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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306001675
Report Date: 02/28/2024
Date Signed: 02/28/2024 08:52:30 AM


Document Has Been Signed on 02/28/2024 08:52 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:SEAVIEW CARE HOME IIFACILITY NUMBER:
306001675
ADMINISTRATOR:RENE LAFIGUERAFACILITY TYPE:
740
ADDRESS:2827 CALLE GUADALAJARATELEPHONE:
(949) 218-5719
CITY:SAN CLEMENTESTATE: CAZIP CODE:
92673
CAPACITY:6CENSUS: 5DATE:
02/28/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:17 AM
MET WITH:Mercy AngTIME COMPLETED:
09:10 AM
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced Plan of Correction (POC) visit to follow up on deficiencies cited on 02/16/2024. LPA was greeted and granted entry into the facility and explained the reason for the visit. Administrator Mercy Ang arrived during the visit.

Deficiency cited under Title 22 Regulation 87705(f)(2) pertaining to Care of Persons with Dementia has been cleared. Upon arrival to the facility, LPA observed sharps and pre-poured medications are secured. Licensee has complied with the POC.









Exit interview conducted and a copy of this report was provided.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2024
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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