Facility Evaluation Report

Facility Type: Adult Residential Facility (ARF)

Application Type: Change in Ownership (CHOW)

COMP II Participants: David Mason, Applicant/Administrator

On November 20, 2023 @ 1:00 PM , Applicant/Administrator participated in COMP II. Identification of the Applicant/Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant/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/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/Administrator. Copy of report sent via email and informed to return sign copy by end of business to CAB.