Senior Care Records.

Facility Evaluation Report

Positive Impact Home, Menifee07/08/2022Licence 331881344

Capacity4
Census0
Date signed07/08/2022 11:48:47 AM
The inspector’s account

Facility Type: Adult Residential Facility (ARF)

COMP II Participants: Tiffany Dupree, Licensee/Administrator

On July 8, 2022 at 11:00 AM, Licensee/Administrator participated in COMP II. Identification of the Licensee/Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Licensee/Administrator confirmed the understanding of the California Code Title 22 Regulations.

During COMP II, CAB Analyst confirmed Licensee/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 Licensee/Administrator. Email report and inform to return sign copy by end of business day today.

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