Facility Evaluation Report

Facility Type: ARF Application Type: INITL Capacity: 4 COMP II Participants: Rojas, Diana Corporate board member and administrator. Interview Method: Telephone interview

On 1/3/2022, 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, applicanty/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/Administrator’s understanding of following areas:

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

4. Restrictive/Prohibited Health Conditions