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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602472
Report Date: 10/28/2024
Date Signed: 10/28/2024 12:03:12 PM

Document Has Been Signed on 10/28/2024 12:03 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SUN AND SEA ASSISTED LIVINGFACILITY NUMBER:
374602472
ADMINISTRATOR/
DIRECTOR:
ANNE OWENS STONEFACILITY TYPE:
740
ADDRESS:740 SEVENTH STREETTELEPHONE:
(619) 429-0633
CITY:IMPERIAL BEACHSTATE: CAZIP CODE:
91932
CAPACITY: 32TOTAL ENROLLED CHILDREN: 0CENSUS: 25DATE:
10/28/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:55 AM
MET WITH:Jay Agustine, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced case management visit for a Plan of Correction clearance. LPA Lopez identified herself and was allowed entry by Shayla Martinez, Lead Caregiver. LPA met with Executive Director Jay Agustin and discussed the purpose of the visit.

On 10/04/2024, the facility was issued deficiencies regarding the temperature of the hot water in various bathrooms, which did not comply with regulations, and resident files did not obtain updated copies of their Physician’s Report’s (LIC602s).

During today’s visit, LPA measured the hot water temperature at taps and were all compliant: kitchen sink measured hot water at 108.5 degrees F; sink in restroom #1 delivered hot water at 108 degrees F; sink in restroom #2 delivered hot water at 110.7 degrees F; sink in restroom #3 delivered hot water at 107.2 degrees F; sink in restroom #4 delivered hot water at 111 degrees F; sink in restroom #5 delivered hot water at 110.8 degrees F; sink in restroom #6 delivered hot water at 110.3 degrees F; sink in restroom #7 delivered hot water at 109.9 degrees F; sink in restroom #8 delivered hot water at 113.9 degrees F; sink in restroom #9 delivered hot water at 113.7 degrees F; sink in restroom #10 delivered hot water at 113.4 degrees F; sink in restroom #11 delivered hot water at 114.1 degrees F; sink in restroom #12 delivered hot water at 115.3 degrees F; and sink in restroom #13 delivered hot water at 117 degrees F.
The hot water temperatures were cleared throughout the facility. The LIC602s were all in the facility internal files and updated. As such, the deficiencies have been corrected and cleared during today’s visit.

No deficiencies were observed during today's visit. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Executive Director Jay Agustin at the conclusion of the visit. The signature below confirms receipt of these documents.
Robyn ClarkTELEPHONE: (619) 767-2312
Carmen LopezTELEPHONE: (619) 767-2301
DATE: 10/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2024
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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