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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191220381
Report Date: 05/21/2024
Date Signed: 05/21/2024 02:18:59 PM

Document Has Been Signed on 05/21/2024 02:18 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
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:NEW HORIZONSFACILITY NUMBER:
191220381
ADMINISTRATOR/
DIRECTOR:		MONTIQUE E JOHNSONFACILITY TYPE:
775
ADDRESS:15725 PARTHENIA STTELEPHONE:
(818) 894-9301
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 177CENSUS: 86DATE:
05/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Tetyana Wynter (Vice President of Member Services)TIME VISIT/
INSPECTION COMPLETED:
02:20 PM
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Licensing Program Analysts (LPAs) Michael Cava and Evelin Rios conducted a Case Management visit to hand deliver an Immediate Exclusion Order of Staff #1 (S1) to the Licensee/Facility. LPAs met with Tetyana Wynter, Vice President of Member Services. LPAs explained the reason for the visit. Tetyana Wynter informed LPAs she is designated to sign for this report and accept the letter.

It was determined by the Department that a complaint of conduct inimical, of C1 was substantiated against S1, thus, necessitating the Order for Immediate Exclusion from all facilities. S1 will also receive copies of the “Order To Licensee/Facility Of Immediate Exclusion From Facility” for the facilities with which S1 is associated with.

The LPA hand delivered the "Order to Licensee/Facility of Immediate Exclusion from the Facility" in regards to S1 to Administrator/Licensee Representative Tetyana Wynter. Tetyana Wynter accepted and read the letter and stated she understood the information on the letter.

Administrator/Licensee Representative states S1 is not on their current staff roster as an active employee.

Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE: DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2024
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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