Facility Evaluation Report

Facility Type: Adult Residential Facility (ARF)

COMP II Participants: Robert Green, Administrator/ Angelina Green, employee

On December 8, 2022 at 11:00 AM , Administrator and employee participated in COMP II. Identification of the Administrator and employee was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22.

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

Exit interview conducted with Administrator. Report sent via email PDF and informed Administrator to return signed copy by end of business today.