Facility Evaluation Report
Capacity6
Date signed08/11/2023 03:11:23 PM
Capacity: Census (if any clients in care): 3
COMP II Participants: Tess Derafera,Admin & Zayden Chen, applicant
On August 11, 2023, 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 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. Signed LIC 809 with copy of photo ID have been obtained
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction