Facility Evaluation Report

COMP II Participants: Applicant/Administrator; Maria Matias & Analyst; Tammy Edwards

Applicant/Administrator participated in COMP II at CAB via telephone call with Analyst at CAB. Identification of the Applicant/Administrator was verified by confirming driver’s license number. During COMP II, Applicant/Administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant/Administrator was advised to email/fax signed LIC 809 with copy of photo ID to CAB.

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