547209315-7-25-2026-24-AS-MVEA-DWC2LS-20260725173001

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 547209315
Report Date: 07/25/2026
Date Signed: 07/25/2026 05:30:15 PM

Document Has Been Signed on 07/25/2026 05:30 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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME:	BELLA HOME SENIOR CARE		FACILITY NUMBER:	547209315
ADMINISTRATOR/ DIRECTOR:	FELIX, MARIA EVA		FACILITY TYPE:	740
ADDRESS:	1968 W MONACHE AVE		TELEPHONE:	(559) 615-1898
CITY:	PORTERVILLE	STATE: CA	ZIP CODE:	93257
CAPACITY: 6		CENSUS: 6	DATE:	07/25/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:30 AM
MET WITH:	Licensee - Maria Eva Felix		TIME VISIT/ INSPECTION COMPLETED:	06:00 PM

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	On 07/25/2026, Licensing Program Analyst (LPA) M Vega arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by staff. Licensee - Maria Eva Felix was notified of licensing visit and not able to attend. Conducted tour with Staff 1 (S1) – Maria, Licensee - Maria Eva Felix arrived a short time later. Furniture and flooring in common rooms observed to be in good repair with adequate lighting throughout. Resident bedrooms have the required furnishings, lighting and bed linens. Smoke and Carbon Monoxide detectors present and in working order. LPA observed supply of extra bed linens, towels, and personal hygiene/grooming products. Resident bathrooms were stocked with hand soap, paper towels and garbage cans. Kitchen observed to have supply of dishes, cups, plates, utensils, pots and pans and cooking utensils in good repair. LPA observed a 7 day of non-perishable food supply. Counter tops and cabinets are clear and appropriate for food preparation. Knives, cleaning supplies and chemicals are stored and locked separate from any food items. A Washer and Dryer were observed with additional shelving for storage. Appliances observed to be in working order and at maintained at proper temperature. Medications will be stored in a locked cabinet along with First Aid Kit. The First aid kit contains all required items. Fire extinguishers are present dated 07/16/2026. Doors and passageways are unobstructed throughout the home. Continuation on LIC 809C

Shawna Doucette
Martin Vega
	DATE: 07/25/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2026

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: BELLA HOME SENIOR CARE	FACILITY NUMBER: 547209315
	VISIT DATE: 07/25/2026

NARRATIVE

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Outside of the facility toured. The home does not have a pool or bodies of water. Outdoor activity space with shaded area and seating were located on the backyard patio. A self-releasing gate was observed on the fence. Facility phone was verified, the phone number is (559) 615-1898.

Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate & up to date information for your facility. In an effort to maintain your facility file, please submit the most current & complete forms &/or information as identified below:

Residential Care Facility for the Elderly (RCFE)

LIC 308 Designation of Facility Responsibility

LIC 309 Administrative Organization

LIC 400 Affidavit Regarding Client/Resident Cash Resources

LIC 402 Surety Bond

LIC 500 Personnel Report

LIC 610E Emergency And Disaster Plan For Residential Care Facilities For The Elderly

LIC 9020 Register of Facility Clients/Residents

Copy of current Liability Insurance

Copy of current Administrator Certificate

Alternate contact information including name, telephone number, & email address.

Please submit the above forms/information to Fresno CCL by: 08/10/2026

As an operator of a Community Care Licensed facility, it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed.

No Deficiencies, Exit interview conducted. A report was signed, and a copy of this report was provided to Licensee - Maria Eva Felix for facility records.

NAME OF LICENSING PROGRAM MANAGER: Shawna Doucette
NAME OF LICENSING PROGRAM ANALYST: Martin Vega
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/25/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2026

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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