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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801728
Report Date: 02/06/2025
Date Signed: 02/06/2025 04:15:01 PM

Document Has Been Signed on 02/06/2025 04:15 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:SEA BREEZE MANORFACILITY NUMBER:
565801728
ADMINISTRATOR/
DIRECTOR:
ROSE MARIE LOPEZFACILITY TYPE:
740
ADDRESS:1511 OFFSHORE STREETTELEPHONE:
(805) 985-5995
CITY:OXNARDSTATE: CAZIP CODE:
93035
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
02/06/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:27 PM
MET WITH:Rose Marie LopezTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced Required 1 Year inspection at the facility today. The LPA met with administrator Rose Lopez and explained the reason for the inspection. The LPA and Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN: Knives are locked in a drawer and cleaning supplies are stored inaccessible in a locked cabinet and in the locked garage. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food.
COMMON AREAS: The living room, family room and dining room areas were furnished appropriately and furnishings were in good condition. The facility maintained a comfortable temperature. Smoke detectors and carbon monoxide detector were tested and functioned properly. The fire extinguisher was fully charged and last serviced 2/05/2025. LPA observed required postings in the hallway. The backyard has a covered outdoor area equipped with furniture for client use. There is a latched self-closing side gate. No bodies of water noted. The garage is locked and inaccessible to the clients. The washer, dryer, detergents, other supplies as well as additional non-perishable food items are located in the garage.
BATHROOMS: The facility has four and one half bathrooms. There is a staff bathroom upstairs, two full bathrooms downstairs, one half bathroom downstairs and one private bathroom in a resident's room. Bathrooms were observed to be clean and sanitary with hand soap and paper towels. The hot water temperature measured at 106.*F. LPA discussed best practices to not let hot water temperature go below 105*F with the administrator..
BEDROOMS: There are four single-occupancy bedrooms for residents and one double-occupancy room. All rooms were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There is two bedroom for staff located upstairs.
No deficiencies were observed during the inspection. LPA will return at a later date to finish the annual inspection. A copy of the report was provided.
Kasandra LopezTELEPHONE: (818) 596-4343
Esther CortezTELEPHONE: (747) 230-2225
DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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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