Senior Care Records.

Facility Evaluation Report

Pacific Senior Care, Lake Balboa11/12/2024Licence 195850523

Capacity6
Date signed11/12/2024 04:21:39 PM
The inspector’s account

COMP II Participant: Viktorya Hayrapetyan, CEO/Administrator

On 11/12/24, applicant/administrator participated in COMP II. Identification of the applicant/administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant/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/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