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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206656
Report Date: 03/28/2023
Date Signed: 03/28/2023 12:58:43 PM

Document Has Been Signed on 03/28/2023 12:58 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, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:NEW HORIZONS HOMES COMMUNITY CARE FAC. INC. #1FACILITY NUMBER:
157206656
ADMINISTRATOR:WYATT, LORIFACILITY TYPE:
735
ADDRESS:3618 COLUMBUS STREETTELEPHONE:
(661) 871-9447
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY: 6CENSUS: 6DATE:
03/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator Lori WyattTIME COMPLETED:
01:00 PM
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Licensing Program Analyst LPA Shawna Doucette arrived at the facility unannounced to conduct the Required Annual Inspection. LPA met with Administrator Lori Wyatt. LPA disclosed the purpose of the inspection and was granted entry into the facility by DSP 2 Dwight Dixon.

A tour of the facility was conducted with the Administrator. The residence was set at 73 F temperature and free of passageway obstructions inside and outside.

LPA Doucette observed 4 bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean. Hot water temperature was measured 118 F.

Kitchen toured, supply of food observed and food stored properly for perishable and nonperishable. Knives were stored in a locked cabinet. Medications were stored in a locked Medication cabinet. Cleaning supplies were in a locked closet/cabinet. First Aid Kit contained the required supplies. Smoke detectors and carbon monoxide detectors were checked and operating. Fire extinguishers were charged and had service dates of 1/17/23. Fire drill was last completed on 3/08/23.

LPA observed a self latching gate on the outside of the residence. There was outdoor seating for the residents.

Resident, medication and staff records were reviewed and found to be complete. Current first aid and CPR were on file for staff.

An exit interview was conducted with Administrator Lori Wyatt. A copy of this report was left with Administrator Lori Wyatt, whose signature on this form confirm receipt of these documents.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2023
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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