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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004328
Report Date: 04/14/2022
Date Signed: 04/14/2022 12:34:42 PM


Document Has Been Signed on 04/14/2022 12:34 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:NEW HORIZON BOARD AND CARE IIFACILITY NUMBER:
306004328
ADMINISTRATOR:IMELDA AGUILAFACILITY TYPE:
740
ADDRESS:20644 VIA JARDINTELEPHONE:
(714) 777-5808
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY:6CENSUS: 6DATE:
04/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Ray Aguila and Maureen AguilaTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Kathrina Chin made an unannounced required annual inspection in this facility. LPA met with Ray Aguila and Maureen Aguila, care staff members and stated the purpose of this visit.

LPA Chin was granted entry after completing the COVID 19 screening procedure. For this visit, there are six residents in care and two staff members on the floor. LPA toured the interior and exterior portions of the facility. LPA toured the facility inside and out. Rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke detectors, carbon monoxide and auditory exit alarms were tested to be operational. Bathrooms were observed to be clean and good repair; and provided with handrails and nonskid - floor mats.

Hot water was measured at 112.2 degrees Fahrenheit. Facility met the minimum two day perishable and seven day non-perishable food stock requirements. Medications, cleaning supplies and sharp items were inaccessible to residents in care. Fire extinguisher was mounted and charged. For the exterior portion, facility had outdoor furniture and an umbrella for shade. The grounds were free of tripping hazards. Side exit door was self-latching and self-closing. The facility has sufficient PPE supplies. LPA Chin reviewed the COVID 19 mitigation plan of the facility.

For this visit, there are no deficiencies cited this review as per Title 22 of the California Code of Regulations.

An exit interview was conducted with Ray Aguila and copy of this report was left in the facility.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 703-2838
LICENSING EVALUATOR NAME: Kathrina ChinTELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022
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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