yaklin, PHN Immunizations During Public Health Week the Community Health Department held Immunization Clinics at the Adult Learning Center and Railroad Square. A total of 25 vaccines and 10 flu shots were provided. Theresa Calope is partnering with the NH Immunization Program in providing assessments and education at physician practices in the region. The Vaccine Management Plan was updated and submitted to the NH Immunization Program. TB Program Highlights The public health staff participated in a webinar entitled “New Directions on MDR/TB” on April 30th. The public health staff continues to provide directly-observed therapy for two clients. Submitted by: Theresa Calope-Yaklin, PHN Communicable Disease Program Highlights The Community Health Department investigated 3 clusters of GI illness at a long-term care facility, a food establishment and a local college. Submitted by: Shannon Casey, RN Other Updates The Community Health Department Manager provided a “TB Update” at the Pediatric Health Symposium on April 22nd. During the month of April, a pharmacy inspection was provided by Roger Hebert, the consultant pharmacist. There were no deficiencies identified. Respectfully Submitted by, Susan Myers, RN, MEd Manager, Community Health Department  City of Nashua Division of Public Health & Community Services Environmental Health Department Board of Health Report- April 2014-FY 2014 FOOD SERVICE EHS II-HP EHS I-AT EHS I-AH ETC. TOTAL Routine Inspections 40 39 39 118 Re-inspections 2 2 Site Visits 15 4 9 28 Change of Ownership 2 2 Inspections Pre-Licensing 2 1 3 6 Inspections Plan Reviews 1 2 1 4 Temporary Plan 4 4 Reviews/Inspections Complaints 4 1 5 Recall Response 0 Establishment: Food 3 4 7 Service Meetings Food Samples 4 4 Collected Temporary Closures: Rincon Colombiano remains closed. Number annual licenses issued 44 New license holders: Los Dos A-A Number annual licenses renewed 43 Number temporary licenses issued 5 LABORATORY Activities New Laboratory Director began 21 April 2014. PUBLIC POOLS/SPAS EHS II-HP EHS I-AT EHS I-AH Total Routine Inspections 0 Site Visits 0 Samples Collected 0 Complaints 0 Number annual licenses issued/renewed 43 RABIES CONTROL Number of Type of sample(s), Date delivered to Negative or sample(s) feline, canine, etc. NH DHHS PHL Positive 1 Feline 4/22/14 Negative 1 Canine 4/9/2014 Negative 1 Bat 4/14/2014 Negative Number of animal bite or non-bite exposure Dog Cat Ferret reports processed: 4 LAND USE Department Address Brief Description Representative Howard Price 20 Sunrise Trail Bed Bottom Inspection Howard Price 77 Pilgrim Circle Bed Bottom Inspection Amanda Hyde 126 Searles Rd Bed Bottom Inspection HOUSING ASSESSMENTS Department Address Partner Brief Description Representative Agency(ies) Howard Price 27-29 Temple Street Code, Bldg, FMO, Rooming house NPD inspections Howard Price and 28-34 Railroad Code, Bldg, FMO, Rooming house Heidi Peek Square NPD inspections Howard Price 23-25 Temple Street Code, Bldg, FMO, Rooming house NPD inspections Heidi Peek 366 Main Street Code, Bldg, FMO, Rooming house NPD inspections INSTITUTIONAL INSPECTIONS Department Type of inspection (Child Name of Facility/Address Representative Care, Foster Home, School, USDA) Howard Price Child Care Granite Start, Merritt Parkway April Torhan Child Care Almost Angels, 275 Broad St GENERAL COMPLAINTS Type of Complaint EHS II-HP EHS I-AT EHS I-AH ETC. Solid Waste 2 Animals Vector Hazardous Materials Swimming Pools/Spas (Residential) Air Quality Other 1 3 Respectfully submitted, Heidi E. Peek Health Officer/Environmental Health Manager 8 May 2014