<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 440704008
Report Date: 05/22/2024
Date Signed: 05/22/2024 12:09:09 PM

Document Has Been Signed on 05/22/2024 12:09 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:OCEAN VIEW HOMEFACILITY NUMBER:
440704008
ADMINISTRATOR/
DIRECTOR:
MARCUS GONZALESFACILITY TYPE:
735
ADDRESS:112 CABRILLOTELEPHONE:
(831) 475-1287
CITY:CAPITOLASTATE: CAZIP CODE:
95010
CAPACITY: 12CENSUS: 11DATE:
05/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Marcus GonzalesTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Administrator Marcus Gonzales.

During visit, LPA Marrufo toured the facility inside and out. LPA Marrufo toured the facility kitchen area. LPA observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA Marrufo observed the first aid kit to be complete.

LPA Marrufo toured two out of two bathrooms. The bathrooms had water temperatures of 108 F and 106 F. Each bathroom had available soap and paper towels and working lights.

LPA Marrufo toured 7 out of 7 resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA Marrufo tested the smoke detectors in each bedroom as well as in the hallways and living room areas. Each smoke detector functioned properly when tested. LPA tested the carbon monoxide detector, which functioned properly when tested.

LPA Marrufo toured the outside area and found the exits to be clear of obstructions.

LPA Marrufo reviewed the Personal and Incidental Monies Log and the Centrally Stored Medication Logs. Both were found to be balanced and complete when reviewed. LPA Marrufo reviewed resident and staff records and found them to be complete. The Emergency Disaster Drill Log stated the last emergency drill was conducted on 04/06/2024.

No deficiencies were cited at this time as per California Code of Regulations Title 22.. This report was reviewed with Administrator Marcus Gonzales and a copy of this report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1