Facility Evaluation Report

Haigler Home, Carson08/13/2024Licence 198320423

Capacity4
Census0
Date signed08/13/2024 11:17:26 AM
The inspector’s account

Facility Type: Adult Residential Facility

COMP II Participants: Karlton Levias, Applicant

On August 13, 2024 at 9AM, applicant and 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 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. Signed LIC 809 with copy of photo ID have been obtained.

During COMP II, CAB analyst confirmed Applicant and 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 Applicant and Administrator. Report sent via email and request to return sign copy to CAB by end of business day today.

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