Senior Care Records.A MITRYXA product
For operatorsSign in

Facility Evaluation Report

Erica B Independent Living Facility, Perris06/27/2022Licence 331881331

Capacity6
Date signed06/27/2022 01:09:50 PM
The inspector’s account

On 06/27/2022, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained.

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

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

4. Restrictive/Prohibited Health Conditions

Applicant and Administrator are aware that the Administrator is the only representative to have access and handle client funds for the facility.

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