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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920234
Report Date: 02/20/2025
Date Signed: 02/20/2025 11:14:55 AM

Document Has Been Signed on 02/20/2025 11:14 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:BAYOAK SRFFACILITY NUMBER:
345920234
ADMINISTRATOR/
DIRECTOR:
EZEANI, IFEANYIFACILITY TYPE:
772
ADDRESS:7309 BAYOAK WAYTELEPHONE:
(530) 888-5000
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 6CENSUS: 0DATE:
02/20/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Ifeanyi EzeaniTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On 02/20/2025, Licensing Program Analyst (LPA) Cheyenne Ratajczak met with Administrator Ifeanyi Ezeani, to conduct an announced Pre-Licensing visit. Facility has an approved fire clearance for six (6) ambulatory residents.

LPA and Administrator conducted a tour of the facility. Areas toured include but not limited to three (3) shared resident bedrooms, two (2) bathrooms, staff office, storage area, garage, and outside area. Bathrooms and bedrooms were in sanitary condition and properly maintained. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked. LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors to be operational. Fire extinguisher and first aid kit are maintained and ready for emergency use. Water temperature was measured in the kitchen sink at 118.1 degrees, which is within the required range. LPA reviewed an example resident file and observed required documents present in file.

Pre-licensing passed and Component III was waived as Licensee has other licensed facilities with Community Care Licensing (CCL). Facility has satisfied all requirements in accordance to Title 22, California Code of Regulations. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. Administrator to notify LPA when first resident moves in.


Exit interview conducted a copy of the report was left at the facility.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE: DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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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