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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700181
Report Date: 06/07/2023
Date Signed: 07/06/2023 01:39:58 PM

Document Has Been Signed on 07/06/2023 01:39 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
SACRAMENTO AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:NEW VISION SERVICES SOUTH 2FACILITY NUMBER:
392700181
ADMINISTRATOR:TANYA SLOANFACILITY TYPE:
735
ADDRESS:10250 VAUGHN DRIVETELEPHONE:
(530) 605-4437
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY: 6CENSUS: 6DATE:
06/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Renisha Miles, House ManagerTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Renee Campbell conducted an unannounced Annual 1-Year Required visit on this date. LPA met and toured with Caregiver Sequioa Chambers and later House Manager Renisha Miles. The administrator Tanya Sloan currently holds a certificate (#6052402735).

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. There are no bodies of water observed. A comfortable temperature is maintained at 69 degrees Fahrenheit. The hot water temperature is maintained at 110 degrees Fahrenheit. All outdoor and indoor passageways were kept free from obstruction. Rooms were furnished appropriately. There was an adequate supply of toiletries, hygiene supplies, and extra linens. LPA observed clients’ linens were in good repair. There is a minimum of 7-day nonperishables and 2-day perishables foods.

The last disaster/fire drill was last conducted on 06/01/2023. Fire extinguishers, smoke detectors and carbon monoxide were checked. LPA reviewed staff record files and the facility has sufficient staffing to provide the services needed to meet the clients’ needs. All staff have criminal record clearance and are associated to the facility. LPA reviewed 5 of 6 client files and reviewed 3 of 7 staff files.

The following forms are to be updated and submitted to CCL by 06/21/2023:
LIC 308 Designation of Administrative Responsibility
LIC 309 Administrative Organization
LIC 610 Emergency Disaster Plan

No deficiencies were cited during this inspection.
Exit interview conducted. Report provided.
SUPERVISORS NAME: Emerita Curiel
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2023
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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