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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
306004793
Report Date:
08/31/2021
Date Signed:
08/31/2021 05:05:32 PM
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:
SEASONS AT LAGUNA - 2
FACILITY NUMBER:
306004793
ADMINISTRATOR:
FEZ JON
FACILITY TYPE:
740
ADDRESS:
28961 PASEO DE OCASO
TELEPHONE:
(949) 340-6688
CITY:
LAGUNA NIGUEL
STATE:
CA
ZIP CODE:
92677
CAPACITY:
6
CENSUS:
6
DATE:
08/31/2021
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
03:47 PM
MET WITH:
Jennifer Floresca
TIME COMPLETED:
05:18 PM
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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection (mitigation). LPA was greeted and granted entry by staff. LPA and staff toured the facility. LPA observed the kitchen is clean and organized. LPA observed 2 day perishable and 7 day non-perishable food supply on hand. LPA observed knives are kept locked in a kitchen cabinet. Facility has 8 bedrooms and 5 bathrooms. 2 bedrooms are for staff and are kept locked. LPA observed all resident bedrooms had the required furnishings. LPA observed all bathrooms were clean and operational. LPA inspected the first aid kit. The first aid kit had all the required elements. LPA inspected the garage. The garage is used for storage and kept locked. Smoke detectors tested operational. LPA inspected the backyard. No bodies of water observed. Exit gates are operational. Facility mitigation plan is pending review. No deficiencies are being cited as a result of this visit. An exit interview was conducted and a copy of the report provided.
SUPERVISOR'S NAME:
Luz Adams
TELEPHONE:
(714) 703-2855
LICENSING EVALUATOR NAME:
Joseph Alejandre
TELEPHONE:
(951) 473-7041
LICENSING EVALUATOR SIGNATURE:
DATE:
08/31/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/31/2021
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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