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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700388
Report Date: 10/29/2024
Date Signed: 10/29/2024 10:31:22 AM

Document Has Been Signed on 10/29/2024 10:31 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:NEW HORIZON BOARD AND CARE IIFACILITY NUMBER:
342700388
ADMINISTRATOR/
DIRECTOR:		PEREZ, SUSANA GFACILITY TYPE:
740
ADDRESS:10051 SHANA WAYTELEPHONE:
(916) 585-9460
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
10/29/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Sharon ManalangTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual required inspection. LPA Valerio met with designated Assistant Administrator Sharon Manalang, and explained the purpose of the visit.

LPA Valerio and S. Manalang toured the facility to ensure compliance with Title 22 regulations. LPA Valerio observed common areas, which were observed to be clean, free from odors, fully furnished, and organized. LPA observed furniture to be in good condition. LPA Valerio observed resident bathrooms to be clean and fully stocked with hygiene supplies. Three (3) resident bedrooms were observed to be fully furnished with a bed, night stand, lamp, chair, closet space, and a dresser. Hot water was observed to be 106.7 degrees, which is within the required range of 105.0 - 120.0 degrees. Linens were observed to be in good quality and clean. Residents were observed sleeping or being assisted with their Activities of Daily Living. The facility food supply met the food requirements, along with an emergency supply. The fire extinguisher was observed to be fully charged and observed to have their annual maintenance check for 2024. Backyard area was observed to have a space for outdoor sitting and fences were maintained in good repair.

LPA Valerio observed two (2) resident files and two (2) staff files. Files were observed to be complete with required annual documentation. LPA Valerio requested the following annual documentation be sent via e-mail:
  • LIC500 – Accurate Personnel Report,
  • LIC308 – Designation of Administrative Responsibility,
  • LIC610E – Emergency Disaster Plan,
  • An updated Liability Insurance Certificate

Per California Code of Regulations (CCR) - Title 22, Division 6, Chapter 8, no deficiencies were observed during today's visit. An exit interview was held, and a copy of the report was provided to Assistant Administrator Sharon Manalang.
Stephen RichardsonTELEPHONE: (916) 263-4746
Christina ValerioTELEPHONE: 916-823-6323
DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2024
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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