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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005604
Report Date: 02/16/2022
Date Signed: 02/16/2022 10:21:52 AM


Document Has Been Signed on 02/16/2022 10:21 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:SEA CLIFF ASSISTED LIVINGFACILITY NUMBER:
306005604
ADMINISTRATOR:PAMELA JUNGEFACILITY TYPE:
740
ADDRESS:18851 FLORIDA STTELEPHONE:
(714) 847-3999
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:84CENSUS: 39DATE:
02/16/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
10:06 AM
MET WITH:Pamela JungeTIME COMPLETED:
10:35 AM
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced health and safety case management visit in conjunction with complaint visit 22-AS-20220215091853. LPA was greeted and granted entry into the facility by Administrator Pamela Junge and explained the reason for the visit.

During the visit, LPA toured the facility and observed the following: Facility is following all covid protocols. LPA observed residents relaxing in their rooms or preparing for an activity. LPA spoke with several residents who appeared happy and well taken care of. Facility appears clean and sanitary. No health and safety concerns noted during today's visit.









No deficiencies noted during today's visit. An exit interview was conducted and a copy of this report was left at the facility.




SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2022
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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