Senior Care Records.

Facility Evaluation Report

Smith Family Home, Murrieta03/09/2022Licence 331881275

Capacity4
Date signed03/09/2022 11:54:48 AM
The inspector’s account

COMP II Participant: MONA AYAD AND ALI ANTAR JR.

Applicant/administrator participated in COMP II via telephone call with the analyst at CAB. Identification of the applicant and administrator was verified by photo ID . 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