Senior Care Records.

Facility Evaluation Report

Hazel Home for Seniors, Fair Oaks02/07/2022Licence 345002868

Capacity6
Census3
Date signed02/07/2022 10:31:37 AM
The inspector’s account

Facility Type: Residential Care Facility for Elderly (RCFE)

Application Type: Change in ownership (CHOW)

COMP II Participants: Farah Aslam, Applicant

On February 7, 2022 at 10:00 AM, Applicant and 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.

During COMP II, CAB analyst confirmed Applicant and 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 Applicant and Administrator. COMP II report sent via emal pdf and informed Applicant and Administrator to return signed copy to Analyst.

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