Senior Care Records.

Facility Evaluation Report

Vincent, the, San Rafael10/12/2021Licence 216804010

Capacity126
Date signed10/12/2021 11:05:46 AM
The inspector’s account

COMP II Participants: Susan McPherson, Applicant Representative; Melon Rivera, Administrator

Applicant/administrator participated in COMP II via telephone call with the analyst at CAB. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed.

During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas:

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

2. Staff qualifications and responsibilities

3. Applicant and Administrator qualifications

4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions

5. Grievances, Complaints, Community resources

7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of property

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