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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604476
Report Date: 01/14/2025
Date Signed: 01/14/2025 01:30:52 PM

Document Has Been Signed on 01/14/2025 01:30 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:NEW VISION HOMES ARFFACILITY NUMBER:
374604476
ADMINISTRATOR/
DIRECTOR:		BELTRAN, YESENIAFACILITY TYPE:
735
ADDRESS:859 LACEBARK STTELEPHONE:
(442) 515-3083
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 4CENSUS: 4DATE:
01/14/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:55 AM
MET WITH:Administrator, Yesenia BeltranTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On 1/14/2025, Licensing Program Analyst (LPA), Janette Romero arrived unannounced to conduct a required annual inspection. LPA was greeted and granted entry by Direct Support Professional (DSP), Angel Diaz who was informed of the purpose of the visit. Administrator, Yesenia Beltran arrived during the visit. The facility has a fire clearance to serve four (4) ambulatory clients ages 18 through 59.

LPA toured the facility with Administrator Beltran and observed the facility is made up of a one-story home with two (2) client bedrooms, a client bathroom, kitchen, dining room, and attached garage. LPA did not observe any bodies of water on the premises. Indoor and outdoor passageways were free of obstruction. Administrator tested one of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. LPA also observed charged fire extinguishers mounted throughout the facility, last serviced on 9/12/2024. The facility's last earthquake drill was conducted on 1/1/2025 and fire drill on 10/20/2024. LPA toured the kitchen and observed the facility has more than two-day supply of perishable foods and seven-day supply of non-perishable foods. Medications are secured in a locked kitchen cabinet and knives in a locked kitchen drawer. Client bedrooms had the required bedding, furniture, and lighting. Bathrooms had toilet paper, paper towels and soap readily available. The laundry service and emergency food, water and supplies are stored in the garage. The facility's certificate of liability insurance expires on 7/25/2025. LPA reviewed the Record Of Client's/Resident's Safeguarded Cash Resources (LIC405) for all four (4) clients while Diaz counted their physical monies and no discrepancies were discovered. Client files reviewed had updated Individual Program Plans and signed admission agreements. Staff present have a criminal record clearance. Complaint information, facility sketch, and emergency phone numbers are visibly posted near the front entrance. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted and a copy of this report was reviewed and provided to Administrator.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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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