Facility Evaluation Report

Application Type: Residential Care Facility for Elderly (RCFE)

COMP II Participants: Desiree Kitagawa, Administrator

On January 29, 2024 at 11:00 AM , 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. Copy of report sent via email and request to return sign copy by end of business day today to CAB.