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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209161
Report Date: 11/16/2021
Date Signed: 11/16/2021 01:26:45 PM

Document Has Been Signed on 11/16/2021 01:26 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:NEW HORIZONS FRESNO, LLCFACILITY NUMBER:
107209161
ADMINISTRATOR:DE LA CUEVA, JOSE ANTONIOFACILITY TYPE:
740
ADDRESS:1693 S HELM AVETELEPHONE:
(559) 349-3922
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 4CENSUS: 0DATE:
11/16/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Jose Antonio De La Cueva, AdministratorTIME COMPLETED:
10:30 AM
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On 11/16/21, Licensing Program Analysts (LPAs) M. Yang and K. Kaur arrived announced to conduct a follow-up Pre-Licensing inspection. LPAs met with Jose Antonio De La Cueva, Administrator. LPAs toured facility with administrator.

LPAs observed all bathrooms with grabbed bars for use of shower and toilet.
Living room is furnished and has adequate lighting.
LPAs observed all windows with binds and coverings. Hallway lighting observed.
Hot water temperature ranged between 105.4 to 109.9 degrees F.

Component III was conducted during today's follow-up pre-licensing visit.

LPAs found that the applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.


Exit interview conducted. Administrator was informed that as COVID-19 precautionary measure, this report was provided via email. Report signed on-site.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2021
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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