<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191204505
Report Date: 09/18/2023
Date Signed: 09/18/2023 03:26:44 PM

Document Has Been Signed on 09/18/2023 03:26 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
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:NEW HORIZONS HOMEFACILITY NUMBER:
191204505
ADMINISTRATOR:NANCY SOOHOO OR CRIS SCHLAFACILITY TYPE:
735
ADDRESS:15756 PARTHENIA STREETTELEPHONE:
(818) 894-9301
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 12CENSUS: 1DATE:
09/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Sylvia Barriga & Sophia SaoTIME COMPLETED:
03:45 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 (LPA) Tuesday Cabiness arrived to the facility to conduct an annual inspection. LPA was greeted by staff Sylvia Barriga, who allowed LPA to enter. Staff contacted the current Administrator Montinque Johnson, who was not available, and back-up Administrator Sophia Sao arrived and assisted with the annual inspection.

The facility has one main entrance and (4) exit doors, where LPA observed Covid-19 prevention signage (hand washing, coughing etiquette, and physical distancing) postings. The PPE screening station is located on a table near the front door. The following areas were inspected:

Kitchen: LPA observed a Licensing requirement of (7) day nonperishable, and (2) perishable, with extra refrigerator and freezer stocked with food. Food was properly wrapped and dated, and appliances were functional, clean, and in good repair. Chemicals, household supplies, and knives, that are stored in the kitchen and laundry room, which were locked and secured. Living/dining: All indoor passageways were free from obstruction; inside temperature was comfortable, with adequate lighting, and all areas were clean and appropriately furnished for client's comfort. Bedrooms: The facility has (4) bedrooms; with (1) room for staff. All bedrooms were properly furnished and supplied with appropriate bedding and linens. There were sufficient linens observed and available. Bathrooms: There are (3); all were clean, with soap and towels, grab bars, and non-skid mats. Hot water measured at 114.8. degrees Fahrenheit. Personal hygiene products are available for clients used. Surrounding Grounds: There were no visible hazards; passageways were free from obstruction and gates were easily accessible to open. There was no swimming pools or other bodies of water. Exit doors do not have alarms, but the facility has cameras installed on the outside. Fire extinguisher fully charged. First aid kit checked. Smoke alarms and carbon monoxide detectors are connected with the fire department, and facility conducts quarterly drills.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: NEW HORIZONS HOME
FACILITY NUMBER: 191204505
VISIT DATE: 09/18/2023
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
26
27
28
29
30
31
32
Record review: A complete record review of (1) staff and (1) client checked: all required documents in files.

Infection/Mitigation Control Review: The common areas were observed to be clean, including client rooms, and staff and visitor bathrooms. Soap and towels, and hand washing signs were visually posted. The facility has cleaning procedures and protocols in place, which include staff cleaning common areas throughout the day. The facility has documentation of all vaccination records for staff and clients. All new employee hires and admits, have new client admits, have the option to be not vaccinated. Currently all clients and staff are vaccinated with (1) booster. If there are any signs or symptoms from clients or staff, the facility has rapid test kits in place. Facility continues to provide and conduct trainings to staff in relation to COVID-19 and other required training. There is a current sick leave policy, and there are no current staffing issues. If clients become positive, they will be temporarily housed at one of the other facilities.

Facility has (30) day supply of PPE. The facility continues to implement the best practices for the facility; to ensure the health and safety of clients and staff. The facility is aware to report any changes to Licensing and there LPA.

No citation issued, and copy of report provided

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2