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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005875
Report Date: 03/17/2025
Date Signed: 03/21/2025 08:55:16 AM

Document Has Been Signed on 03/21/2025 08:55 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:PACIFIC SOLSTICE INTEGRATIVE CLINICFACILITY NUMBER:
306005875
ADMINISTRATOR/
DIRECTOR:		DEVEREUX, BRITTENFACILITY TYPE:
775
ADDRESS:26732 CROWN VALLEY PKWY #443TELEPHONE:
(949) 402-9520
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 30CENSUS: 0DATE:
03/17/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:58 AM
MET WITH:Lena OsborneTIME VISIT/
INSPECTION COMPLETED:
10:55 AM
NARRATIVE
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Licensing Program Analyst (LPA) Michael Tea made an unannounced visit to the facility in order to conduct a required annual inspection. LPA arrived at the facility and was greeted and granted entry by Case Manager Lena Osborne and explained the purpose of the visit. LPA Tea spoke to Administrator (AD) Britten Devereux over the phone about the annual inspection.

At approximately 9:15 AM, LPA toured the facility. The facility maintains a license for an Adult Day Program but has not actively started receiving clients in that capacity. At this time, the facility only receives patients through their Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) licensed through the California Department of Public Health and Department of Health Care Services. LPA observe patients from these programs doing yoga in the common area at the time of the visit. The facility has therapy rooms, staff and therapist office space, a kitchenette, a staff inventory room, common areas, and three client bathrooms. The water temperature in the bathrooms measured between 110.1 and 110.6 degrees Fahrenheit. The fire extinguishers throughout the facility are fully charged. Facility appears to be clean, sanitary and free of odors in all areas inspected. Cleaning supplies and other toxic substances were locked in the staff inventory room.

No client files were reviewed, and interviews were not conducted as there are no clients being currently served. There were no health and safety concerns observed during today's visit.

Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations.

This report was reviewed with a facility staff and a copy of this report was provided to the facility.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2025
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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