Senior Care Records.

Facility Evaluation Report

Magnolia Residence 1, Stockton05/24/2023Licence 392701287

Capacity6
Census0
Date signed05/24/2023 12:10:37 PM
The inspector’s account

Facility Type: Residential Care Facility for Elderly (RCFE)

Application Type: Change in Ownership (CHOW)

COMP II Participants: Joshua Rivera, Administrator

On May 24, 2023 at 10:30 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 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 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. Co.py of report sent via email pdf and informed to send back signed by end of business day to CAB

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