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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002490
Report Date: 05/24/2023
Date Signed: 05/24/2023 03:53:41 PM

Document Has Been Signed on 05/24/2023 03:53 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
FACILITY NAME:NEW VISION SERVICES, INC. 6FACILITY NUMBER:
455002490
ADMINISTRATOR:TROY WATKINSFACILITY TYPE:
735
ADDRESS:6462 KIMBERLY DRIVETELEPHONE:
(916) 224-2206
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY: 4CENSUS: 4DATE:
05/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Melissa Johnson and Amber WatkinsTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) K. Hiratsuka, conducted this unannounced annual visit. LPA met with facility representatives Melissa Johnson and Amber Watkins.

This facility has a fire clearance for three ambulatory and one non-ambulatory residents. To the left of the main entrance is a doorway leading to the kitchen. To the right of the main entrance is a hallway leading to four private resident rooms, a full common bathroom, and the largest resident room has a full private bathroom and exit to the outside. Across the main entrance leads to the main sitting, dining, and kitchen. There is a door leading to the garage. The laundry machines is in the garage. There are gates on both sides of the house. The backyard has a wood deck and a covered patio that is well maintained.

Several topics were discussed.



No deficiencies cited.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2023
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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