Senior Care Records.

Facility Evaluation Report

Blossomkare, Stockton10/04/2023Licence 392701308

Capacity3
Date signed10/04/2023 10:38:59 AM
The inspector’s account

COMP II Participant: LaQueta Gilbert, Managing Member/Administrator

On 10/4/23, applicant/administrator participated in COMP II. Identification of the applicant/administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant/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.

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

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