Senior Care Records.

Facility Evaluation Report

Carlson Springs ARF, Diamond Springs02/21/2024Licence 095920083

Capacity12
Date signed02/21/2024 12:26:37 PM
The inspector’s account

Facility Type: Adult Residential Facility

COMP II Participants: Iheoma Ngwangburuka, Ifeanyi Ezeani

On February 21, 2024, applicant/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 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. Restricted/Prohibited Health Conditions

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