Facility Evaluation Report

Facility Type: Adult Residential Facility (ARF)

COMP II Participants: Simonie Webster, Administrator

Interview Method: Virtual interview (Microsoft Teams)

On December 15, 2023, Applicant and Administrator participated in COMP II. Identification of the Applicant and Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant and Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22.

During COMP II, CAB Analyst confirmed Applicant and Administrator’s understanding of following areas:

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

4. Restrictive/Prohibited Health Conditions

Note: shows on LIC 809 form capacity of 13, updated to only capacity 6 only. Exit interview conducted with Applicant and Administrator. Report sent via email and informed to return sign copy by end of business day to CAB.