Facility Evaluation Report

Application Type: CHOW-change in ownership

On January 3, 2022 at 9:00 AM, Administrator participated in COMP II. Identification of the Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Administrator confirmed the understanding of the California Code Title 22 Regulations.

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

Exit interview with Administrator, copy sent via email and informed Administrator to return a signed LIC 809 with copy of photo ID have been obtained.