Facility Evaluation Report
Capacity6
Census4
Date signed12/20/2021 08:38:41 AM
On December 17, 2021 at 10:00 AM , 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. Administrator did not provide sufficient knowledge the program and the California Code Title 22 Regulations. Component II will be rescheduled.
Exit interview conducted with Administrator. Analyst sent copy of report via email to Administrator to sign and return LIC 809. Photo ID was verified via interview with copy of ID provided prior to call.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction