Senior Care Records.

Facility Evaluation Report

Good Samaritan Care Home, Suisun City11/18/2022Licence 486804114

Capacity6
Census5
Date signed11/18/2022 12:09:52 PM
The inspector’s account

COMP II Participants: Luningning Sikat (Licensee), Janolyn De Guzman (Administrator)

On November 18, 2022, 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 the understanding of the California Code Title 22 Regulations. 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

3. Staffing requirements/CPMB associations & Training

4. Restrictive/Prohibited Health Conditions

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