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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 577001978
Report Date: 04/25/2024
Date Signed: 04/25/2024 04:56:56 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/25/2024 04:56 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:ANISIA'S HEALTHY LIVINGFACILITY NUMBER:
577001978
ADMINISTRATOR:BURRESS, SVETLANAFACILITY TYPE:
740
ADDRESS:1904 MICHIGAN BLVD.TELEPHONE:
(916) 372-3174
CITY:WEST SACRAMENTOSTATE: CAZIP CODE:
95691
CAPACITY:6CENSUS: DATE:
04/25/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Svetlana Burress, AdministratorTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to complete an Annual inspection of Anisia's Healthy Living. LPA met with Administrator/Licensee Svetlana Burress, who has decided to close the facility. LPA conducted a final inspection and found there were no residents receiving care or supervision.

Licensee understands they will need to reapply and obtain a new license if you wish to operate a Residential Care Facility for the Elderly or a Community Care Facility again.

Closure of this facility has been finalized. Facility was closed effective 04/25/2024.

LPA took possession of the physical license.

No citations issued.
SUPERVISOR'S NAME: Kimberley MotaTELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Jill NakagawaTELEPHONE: 707-588-5063
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2024
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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