Senior Care Records.

Facility Evaluation Report

Tennessee Care LLC, Vallejo08/17/2021Licence 486803980

Capacity6
Date signed08/17/2021 10:53:41 AM
The inspector’s account

COMP II Participants: MARK JAYSON DITAN SY & RACHEL ANN ARCEO SY Applicant/administrator

Applicant/administrator participated in COMP II via telephone call with the analyst at CAB. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed.

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

3. Applicant and Administrator qualifications

4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions

5. Grievances, Complaints, Community resources

7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of property

8. Discussed the COVID-19 Mitigation Plan & PIN emailed

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