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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206657
Report Date: 05/11/2022
Date Signed: 05/11/2022 04:55:18 PM

Document Has Been Signed on 05/11/2022 04:55 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. #2FACILITY NUMBER:
157206657
ADMINISTRATOR:FRANKLIN, R. & BORDERS, S.FACILITY TYPE:
735
ADDRESS:409 SPERRY STREETTELEPHONE:
(661) 792-3831
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY: 6CENSUS: 5DATE:
05/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Manager Joye WalkerTIME COMPLETED:
05:15 PM
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On 5/11/2022, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection- Infection Control. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by Staff. Permission was received via phone from Administrator Rebecca Franklin to have Manager Joye Walker sign report.

Visitor log-in/temperature check, masks, and disinfection station were observed upon entry. Facility has one entrance/exit point. Hand washing and other various Covid-19 related signs were observed in the common areas. Facility staff observed with facial coverings.

Facility appeared cleaned with no obstruction or fire clearance issues. Fire extinguisher in kitchen was
last serviced on 1/17/2022 and was fully charged. Hand sanitizer was readily available to residents and visitors. Bathrooms have trash cans with lids. Hand washing posters were observed by the bathroom sink. Bedrooms were checked and beds are six feet apart or have head-to-toe orientation.

LPA checked residents’ locked medications and observed a 30-day supply. LPA observed a 7-day supply of
non-perishable foods and a 2-day supply of perishable foods. Cleaning and PPE supplies were checked. Staff records were reviewed for good health. Resident’s files have updated emergency contact information. No deficiencies were observed.

LPA is requesting the following documents be submitted to the Fresno CCL office by 3/18/2022: Current copy
of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC
309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel
Report (LIC500), Register of Facility Clients/Residents for LIC9020.

An exit interview was conducted with Staff. Report signed on-site by Manager and printed copy provided.
SUPERVISORS NAME: Brenda White
LICENSING EVALUATOR NAME: Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/11/2022
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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