Senior Care Records.

Facility Evaluation Report

Mila's Home, Hayward01/05/2022Licence 019201111

Capacity4
Census0
Date signed01/05/2022 12:10:12 PM
The inspector’s account

Facility Type: ARF Application Type: INITL Capacity: 4 Participants: Yambao, Raphael (Corporate Board Member) & Yambao, Joaquin (Corporate Board Member and Administrator) Interview Method: Telephone interview

On 1/5/22, applicant(s) and administrator participated in COMP II. Identification of the applicant(s) and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant(s) and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained.

During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas:

1. Facility operation: License type, client/resident populations, and program

4. Restrictive/Prohibited Health Conditions

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction