Facility Evaluation Report

Facility Type: Adult Residential Care Facility (ARF)

Application Type: Change in ownership (CHOW)

COMP II Participants: Ashley Acosta, Administrator

On March 18, 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 Administrator’s understanding of following areas:

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

4. Restrictive/Prohibited Health Conditions

Exit interview conducted with Administrator. Administrator will return sign copy of report by end of business today. Report email PDF to the Administrator. ****Amended****