Facility Evaluation Report

COMP II Participants: Maricel Nepomuceno (Licensee), Eleazar Cuyson (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 numbers. During COMP II,

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

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

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

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

4. Restrictive/Prohibited Health Conditions