Senior Care Records.

Facility Evaluation Report

Plymouth, Inglewood06/17/2022Licence 198320271

Capacity4
Date signed06/17/2022 01:01:02 PM
The inspector’s account

COMP II Participants: Ngoc Phan, Administrator; Fatima Reyes, Back-up Administrator

On 6/17/22, 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. Signed LIC 809 with copy of photo ID have been obtained.

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

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