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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 011440848
Report Date: 08/25/2021
Date Signed: 08/25/2021 02:03:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:NEW HORIZONS (HOME #1 FOR THE AGED)FACILITY NUMBER:
011440848
ADMINISTRATOR:ROSARIO UTLEGFACILITY TYPE:
740
ADDRESS:5115 FOOTHILL BLVD.TELEPHONE:
(510) 261-1112
CITY:OAKLANDSTATE: CAZIP CODE:
94601
CAPACITY:15CENSUS: 7DATE:
08/25/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Rosario Utleg, AdministratorTIME COMPLETED:
02:15 PM
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On 8/25/2021 starting at 1:45pm, Licensing Program Analysts (LPAs) L. Francisco and G. Clark conducted a Case Management concurrently with an Annual Inspection. LPAs met with Licensee, Rosario Utleg.

Licensee stated she is in the process of closing facility and plans to have all residents relocated by the end of September. Licensee will provide LPAs a copy a 60-day notice by 9/1/2021.

Exit interview conducted and a copy of this report provided.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Lizette FranciscoTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021
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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