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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045002895
Report Date: 06/23/2022
Date Signed: 06/23/2022 11:22:27 AM

Document Has Been Signed on 06/23/2022 11:22 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:BELLA VIDA CENTERFACILITY NUMBER:
045002895
ADMINISTRATOR:EZEANI, IFEANYIFACILITY TYPE:
772
ADDRESS:556 COHASSET ROADTELEPHONE:
(916) 870-9676
CITY:CHICOSTATE: CAZIP CODE:
95926
CAPACITY: 10CENSUS: 0DATE:
06/23/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ifeanyi Ezeani, administratorTIME COMPLETED:
11:45 AM
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A pre licensing visit was conducted on 6/7/2022 by Licensing Program Analyst (LPA) Jaclyn Avila. Today's visit, LPA met with the Administrator, Ifeanyi Ezeani to follow up on the following observations made on 6/7/2022.

During the tour on 6/7/2022, of the outside grounds, the following areas were identified as needing to be corrected prior to licensure: Weed abatement, leveling of yard, cleaning of roof and gutters, removal of dead tree limbs as they pose an immediate risk to clients in care during fire season. Ref Title 22 CCR 81087 Building and Grounds. Additionally, licensing is requesting the kitchen sink to be evaluated by a certified professional for leaks and mold. The fire map needs to updated to reflect a wall that was removed between the office and what the map identifies as room bedroom #107.

On 6/23/2022, LPA observed that the aforementioned observations made above have been resolved. At time of visit, LPA observed contractors working on evaluating the dead tree limbs. LPA observed that the yards have been cut down and leveled. LPA observed that the piping under the kitchen sink was replaced. Ifeanyi provided LPA with an updated map that accurately reflects the floor plans.

LPA provided information regarding waivers and regulations related to locked refrigerator and/or kitchen.

No citations issued and an exit interview was conducted.

Pre-Licensing deficiencies have been resolved. Pre-Licensing is now complete
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Jaclyn Avila
LICENSING EVALUATOR SIGNATURE: DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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