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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197607898
Report Date: 12/03/2024
Date Signed: 12/03/2024 01:58:15 PM

Document Has Been Signed on 12/03/2024 01:58 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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:COASTAL HOUSE, INC.FACILITY NUMBER:
197607898
ADMINISTRATOR/
DIRECTOR:		CLAUDIA PRECIADOFACILITY TYPE:
740
ADDRESS:2527 S. BUNDY DRIVETELEPHONE:
(310) 770-2029
CITY:LOS ANGELESSTATE: CAZIP CODE:
90064
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
12/03/2024
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:55 PM
MET WITH:Claudia Preciado-LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:58 PM
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On 12/3/2024, Licensing Program Analyst Alfonso Iniguez had an Office Meeting/Plan of Correction with Claudia Preciado/Licensee. The LPA explained the purpose of today’s visit.

On 11/9/2024, Licensing Program Analyst-LPA Alfonso Iniguez conducted an announced required annual evaluation at the facility named above. During the evaluation, LPA Iniguez was not able to review residents' and staff's records; therefore, a plan of correction was set in place.

On 12/3/24, the licensee entered the office and presented the Plan of Correction to LPA Iniguez. LPA reviewed all the Plan of Correction items and cleared the POC.


An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Claudia Preciado / Administrator.
Eva M AlvarezTELEPHONE: (323) 629-7047
Alfonso IniguezTELEPHONE: 323-981-1755
DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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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