157206657-4-30-2025-24-AS-RABE-DG8S8D-20250430133857

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 157206657
Report Date: 04/28/2025
Date Signed: 04/30/2025 01:39:06 PM

Document Has Been Signed on 04/30/2025 01:39 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:	NEW HORIZONS HOMES COMMUNITY CARE FAC. INC. #2		FACILITY NUMBER:	157206657
ADMINISTRATOR/ DIRECTOR:	WOOD, REBECKAH LYNN		FACILITY TYPE:	735
ADDRESS:	409 SPERRY STREET		TELEPHONE:	(661) 662-8651
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93307
CAPACITY: 6		CENSUS: 6	DATE:	04/28/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	03:00 PM
MET WITH:	Joy Mackey, Administrator		TIME VISIT/ INSPECTION COMPLETED:	05:00 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	Licensing Program Analyst R. Bruce (LPA) , conducted an unannounced annual visit to the facility and met with Caregiver, Jazmyne Shiver (CG) and Shelli Howard, House Manager (HM) . LPA stated the purpose of the visit and was accompanied by CG and HM while conducting the inspection of the facility. Joy Mackey, Administrator showed up as LPA was wrapping up the visit. At the time of the visit, LPA observed 4 residents in the facility, the remaining two were still in day program. LPA was provided a tour of the kitchen. LPA observed that the kitchen was well maintained, with working lights and well maintained appliances. The kitchen counters and sink are free from debris. LPA observed that refrigerator, was well maintained and clean. LPA observed extra freezer with extra food supply in the lanudry room. LPA observed a 2 day perishable food supply. Facility uses two standing cabinet to store dry food and juices. Cabinets were clean, organized, and had 7 days of non-perishable food. No expired food was observed. Medications are stored in locked cabinet in the kitchen. Medication was properly labeled and organized. Locked sharps located in the same cabinet. LPA observed the dining room is well lit, and the table and can seat six people. LPA inspected the living room with HM. LPA observed a non-operating fireplace with appropriate cover. Television was observed to be in a secure place, the living room floor has carpet in good condition. LPA observed adequate sofas and a chair. The living room can accommodate at least 8 people. The living room has a window that is kept clean and is not obstructed. The furniture was clean and in good condition. Cleaning supplies are stored in locked entryway closet.

NAME OF LICENSING PROGRAM MANAGER: Sergiy Pidgirny
NAME OF LICENSING PROGRAM ANALYST: Rachel A Bruce
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

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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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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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: NEW HORIZONS HOMES COMMUNITY CARE FAC. INC. #2	FACILITY NUMBER: 157206657
	VISIT DATE: 04/28/2025

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LPA entered the office. Everything appeared to be in order. The door is kept locked and extra supplies for staff are stored there as well as client and resident files.
LPA observed the hallway that leads to the bedrooms. This facility does not use night lights, they leave the hall light on at night. Smoke detectors, and carbon monoxide detector were tested and found to be functioning. LPA observed thermostat reading at 68 degrees F.

A fire extinguisher is mounted on the wall in laundry room and a second in the office. Both were inspected on 2/22/2025 with the correct pressure gauge as indicated on the meter.

LPA inspected the hallway bathroom and observed that the bathroom is well maintained, well lit, and in good condition. Water temperature will be measured at next visit. The bathroom was observed to have non-skid flooring in the shower, grab bars, grip bar next to toilet, faucets, shower. The toilet mechanism is in working condition. LPA observed the linen closet next to the bathroom have clean towels and linens. The grout in the bathroom showers needs to be cleaned but otherwise no issue.

LPA inspected the 3 resident’s bedrooms with HM and CGp. LPA observed Bedroom #1 is shared, appeared clean and organized and had required furniture.
Bedroom #2 is shared, appeared clean and well organized, has a private bathroom with covered trash bin, non-skid floor. The bedroom is well lit, and had required furniture
Bedroom #3 is shared, appeared clean and with required furniture.

LPA with caregiver, will inspected outside/garage and perimeter of property on the next visit.

First aid kit was inspected and found to be in compliance per regulation to have tweezer, bandages, manual, scissors and wound ointments.

No deficiencies cited during today's visit per California Code of Regulations (CCR) Title 22. An exit interview was conducted with Administrator. A subsequent inspection will be done to review staff/ resident files and conclude physical inspection. An exit interview was held with AD and a copy of this visit report was provided.

NAME OF LICENSING PROGRAM MANAGER: Sergiy Pidgirny
NAME OF LICENSING PROGRAM ANALYST: Rachel A Bruce
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC809 (FAS) - (06/04)

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