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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002003
Report Date: 01/23/2025
Date Signed: 01/23/2025 01:47:10 PM

Document Has Been Signed on 01/23/2025 01:47 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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:BROAD HORIZONFACILITY NUMBER:
455002003
ADMINISTRATOR/
DIRECTOR:		KINGSLEY, SHERRIEFACILITY TYPE:
775
ADDRESS:465 LAKE BLVDTELEPHONE:
(530) 243-9500
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY: 30CENSUS: DATE:
01/23/2025
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:32 PM
MET WITH:Bree Hampton AdministratorTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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On 1-23-25 Licensing Program Analyst LPA Sarah Benson arrived at the facility to perform a collateral visit concerning a complaint investigation.

LPA Benson interviewed the administrator and one staff member.

The interviews are recorded in the complaint 812.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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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