<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 344700123
Report Date: 04/17/2024
Date Signed: 04/17/2024 09:31:30 AM

Document Has Been Signed on 04/17/2024 09:31 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE ORGANIZATION EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:LIVEWELL HOMECARE, LLCFACILITY NUMBER:
344700123
ADMINISTRATOR/
DIRECTOR:		STELLA NZEFACILITY TYPE:
300
ADDRESS:10048 AVOCADO WAYTELEPHONE:
(916) 822-4722
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY: CENSUS: DATE:
04/17/2024
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Stella NzeTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Associate Government Program Analyst (AGPA) Megan Vigil arrived at the business office Livewell Homecare LLC for a post licensing inspection on 4.17.2024 at approximately 8:00 am.

Upon arrival, AGPA Vigil identified herself and was greeted by Licensee, Stella Nze. The proper posting of business hours and license was observed. The analyst was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review AGPA Vigil discussed the findings of the inspection with the Licensee and informed no discrepancies were found. A copy of the report was provided with appeal rights.

LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 04/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
Page: 1 of 1