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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002875
Report Date: 01/30/2023
Date Signed: 01/30/2023 02:46:33 PM


Document Has Been Signed on 01/30/2023 02:46 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926



FACILITY NAME:DAISY AWARD RESIDENTIAL CARE, THEFACILITY NUMBER:
345002875
ADMINISTRATOR:MELVIN, JOYCELYN EFACILITY TYPE:
740
ADDRESS:5121 ARROYO STTELEPHONE:
(415) 444-6875
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY:6CENSUS: 6DATE:
01/30/2023
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Joycelyn E Melvin, AdministratorTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Michael Hood arrived at the care home today and met with the Administrator, Joycelyn E Melvin, to conduct an annual required and post licensing visit.

For more information on the post licensing visit, please see LIC 809 dated 1/30/23.

No deficiencies cited for the post licensing visit.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:
DATE: 01/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/30/2023
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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