Facility Evaluation Report

COMP II Participants: Maricel Nepomuceno (Licensee/Administrator), & Tammy

Licensee/administrator participated in COMP II via Telephone call with CAB Analyst. Identification

of licensee/ administrator was verified by confirming driver’s license number. During COMP II,

licensee/administrator confirmed the understanding of Title 22. Component II was successfully

completed. Licensee/administrator was advised to email signed LIC 809 with copy of photo ID to

During COMP II, CAB analyst confirmed licensee/administrator’s understanding of following

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

4. Restrictive/Prohibited Health Conditions