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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600872
Report Date: 04/20/2023
Date Signed: 04/20/2023 12:41:22 PM


Document Has Been Signed on 04/20/2023 12:41 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:OCEAN VIEW HOMES IIIFACILITY NUMBER:
374600872
ADMINISTRATOR:ALICIA MILLANFACILITY TYPE:
740
ADDRESS:6602 AVENIDA MIROLATELEPHONE:
(858) 551-2736
CITY:LA JOLLASTATE: CAZIP CODE:
92037
CAPACITY:6CENSUS: 5DATE:
04/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Caregiver, Raymond MillanTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced Case management visit. The LPA was greeted by, identified himself, and explained the purpose of the visit to Caregiver, Raymond Millan.

During today's visit, the LPA secured report signatures and delivered amended reports.

An exit interview was conducted with Caregiver, Raymond Millan, to whom a copy of this report and the licensee appeal rights (LIC9058) were provided via electronic mail. An electronic mail read receipt confirms the documents were received.
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (610) 767-2317
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2023
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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