Facility Evaluation Report

COMP II Participants: Ting Xiu Li , Administrator/Owner; Shannon Betker, analyst, Darla Neeley, CAB manager.

Applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB.

During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas:

1. Facility operation: License type, client/resident populations, and program

2. Staff qualifications and responsibilities

4. Applicant and Administrator qualifications

5. Grievances, Complaints, Community resources

8. Application document review and technical assistance: Pre-licensing inspection

9. Reporting process for unusual incident/Injury