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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603846
Report Date: 12/17/2021
Date Signed: 12/20/2021 12:22:08 AM

Document Has Been Signed on 12/20/2021 12:22 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, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:OCEANSIDE HOUSE-ADULT RESIDENTIAL FACILITY, THEFACILITY NUMBER:
374603846
ADMINISTRATOR:CURRY, AMYFACILITY TYPE:
735
ADDRESS:658 MICHAEL STREETTELEPHONE:
(760) 529-4233
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY: 4CENSUS: 2DATE:
12/17/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:53 PM
MET WITH:Assistant Administrator, Leslie CurryTIME COMPLETED:
05:00 PM
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Licensing Program Analyst, (LPA), Kristina Ryan conducted an unannounced Case Management visit. The purpose of the visit was to conduct a Post Licensing inspection to ensure ongoing compliance with regulations. The facility was first licensed in May 2019 and admitted clients in August 2021. LPA was granted entry by and met with Assistant Administrator, Leslie Curry. LPA was granted entry after identifying herself and disclosing the purpose of the visit.

During today’s visit, LPA toured the facility, observed clients in care, and provided consultation regarding Title 22 requirements. LPA discussed most recent COVID-19 guidance and reviewed the facility’s mitigation strategies.

Based on today’s inspection, there were no deficiencies cited. An exit interview was conducted with Leslie Curry. A copy of this report and Licensee's Appeal Rights (LIC 9058 01/16) were provided to the Licensee via e-mail. A confirmation receipt has been requested.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Kristina Ryan
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2021
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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