The Hills of Browning

Allegation investigated: Resident developed pressure injury due to lack of care and supervision Facility did not notify family regarding pressure injury

On September 12, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to deliver the findings of the complaint investigation into the allegations listed above. LPA met with Licensee Allen Medina and explained the reason for the visit. During the course of the investigation, LPA inspected the facility, interviewed staff and residents, obtained and reviewed resident records. The investigation revealed the following: It was alleged that a resident developed a pressure injury due to lack of care and supervision. Resident #1 (R1) was admitted to the facility on April 25, 2025. R1 was also admitted under hospice care on April 25, 2025. R1 moved out of the facility on May 29, 2025, as R1 was admitted to the hospital and did not return to the facility once discharged. Per R1’s Physician Report dated April 28, 2025, R1 has a diagnosis of Alzheimer's disease and Dementia. R1 was on a mechanical soft diet; requires medical supervision for bowel and bladder impairment; motor impairment/paralysis; is non-ambulatory and requires assistance with all Activities of Daily Living (ADLs). CONTINUED ON LIC9099-C Substantiated LPA reviewed the hospice care reports for R1 dated between April 25, 2025, to May 28, 2025, which stated that on April 25, 2025, R1 has a diagnosis of senile degeneration of the brain, dysphagia, unspecified dementia, chondromalacia patellae in left and right knee, hypothyroidism, heart disease, chronic pain syndrome, essential hypertension, hyperlipemia, gastroesophageal reflux disease without esophagitis, chronic kidney disease, weakness, depression, and generalized anxiety disorder. A skin assessment was done on R1 upon admission on April 25, 2025, in which R1’s skin was normal and intact. R1 was a high risk for pressure ulcers. Per the hospice report dated April 26, 2025, R1 continues to be at high risk for pressure injuries due to immobility and chronic pain. Staff were advised to reposition R1 every two hours to maintain skin integrity, and that staff verbalized understanding of the instructions and to participate actively in R1’s plan of care. Per hospice report dated May 9, 2025, R1 had developed stage 2 pressure sore on her coccyx. The hospice reports further details that wound care treatment was done during the visit and that wound care services for R1 were requested. On May 12, 2025, wound care treatment was done on R1 and staff were advised to continue turning R1 every two hours for wound care prevention and worsening of the wound. On May 23, 2025, R1 continued to develop a stage 2 pressure sore on her coccyx and staff were reinforced to reposition R1 every two to three hours on her sides to off-load pressure on her coccyx. Staff verbalized understanding of the instructions. Hospice care report dated May 28, 2025, a Foley catheter was inserted in R1 for wound management. LPA reviewed the wound care specialist reports for R1 dated between May 12, 2025, and May 27, 2025, which stated that R1 has a pressure induced deep tissue damage of left heel and an unstageable pressure ulcer of sacral region. LPA conducted interviews with four (4) witnesses from R1’s hospice agency. Witness #1 (W1), who admitted R1 was under hospice agency on April 25 and April 26, 2025. W1 confirmed that upon R1 admission, a skin assessment was done on R1 in which R1’s skin was normal, did not have any redness or open wounds. W1 confirmed that R1 was a high risk for pressure ulcers due to R1’s immobility and diagnoses. Four out of four witnesses interviewed confirmed that during hospice visits, orders were given to facility staff to reposition R1 every 2-3 hours to maintain skin integrity and facility staff on duty verbalized to hospice nurse's that they understood the instructions to reposition R1 every 2-3 hours. LPA interviewed five facility staff who were involved in R1’s care between April 25 and May 29, 2025. Five out of five staff confirmed that R1 was not being repositioned every 2-3 hours since April 25, 2025. LPA reviewed the facility’s R1 turning chart records that shows the facility only documented R1 being repositioned on May 28 and May 29, 2025. CONTINUED ON LIC9099-C Facility staff did not consistently reposition R1 every 2-3 hours per hospice care instructions which resulted in R1 being admitted to the hospital on May 29, 2025, due to a wound infection described as a large decubitus ulcer on the back, which was very foul smelling, with yellow-colored discharge draining from it, involving skin subcutaneous tissues, at least to muscle. R1 was discharged from the hospital on June 7, 2025, and was transferred to a skilled nursing facility for a higher level of care for wound care treatment. Based on the evidence gathered during this investigation, the Department obtained sufficient evidence to substantiate the allegation that, resident developed pressure injury due to lack of care and supervision. The preponderance of evidence standard has been met; therefore, the above allegation is SUBSTANTIATED. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. Immediate civil penalties are being assessed. See LIC421IM. A Civil Penalty is pending determination by the Community Care Licensing Division. The investigation revealed the following: It was alleged that the facility did not notify the family regarding pressure injury. LPA conducted an interview with R1’s Power of Attorney (POA) who confirmed that the facility did not notify him of R1 developing a pressure injury. The POA stated that he learned about R1’s pressure injury from a wound care specialist who was requesting to treat R1 for her wound. During staff interviews, LPA received an admission from the facility Administrator (AD). The AD confirmed that R1’s family was not being updated regarding R1’s change of condition and that the AD regretted not keeping them updated. Based on the evidence gathered during this investigation, the Department obtained sufficient evidence to substantiate the allegation that, facility did not notify the family regarding pressure injury. The preponderance of evidence standard has been met; therefore, the above allegation is SUBSTANTIATED. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Licensee Allen Medina. A copy of the report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Sep 12, 2025 · control 22-AS-20250527154814

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f)(1) · Plan of correction due date: Sep 15, 2025

87464 Basic Services: (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not evidenced by: Based on documents reviewed and interviews conducted, the Licensee did not ensure staff were following R1’s hospice care plan which caused R1 to develop pressure-induced deep tissue injury on the left heel and an unstageable pressure ulcer on the coccyx. This poses an immediate health and safety risk to persons in care. Civil Penalty Assessed.the state’s words, verbatim · CDSS document, Sep 12, 2025

Plan of correction: The Licensee stated that they will review the regulation cited. The Licensee agreed to provide a written statement of understanding of the regulation to LPA via email or fax by POC date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87463(f) · Plan of correction due date: Sep 15, 2025

87463 Reappraisals: (f) The licensee shall immediately, or as soon as reasonably possible, communicate with the resident and, if applicable, the resident's representative, about any significant change in condition and the recommendation... This requirement is not evidenced by: Based on interviews conducted, the Licensee did not ensure that R1’s family was notified of R1’s change of condition as a result of the pressure-induced deep tissue injury on the left heel and an unstageable pressure ulcer on the coccyx of R1. This poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 12, 2025

Plan of correction: The Licensee stated that they will review the regulation cited. The Licensee agreed to provide a written statement of understanding of the regulation to LPA via email or fax by POC date.

Allegation investigated: Facility converted shed into a living area. Facility was kept unclean, unsanitary, and not in good repair. Facility auditory device was inoperable.

On July 2, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to initiate the investigation into the above listed allegations. On today’s visit, LPA observed the facility to be vacant with no residents or staff located on the property. LPA was informed by the Administrator (AD) Mar Jason Dasco and Licensee (LI) Allen Medina via telephone that the facility was vacant and that the last resident moved out of the facility on June 30, 2025. The AD and LI also informed LPA that they no longer had access to the facility since they no longer had control of the property. Due to the facility being vacant and the Licensee no longer having control of the property, LPA was unable to physically inspect the physical plant of the facility for this complaint. However, LPA conducted a Case Management visit on June 25, 2025, in which he inspected the physical plant of the facility. Regarding that, facility converted shed into a living area, the following has been concluded: During the Case Management visit conducted on June 25, 2025, LPA inspected the physical plant of the facility which included the shed located in the backyard. CONTINUED on LIC9099-C Unsubstantiated During the case management visit, LPA observed the shed to be used for storage with items located inside which included wheelchairs, mattresses, tables, portable AC units, and holiday decorations. During the visit, LPA did not observe any signs of residents or staff living inside of the shed. Based on the observations made during the Case Management visit conducted on June 25, 2025, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Regarding that, facility was kept unclean, unsanitary, and not in good repair, the following has been concluded: During the Case Management visit conducted on June 25, 2025, LPA inspected the physical plant of the facility which included areas such as the dining room and the four resident bathrooms. LPA observed the dining room to be clean with furniture in good repair. LPA also observed the lights in the dining room to be operational at time of the visit. LPA additionally inspected the four resident bathrooms and observed them to be free of hazards. LPA observed the floors and the walls in resident bathrooms to be clean. LPA observed resident bathrooms to be equipped with grab bars and nonskid floor mats. Faucets and toilets were operational and did not have any missing parts. Based on the observations made during the Case Management visit conducted on June 25, 2025, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Regarding that, facility auditory device was inoperable, the following has been concluded: During the Case Management visit conducted on June 25, 2025, LPA inspected the physical plant of the facility. During a tour of the facility, LPA observed that each auditory device placed on exit doors were operational, including the auditory device located on the door leading to the backyard. Based on the observations made during the Case Management visit conducted on June 25, 2025, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Administrator (AD) Mar Jason Dasco and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jul 2, 2025 · control 22-AS-20250626151202

Type of visit: Case Management - Other

On July 2, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct a 10-day visit in reference to complaint number 22-AS-20250626151202. This report is being issued to document additional information gathered and observations made during the 10-day visit. Upon arrival to the facility, LPA observed the facility to be vacant with no residents or staff being located on the property. LPA also observed the facility to not have any furniture inside. LPA spoke with Licensee (LI) Allen Medina via telephone who stated the following: Licensee stated that the facility is vacant and there are no staff or residents on property. Licensee stated there was a mutual agreement with the landlord to vacate the property by July 1,2025 in order to begin the process of renovating the property to sell. Licensee stated that the last resident, Resident #1 (R1), moved out of the facility on June 30, 2025. Licensee stated that they did not issue an written eviction notice to the three residents that were relocated to a different facility. Licensee stated that he met with the landlord on July 1, 2025 to remove the facility's belongings from the property and return the keys to the property. Licensee stated that he needs permission from the landlord or broker in order to access the property. Licensee stated that he would need to retrieve the keys from the landlord or broker in order to access the property. Licensee stated that LPA would not be able to access the property for the complaint since he no longer had control of the property. LPA also spoke with the landlord via telephone who stated the following: Landlord stated that the facility is vacant and confirmed there are no staff or residents on the property. Landlord stated he met with the Licensee on July 1, 2025 to collect the keys for the property. Landlord stated that only himself and the broker have keys to access the property. Landlord stated that the Licensee would need permission from himself to get a key to access the property. Landlord confirmed there was a mutual agreement with the Licensee to vacate the property by July 1, 2025 in order to begin the process of renovating the property to sell. Landlord stated that the Licensee is two months behind on rent. Based on the information gathered above, the Licensee has lost control of the property since the Licensee did not have keys to access the property and had to ask for permission to access the property. Deficiencies are being cited on the attached LIC809-D. An exit interview was conducted with Licensees Allen Medina and Keak Vongphakdy. A copy of the report and Appeal rights were provided.the state’s words, verbatim · CDSS document, Jul 2, 2025

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.682(a)(2) · Plan of correction due date: Jul 3, 2025

1569.682 Transfer of resident upon forfeiture of license or change in use of facility... : (a)... prior to transferring a resident.... (2) Provide each resident or the resident’s responsible person with a written notice no later than 60 days before the intended eviction... This requirement is not evidenced by: The licensee failed to provide a 60 day written notice to the residents that were relocated to a different facility. This poses/posed an immediate health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 2, 2025

Plan of correction: Licensee agreed to complete a statement of understanding regarding the regulation listed. Licensee agreed to submit the statement of understanding to LPA via email or fax by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(d) · Plan of correction due date: Jul 16, 2025

87211 Reporting Requirements: (d) The licensee shall notify the Department, the State Long-Term Care Ombudsman, all residents, and, if applicable, their representatives, in writing within two business days of any of the following specified events, or knowledge thereof: This requirement was not evidenced by: LPA spoke with the landlord via telephone who stated that the facility was two months behind on rent. This information was not disclosed to the Department prior. This poses/posed a potential health, safety, or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 2, 2025

Plan of correction: Licensee agreed to complete a statement of understanding regarding the regulation and agreed to keep the department informed on any future events. The Licensee agreed to submit the statement of understanding to LPA via email or fax by POC date.

Type of visit: Case Management - Health Checks

On June 25, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced Case Management visit for a Health and Safety check. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Mar Jason Dasco was notified via telephone but could not arrive to assist with the inspection. On today's visit, LPA observed three residents in care and two care giving staff present. LPA observed residents eating lunch in the dining room which included pasta, chicken, and fruit. LPA observed residents to be in clean clothes. LPA, accompanied by a caregiver staff, conducted a tour of the physical plant. LPA inspected the five resident bedrooms and observed them to be free of hazards. LPA observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed the lights in each of the resident bedrooms to be operational. LPA inspected the four shared resident bathrooms and observed them to be clean. The water in each of the resident bathrooms were operational. Hot water temperature measured between 105.8 to 107 degrees Fahrenheit. LPA observed the facility has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. LPA observed the five burner gas stove lights unassisted. LPA observed the facility has a three day emergency food and water supply stored in the attached two car garage. No health or safety concerns were observed. LPA additionally conducted interviews with staff and residents. Licensee to provide LPA with copies of any new business loans, bank statements, lease payments/bills paid up to date, and payroll information. CONTINUED ON 809-C LPA was also advised by the Licensee via telephone that they plan to vacate the facility by June 30, 2025. The Licensee advised LPA via telephone that they had a plan in place to relocate one resident but were undetermined with the other two residents. Based on the observations made during today's visit, no deficiencies are being cited per the Title 22 of the California Code of Regulations. An exit interview was conducted with an authorized facility representative and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jun 25, 2025

Type of visit: Office

On today's date, Licensing Program Managers (LPM) Alisa Ortiz and Licensing Program Analysts (LPAs) Michael Tea and Brandon Lopez met with Licensee Allen Medina, Maricel Nepomuceno, and Keak Vongphakdy on this day for the purpose of discussing financial operations and distress and reporting requirements The following was discussed: Licensee's responsibilities of facility oversight Licensee's requirement to maintain control of facility and property Licensee’s responsibility to maintain financial solvency Licensee’s responsibility to communicate with the department Report of suspected dissolution of partnership Report continued on LIC809-C The following was agreed upon during today's meeting: The Licensee has clarified the dissolution of partnership is not related to license, but rather a separate business deal. The dissolution of partnership will not impact licensee’s facilities. The Licensee has reported they are in communication with landlords for properties leased and will maintain a valid lease and control of property. The Licensee will maintain payment of all facilities bills and ensure sufficient staffing to meet residents needs, the Licensee will communicate any health and safety concerns related to residents in care to the department immediately. The following items are to be provided to the Department: Updated LIC 500 Personnel Report identifying all current working staff and their agreed upon schedules by close of business May 29, 2025. Updated lease agreements with letters from landlords voiding any outstanding evictions or unlawful detainers by close of business May 23, 2025. A copy of loan contract to support financial solvency by close of business May 29, 2025. An exit interview was conducted Licensee Allen Medina, Maricel Nepomuceno, and Keak Vongphakdy. A copy of this report, LIC 809, was provided to Licensee Allen Medina, Maricel Nepomuceno, and Keak Vongphakdy.the state’s words, verbatim · CDSS document, May 22, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Administrator (AD) Mar Jason Dasco was notified via telephone and later arrived to assist with the inspection. LPA observed that Administrator Mar Jason Dasco has a valid administrator certificate which expires on January 30, 2027. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, of which one may be bedridden, and has a hospice waiver for six. The facility is a single story home with five resident bedrooms, one of which is shared, one staff bedroom, four resident bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. LPA, accompanied by the AD, conducted a tour of the interior portions of the facility. On today's visit, LPA observed two residents in care and two staff present. LPA observed residents relaxing in common areas and in their respective bedrooms. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected the five resident bedrooms and observed them to be free of hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway closet. LPA inspected the four resident bathrooms and observed them to be clean. LPA observed resident bathrooms to be equipped with grab bars and nonskid floor mats. Faucets and toilets were operational. Hot water temperature measured between 112.8 to 114.6 degrees Fahrenheit. LPA observed the staff room to be kept locked and inaccessible to residents in care. CONTINUED ON 809-C LPA observed the facility has a two day perishable and a seven day nonperishable food supply in the kitchen. LPA observed kitchen appliances to be clean and operational. The four burner gas stove lights unassisted. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. LPA observed fire extinguishers to be mounted on the wall in the kitchen and in the resident hallway. Fire extinguishers were observed to be charged and serviced as of April 9, 2025. LPA tested the wired smoke detectors and the individual carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on March 7, 2025. LPA observed the centrally stored medication to be kept in a locked cabinet in the dining room. LPA observed a First Aid Kit to be stored in the cabinet and it had all the required components. LPA observed a fire place in the dining room and it was adequately fenced and not in operation at time of visit. LPA observed chemicals and toxins to be stored in a locked closet. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage and laundry. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA, accompanied by the AD, conducted a tour of the exterior portions of the facility. LPA observed the exterior to be free of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use. LPA observed the perimeter gates on the north side and south side of the facility to be self latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed the two resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed residents' medication and medication records. LPA reviewed five staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per the Title 22 of the California Code of Regulations. LPA spoke with the AD regarding the balance for the facility's annual fees. AD stated that the balance will be paid and the AD will provide proof of payment to LPA. An exit interview was conducted with Administrator Mar Jason Dasco and a copy of the report was provided.the state’s words, verbatim · CDSS document, May 1, 2025

Type of visit: Case Management - Other

Licensing Program Analysts (LPAs) Joseph Alejandre and Samer Haddadin made an unannounced visit to conduct a case management visit. LPAs were greeted and granted entry by staff. LPAs explained the reason for the visit and toured the facility with staff. LPAs observed the See Something, Say Something poster (PUB 475) posted in the main entry of the facility. LPAs observed the facility has all utilities, a 2 day supply of perishable food and a 7 day supply on non-perishable food. No obstacles or hazards observed at the facility. LPAs interviewed staff and residents. No health or safety concerned noted during the visit. An exit interview was conducted and a copy of the report provided.the state’s words, verbatim · CDSS document, Sep 25, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Ruth Martinez conducted an announced visit to the facility for purpose of a pre-licensing evaluation. LPA arrived at facility was greeted and granted entry. LPA met with Maricel Nepomuceno, Director and Jeffrey Bencito, Administrator and explained the visit. An initial application to operate an Adult Residential Facility for the Elderly, age 60 years and over, for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden resident was submitted to CCL on 01/30/23. Structure: The facility is a one story house with an attached garage with 5 resident bedrooms, 1 staff bedroom, 4 full bathrooms, a living rooms, a dining room, and a kitchen. The resident’s bedrooms are spacious and will easily accommodate the resident’s furnishings. There is a large back yard with a covered patio and one exit walkway on both sides of the house with seating for the residents. Air/Heating: Central air/heating system installed with a central panel to control entire house. Bedrooms Residents: Bedrooms will accommodate 6 residents with 4 private rooms and 1 shared room accommodating two residents. Bedrooms 1, 5 and 6 has a full bathroom. Bedrooms Staff: Bedroom 4 is designated for live-in staff. Bathrooms: Facility has four full bathrooms. All bathrooms have a working toilet, wash basin, walk in shower. Linens & Hygiene Supplies: Adequate supply of linen in closet storage in hallway closet. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menus posted and available. Menus prepared one week prior and listed for food serve for one week. Food Service: Adequate supply of 7-day non-perishable and 2-day perishables are stored in the kitchen with surplus goods stored in garage. Smoke Detectors: Smoke detectors and carbon monoxide alert systems are hardwired, were tested, Continued on LIC-C and found operational. 3 fire extinguishers mounted and located in kitchen, resident bedroom hallway and garage charged and dated 10/9/23. Appliances: Gas four burner stove, single oven, 2 refrigerator (kitchen and garage), toaster oven, microwave, dishwasher, washer, and dryer are clean and noted to be operational. Toxins: All and any toxic chemicals, cleaning solutions and disinfectants are inaccessible to residents are stored and locked underneath kitchen sink, laundry unit, garage and hallway closet. Water Temperature: Tested and recorded maintained at a comfortable temperature and the water temperature measures 107 Fahrenheit degrees in facility bathrooms. Medications, First-Aid Kit & Book: Medication in locked storage cabinet in dining room and the first aid kit is mounted in kitchen. Resident & Staff Files: Records will be kept locked in with medication storage. Reading Material, Games, Equipment & Materials: The facility has board games, books, and other recreational materials for the resident's use, commensurate with the plan of operation. Fire clearance: Was approved on 03/13/24. Component III: Component three waived during visit. Applicant is Licensee/Administrator of other licensed facilities. The applicant has met all pre-licensing requirements. LPA will submit notification to CAB in Sacramento for final review prior to license being issued. Exit interview was conducted and a copy of this report was left with the applicant.the state’s words, verbatim · CDSS document, Apr 30, 2024

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Maricel Nepomuceno (C) & Jeffrey Bencito (A) Interview Method: Telephone interview On April 12, 2024, 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 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. 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 2. Staffing requirements & Training 3. General provisions / Pre Licensing Readinessthe state’s words, verbatim · CDSS document, Apr 12, 2024