Facility Evaluation Report
On 11/16/22 Licensing Program Analyst (LPA) Kevin Gould conducted a component III pre licensing at The Vintage Farmhouse meeting with Administrator Kim Tiller. LPA Gould, Administrator and Licensee went over the component 3 powerepoint.
LPA Gould discussed Operating Requirements, Physical Environment, Personnel Requirements, Resident Records, Health Related Services and Conditions.
LPA discussed the department's and LPA's responsibilities and the responsibilities of the Administrator and reporting requirements including but not limited to the forms required for reporting and documenting any changes in resident files.
Exit interview was conducted. Once approved, a copy of the license will be set to the Licensee.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction