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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002484
Report Date: 06/09/2022
Date Signed: 06/09/2022 09:47:44 AM

Document Has Been Signed on 06/09/2022 09:47 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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:NEW VISION SERVICES, INC. 5FACILITY NUMBER:
455002484
ADMINISTRATOR:WATKINS, TROYFACILITY TYPE:
735
ADDRESS:7063 RIVER DRIVETELEPHONE:
(530) 229-0722
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY: 5CENSUS: DATE:
06/09/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Administrator Troy Watkins TIME COMPLETED:
10:00 AM
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On 06/09/2022, Licensing Program Analyst (LPA) Misty Valencia conducted an unannounced Case Management Health and Safety visit as directed by the department. LPA met with Administrator Troy Watkins and explained the reason for the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted Administrator and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened at the front door

LPA toured the facility inside and out including but not limited to facility dining area, outside area, kitchen area, and three of five (3/5) client rooms. LPA observed that the facility has all proper and required signs for COVID-19 prevention and safety protocol. LPA observed that all sinks had hand washing signs posted. LPA observed all staff members to be wearing surgical masks or N95 masks. All staff and visitors are screened upon entrance and leaving the facility. LPA observed hand sanitizers throughout the facility. LPA reviewed facility's employee screening log and observed no issues. LPA observed three of five (3/5) clients walking around, having social time while social distancing and seemed to be happy. LPA observed one of three (1/3) clients throwing himself on the floor three times. Staff explained that C1 does that for attention. LPA interviewed three of five (3/5) clients.

No deficiencies observed.

Exit interview conducted and a copy of report was emailed.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Misty Valencia
LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022
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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