Facility Evaluation Report

Application Type: Change in Ownership (CHOW)

COMP II Participants: Jacob Hall, Licensee

On July 24, 2023 at 11:50AM, Licensee participated in COMP II. Identification of the Licensee was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Licensee 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 Licensee's understanding of following areas:

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

3. Staffing Requirements & Training: Ratio. Licensee indicated 2:1 client/staff ratio.

4. Restrictive/Prohibited Health Conditions

Exit interview conducted with Licensee. Copy of report sent via email and informed to return sign copy back to CAB by end of business today.