Facility Evaluation Report

Facility Type: Residential Care Facility for Elderly (RCFE)

Application Type: Change in Ownership (CHOW)

COMP II Participants: Kenneth Williams, Licensee/Administrator

On January 6, 2023 at 10:00 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. Report sent via pdf email and informed to return signed copy back to CAB by end of business day today.