Summer Place

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced case management visit regarding a change in capacity. LPA was greeted by and allowed entry into the facility by staff Diana Cisneros and discussed the purpose of the visit. The Licensee applied for an increase in bedridden capacity. The approved Fire Clearance dated 5/27/26 reflects a total capacity of 10 residents in care, 4 of whom may be ambulatory and 6 of whom may be bedridden. The Fire Clearance specifies that rooms 2 and 3 are not cleared for bedridden status. LPA toured the facility and observed it to reflect the updated Fire Clearance and floor plan. No deficiencies were observed or cited during today's today. An exit interview was conducted with Diana Cisneros and a copy of this report and the Licensee Rights (LIC 9058 03/22) were provided and signature on this form acknowledges receipt.the state’s words, verbatim · CDSS document, Jun 2, 2026

Allegation investigated: Staff did not provide resident's records to resident's representative in a timely manner.

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to initiate a complaint investigative regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Administrator Aleksandar Boskoski. On March 4, 2026 the Department received this complaint which alleged staff did not provide Resident #1's (R1) records to R1's representative in a timely manner. [See LIC811 Confidential Name List for a description of select person identifiers used in this report.] The Department’s investigation included a facility tour, record reviews, as well as interviews with staff. (Continued on LIC9099-C) Substantiated (Continued from LIC9099) Records reviewed revealed that R1's representative sent a letter dated December 15, 2025 to the facility requesting a copy of R1's records. R1's representative reported to LPA that they did not receive anything indicating that the mail sent out was undeliverable, nor was it returned back to sender. LPA confirmed with R1's representative that the request was sent to the correct facility mailing address. As of March 5, 2026 R1's representative reported still not receiving records or receiving any response from facility staff despite several follow up communication efforts via telephone. LPA interviews with staff reported not provided R1's representative with a copy of R1's records and deny receiving any letter of request. The Department has investigated the allegation that staff did not provide R1's records to R1's representative in a timely manner. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was met to support or corroborate this allegation and therefore deemed substantiated. One deficiency is being cited per Title 22 California Code of Regulations (please refer to 9099-D page). A Plan of Correction was jointly developed with the Administrator. An exit interview was conducted with Administrator Aleksandar Boskoski, to whom a copy of this report, the LIC811, and the Licensee’s Rights (LIC9058 01/16) were provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Mar 5, 2026 · control 08-AS-20260304125453

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(9) · Plan of correction due date: Mar 20, 2026

87468.1 Personal Rights of Residents in All Facilities (a) Residents...shall have all of the following personal rights: (9) To have communications to the licensee from their representatives answered promptly and appropriately. This requirement was not met as evidenced by: Records review and interview with staff reveal that the licensee did not respond to R1's communication promptly. This poses a personal rights risk to R1.the state’s words, verbatim · CDSS document, Mar 5, 2026

Plan of correction: Administrator stated that he will provide R1's representative with R1's complete files by POC due date and provide proof to LPA.

Allegation investigated: Staff did not ensure a resident was properly fed Staff yelled at a resident Staff was sleeping while providing care and supervision Staff did not meet a resident's bathing needs Staff did not properly dress a resident

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Administrator Dragana Lekovic. On December 3, 2025 the Department received this complaint with the above mentioned allegations. The Department’s investigation included a facility tour, record reviews, as well as interviews with residents, staff and outside sources. (Continued on LIC9099-C) Unsubstantiated (Continued from LIC9099-A) Regarding the allegation that staff did not provide a comfortable temperature for a resident, during unannounced visits LPA observed the only thermostat located towards the front of the facility to read within regulation range. However, the back of the facility was noticeably colder than the front of the facility. LPA utilized a thermometer to read the ambient temperature at the back of the facility several times during unannounced visits. Temperatures recorded (in Fahrenheit) by LPA that were below the minimum heated temperature were as follows: 64.9, 67.3, 66.6, 66.0, 67.6. Regarding the allegation that staff are not properly trained, LPA reviewed staff files which revealed staff were not up to date on their annual training including but not limited to, bathing, grooming, dressing, feeding, toileting, and infection control. The Department has investigated the above mentioned allegations. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was met to support or corroborate these allegations and therefore deemed substantiated. Two deficiencies are being cited per Title 22 California Code of Regulations (please refer to 9099-D page). An exit interview was conducted with Administrator Dragana Lekovic, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided. (Continued from LIC9099) Regarding the allegation that staff did not ensure a resident was properly fed, interviews with residents in care did not report concerns regarding being properly fed. During unannounced visits LPA observed menus posted and observed breakfast and lunch being served to residents. Interviews with outside sources reported their observations of meals to be satisfactory and no concerns regarding residents not being properly fed. Regarding the allegation that staff yelled at a resident, interviews with residents in care and outside sources did not report observing staff yell at residents. Interviews with staff did not report observing other staff yelling at residents. During LPA unannounced visits, LPA observed residents being treated with dignity and respect. Regarding the allegation that staff was sleeping while providing care and supervision, interviews with staff reported that overnight there is at least one staff awake. Records reviewed corroborated this staff schedule. Interviews with residents in care did not report lack of supervision during the night, or ever observing staff to be asleep while providing care and supervision. Interviews with outside sources did not report observing staff sleeping while providing care and supervision. Regarding the allegation that staff did not meet a resident’s bathing needs, during unannounced visits LPA observed residents in care to appear clean and well groomed. Interviews with staff reported regularly bathing residents. Interviews with residents in care reported their bathing needs being met. Additionally, interviews with outside sources did not report concerns regarding residents not receiving regular bathing. Regarding the allegation that staff did not properly dress a resident, during unannounced visits LPA observed residents in care to be properly dressed. Interviews with staff reported assisting residents with getting dressed every morning. Interviews with residents in care reported staff assisting them with getting dressed. Interviews with outside sources did not report any concerns regarding residents not being properly dressed. The Department has investigated the above mentioned allegations. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate these allegations and therefore deemed unsubstantiated. An exit interview was conducted with Administrator Dragana Lekovic, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.the state’s words, verbatim · CDSS document, Jan 12, 2026 · control 08-AS-20251203130348

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(b)(1) · Plan of correction due date: Jan 12, 2026

87303 Maintenance and Operation (b)A comfortable temperature for residents shall be maintained...(1)... a minimum of 68 degrees F. This requirement was not met as evidenced by: Based on LPA observations licensee did not ensure comfortable facility temperature of a minimum of 68 degrees F. This poses a potential risk to persons in care.the state’s words, verbatim · CDSS document, Jan 12, 2026

Plan of correction: During LPA visit, Administrator set up two small heaters in the back of the facility. Therefore, this deficiency is cleared.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(c)(3) · Plan of correction due date: Mar 13, 2026

87411 Personnel Requirements-General(c)...staff who assist residents...shall receive...annual training...(3)The training shall include...bathing, grooming, dressing, feeding, toileting, and infection control... This requirement was not met as evidenced by: Based off record review, 5 of 5 staff did not have up to date annual training. This poses a potential risk to persons in care.the state’s words, verbatim · CDSS document, Jan 12, 2026

Plan of correction: Administrator agreed to submit proof of annual required staff training to LPA by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Required 1 year annual inspection visit. LPA was greeted by, identified herself to, and explained the purpose of the visit to Administrator Dragana Lekovic. The facility is licensed for 10 residents all of whom may be non-ambulatory and 1 may be bedridden. The facility has a hospice waiver for 10 residents. LPA and Administrator toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Resident bedrooms allowed for easy passage and contained the required furnishings. Toilets, sinks, and showers were in working order and bathroom sinks were compliant temperatures. The facility has enough linens, hygiene supplies, cooking and dining supplies. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. All kitchen appliances were in working order. The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and resident activities. The facility has locked areas for storage of sharp objects, medication, and confidential resident and staff records. LPA observed old medications of former residents not discarded or destroyed. (CONTINUED ON LIC 809-C, NEXT PAGE) (CONTINUED FROM LIC 809) No pools or bodies of water present on the premises. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. Per Administrator, no firearms or ammunition are at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. All fire extinguisher(s) were serviced within the last twelve months. A complete first aid kit was present. Required licensing postings were observed in visible areas of the facility. A deficiency was observed and is being cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D page). A Plan of Correction was jointly developed with the Administrator. An exit interview was conducted with Dragana Lekovic, Administrator, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Jan 12, 2026

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to the facility on November 24, 2025, to issue deficiencies identified during an unrelated visit. LPA Correia identified herself with Caregiver Pabustan, was granted entry, and explained the purpose of the visit. During an unrelated visit, LPA observed and obtained information indicating that the facility is retaining bedridden residents in violation of its current licensing limitations. Specifically, LPA observed and obtained information that confirmed the facility retained six (6) bedridden residents over its current licensing limitation. It was determined residents R1 through R6 are classified as bedridden, and unable to reposition themselves without assistance. R1 through R6's bedridden status were verified through observations and staff interviews and are being retained in the facility without proper fire clearance or licensing approval to serve over one (1) bedridden individual. An exit interview was conducted with Caregiver Pabustan to whom a copy of this report, a copy of the LIC 811 Confidential names list, LIC 421IM, and Licensee Rights (LIC 9058), were provided.the state’s words, verbatim · CDSS document, Nov 24, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a)(2) · Plan of correction due date: Nov 25, 2025

87202 Fire Clearance (a) All facilities... Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. (2) Bedridden persons... This requirement was not met as evidenced by: On November 24, 2025, LPA observations, and staff interviews showed R1, R2, R3, R4, R5, and R6 were bedridden and unable to turn and reposition themselves without assistance. The Licensee did not obtain appropriate fire clearance nor receive Community Care Licensing approval. This poses an immediate health and safety risk to 6 out of 10 of residents in care.the state’s words, verbatim · CDSS document, Nov 24, 2025

Plan of correction: Licensee stated they will submit an LIC200 application for increased bedridden clearance, update the facility sketch, and contact the Fire Marshall. The Licensee will provide the Proof of Correction(POC) to the Department by the POC due date.

Allegation investigated: Staff did not dispense medication to resident as prescribed. Staff did not provide adequate personal hygiene care to resident. Staff did not assist resident with repositioning.

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Caregiver Nita Pabustan. LPA also spoke with Administrator Alex Boskoski and Dragana Lekovic over the phone. On August 27, 2025 the Department received this complaint which alleged staff did not dispense medication to Resident #1 (R1) as prescribed, staff did not provide adequate personal hygiene care to R1, and staff did not assist R1 with repositioning. [See LIC811 Confidential Name List for a description of select person identifiers used in this report.] The Department’s investigation included a facility tour, record reviews, as well as interviews with residents, staff and outside sources. (Continued on LIC9099-C) Unsubstantiated (Continued from LIC9099) Regarding the allegation that staff did not dispense medication to R1 as prescribed, interviews with residents reported receiving their medications as they should. Interviews with outside sources reported no concerns regarding residents not receiving their medications as prescribed, including stopping or starting medications as ordered by physicians. In reviewing records, there was no evidence to indicate medications not being dispensed as prescribed. LPA did a count audit of R1's medications which indicated the right amount of dosages being administered. Regarding the allegation that staff did not provide adequate personal hygiene care to R1, interviews with residents reported receiving appropriate hygiene care. Interviews with outside sources reported no concerns regarding the hygiene of residents in care. During LPA unannounced visits LPA observed residents appearing to be clean and well groomed. Regarding the allegation that staff did not assist R1 with repositioning, R1 reported in an interview not needing assistance in repositioning. A review of R1’s Physician’s Report signed 4/25/25 indicated R1 as nonambulatory and not requiring assistance with turning or repositioning in bed. LPA observed R1 independently transferring in and out of bed. The Department has investigated the above mentioned. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate these allegations and therefore deemed unsubstantiated. An exit interview was conducted with Caregiver Nita Pabustan, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.the state’s words, verbatim · CDSS document, Nov 19, 2025 · control 08-AS-20250827143119

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Case Management visit to cite deficiencies identified during a separate complaint investigation. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Caregiver Nita Pabustan. LPA also spoke with Administrators Alex Boskoski and Dragana Lekovic over the phone. During a facility tour, LPA observed resident records containing medication information stored underneath a table, easily accessible. These records were not secured or safeguarded to protect the confidentiality of their contents. During a record review of Resident #1 files (R1) [See LIC811 Confidential Name List for a description of select person identifiers used in this report.] it was revealed that there were no previous records for R1's centrally stored medication prior to 10/20/25. Per Admission's Agreement, R1 was admitted to the facility 4/26/25. During interviews with staff, it was revealed that R1 is currently at the hospital. LPA also reviewed R1's records that indicated at least two other prior hospital visits. LPA reviewed the Department's internal database of reports received from facilities which revealed that the Licensee did not submit any Unusual Incident/Injury Reports (LIC 624) to the Department of these incidences per reporting requirements. Three deficiencies were cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). A Plan of Correction was jointly developed with Administrators. An exit interview was conducted with Caregiver Nita Pabustan, to whom a copy of this report, the LIC 809-D, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Nov 19, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(c)(1) · Plan of correction due date: Nov 19, 2025

87506 Resident Records(c)All information and records...shall be confidential(1)The licensee shall be responsible for storing active and inactive records and for safeguarding the confidentiality of their contents… This requirement has not been met as evidenced by: Based on LPA observations, licensee did not ensure 10 of 10 resident records were not safegaurded. This posed a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Nov 19, 2025

Plan of correction: Caregiver immediately relocated resdident records in a locked and secured closet. Thereofore, this deficiency has been cleared.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87465(h)(6) · Plan of correction due date: Dec 4, 2025

87465 Incidental Medical and Dental Care(h)The following...shall apply...(6)The licensee shall be responsible for assuring that a record of centrally stored...medications for each resident is maintained for at least one year This requirment has not been met as evidenced by:Based on records review licensee did not keep proper medication record for 1 of 10 resdients prior to 10/30/25. This posed a potential risk to persons in care.the state’s words, verbatim · CDSS document, Nov 19, 2025

Plan of correction: Licensee and staff will conduct a training reviewing Incidental Medical and Dental Care regulation and submit proof of training to LPA by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(10(D) · Plan of correction due date: Dec 4, 2025

87211 Reporting Requirements(a)Each licensee shall furnish to the licensing agency such reports...(1)A written report shall be submitted to the licensing agency ....(D)Any incident which threatens the welfare, safety or health of any resident... This requirment has not been met as evidenced by: Staff interviews and records review revealed that Licensee did not submit written reports for 1 of 10 resdients when hospitalized. This poses a potnetial risk to 1 of 10 resdients in care.the state’s words, verbatim · CDSS document, Nov 19, 2025

Plan of correction: Licensee and staff will conduct a training reviewing Reporting Requirements and submit proof of training to LPA by POC date.

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced post licensing visit. LPA was greeted by, identified herself to, and explained the purpose of the visit to Administrator Dragana Lekovic. The facility is licensed for 10 residents all of whom may be non-ambulatory and 1 may be bedridden. The facility has a hospice waiver for 10 residents. LPA and Administrator toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Resident bedrooms allowed for easy passage and contained the required furnishings. Toilets, sinks, and showers were in working order and bathroom sinks were compliant temperatures. The facility’s ambient internal temperature was comfortable and complaint. The facility has enough linens, hygiene supplies, cooking and dining supplies. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. All kitchen appliances were in working order. The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and resident activities. The facility has locked areas for storage of sharp objects, medication, and confidential resident and staff records. LPA reviewed facility records. The files reviewed by LPA contained required documents. LPA observed medications not being stored in their original packaging. (CONTINUED ON LIC 809-C, NEXT PAGE) (CONTINUED FROM LIC 809) No pools or bodies of water on the premises. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. Per Administrator, no firearms or ammunition are at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. All fire extinguisher(s) were serviced within the last twelve months. A complete first aid kit was present. Required licensing postings were observed in visible areas of the facility. A deficiency was observed and is being cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D page). Due to this deficiency being a repeat violation, a Repeat Civil Penalty totaling $250 was assessed/charged to Licensee (refer to the LIC421-FC page). A Plan of Correction was jointly developed with the Administrator. An exit interview was conducted with Dragana Lekovic, Administrator, to whom a copy of this report, the LIC421-FC, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Oct 24, 2025

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Case Management visit to cite a deficiency identified during a separate visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Administrator Aleksandar Boskoski. During the facility tour, LPA observed medications being stored in plastic containers with different sections for morning, noon, evening, and bed time. An interview with Staff #1 (S1) revealed that S1 transfers medications every morning into the corresponding time residents are suppose to receive their medication. These medications were not stored in the original medication packages. LPA explained to Administrator that medications must not be transferred into different containers in this way and in accordance with licensing guidelines must stay in their original packaging. A deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). A Plan of Correction was jointly developed with Administrator. LPA also issued one (1) Technical Violation (TV) regarding submitting written hospice notification letters to the Department (refer to the LIC 9102-TV page). An exit interview was conducted with Administrator Aleksandar Boskoski, to whom a copy of this report, the LIC 809-D, LIC9102-TV, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Sep 2, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(5) · Plan of correction due date: Sep 30, 2025

87465 Incidental Medical and Dental Care (h)The following...shall apply to medications...(5)...shall be stored in its originally received container. No medications shall be transferred... This requirement is not met as evidenced by: Based upon LPA observation and staff interview, the licensee did not comply with the above cited section in that 10 out of 10 residents medications are not stored in the original packaging. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 2, 2025

Plan of correction: LPA instructed Administrator to immeditaley cease pre-pouring medications. Administrator agreed to have staff complete training on centrally stored medications and provide the Department proof of training.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Ryan Fulton conducted an announced Pre-Licensing visit to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. LPA was greeted by, identified himself to, and explained the purpose of the visit to the applicant’s representative, Licensee Dragana Lekovic. The facility fire clearance was granted on 06/11/2024 and reflected that the facility was approved for ten (10) residents in total, of which nine (9) may be non-ambulatory and one (1) may be bedridden. The facility's fire clearance did not include delayed-egress door or secured perimeter endorsements, and neither were present during today's visit. The submitted facility sketch was consistent with the current layout of the facility. During today’s visit, LPA, accompanied by the applicant’s representative, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Resident bedrooms allowed for easy passage and contained the required furnishings. Toilets, sinks, and showers were in working order. The facility’s ambient internal temperature was compliant. Hot water temperature at taps accessible to residents were also compliant: Kitchen sink was 117.2 F, Bathroom #1 sink was 115.2 F, and Bathroom #2 sink was 114.3 F. The facility has enough linens, hygiene supplies, cooking and dining supplies, and perishable and non-perishable food for future resident use. All kitchen appliances were in working order The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and resident activities. The facility has locked areas for storage of sharp objects, medication, and confidential resident and staff records. No pools or bodies of water were observed on the premises. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. Per the applicant’s representative, no firearms or ammunition are or will be stored at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. All fire extinguisher(s) were serviced within the last twelve months. A complete first aid kit was present. Required licensing postings were observed in visible areas of the facility. The items reviewed were complaint with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. The applicant passed the pre-licensing inspection. LPA also provided the Component III Training during today’s visit. Licensee Dragana Lekovic was advised that the facility’s application is pending management final review and approval. An exit interview was conducted with the applicant’s representative, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visitthe state’s words, verbatim · CDSS document, Jan 9, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 10 Census (if any clients in care): 9 Interview Method: Telephone interview On 12/12/2024, 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. 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. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Dec 12, 2024