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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347004460
Report Date: 02/28/2023
Date Signed: 02/28/2023 03:15:00 PM


Document Has Been Signed on 02/28/2023 03:15 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:HARMONY HOME CAREFACILITY NUMBER:
347004460
ADMINISTRATOR:JOANNA BROTNEIFACILITY TYPE:
740
ADDRESS:7900 BELLINGRATH DR.TELEPHONE:
(916) 992-6032
CITY:ELVERTASTATE: CAZIP CODE:
95626
CAPACITY:6CENSUS: DATE:
02/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:53 PM
MET WITH:TIME COMPLETED:
01:09 PM
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On February 28, 2023, Licensing Program Analyst (LPA) DeAnna Williams-Lyons attempted to conduct an annual inspection. LPA knocked on the door but no one answered. LPA left her business card on the door and left.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-LyonsTELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2023
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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