Facility Evaluation Report

Facility Type: ARF Application Type: INITL Capacity: 6

COMP II Participants: Allen, Leroy III (Corporate Board Member and Administrator) and Williams, Latrice (Corporate Board Member)

On 1/6/22, applicant(s) and administrator participated in COMP II. Identification of the applicant(s) and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant(s) 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(s') and Administrator’s understanding of following areas:

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

4. Restrictive/Prohibited Health Conditions