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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004769
Report Date: 08/09/2024
Date Signed: 08/09/2024 04:06:37 PM


Document Has Been Signed on 08/09/2024 04:06 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:SEASONS AT LAGUNA - 3FACILITY NUMBER:
306004769
ADMINISTRATOR:MARICEL GUIBILONDOFACILITY TYPE:
740
ADDRESS:26291 AVENIDA CALIDADTELEPHONE:
(949) 482-7412
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:6CENSUS: 6DATE:
08/09/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Administrator/Licensee Maricel N. GuibilondoTIME COMPLETED:
04:10 PM
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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to commence a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA Rodgers were welcomed by, identified themselves to, and discussed the purpose of the visit with Administrator/Licensee Maricel N. Guibilondo.

During today’s visit, LPA toured the facility, reviewed staff and client records, and interviewed staff and clients. No deficiencies were cited during today’s visit. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection.

An exit interview was conducted with the Administrator/Licensee Maricel N. Guibilondo whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.
SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Amy RodgersTELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2024
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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