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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565802425
Report Date: 06/27/2024
Date Signed: 06/27/2024 01:41:36 PM


Document Has Been Signed on 06/27/2024 01:41 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364



FACILITY NAME:PACIFICA SENIOR LIVING OXNARDFACILITY NUMBER:
565802425
ADMINISTRATOR:THORNTON, TIERREFACILITY TYPE:
740
ADDRESS:2211 E GONZALES RDTELEPHONE:
(805) 983-6808
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY:100CENSUS: 38DATE:
06/27/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Rick OldsTIME COMPLETED:
02:10 PM
NARRATIVE
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Licensing Program Analyst (LPA) Teresa Camara conducted a Case Management - Other visit due to receiving notification from an outside party stating the facility is representing themselves as another name: "The Vistas at Oxnard Senior Living". LPA was notified the signage at the facility had already changed.

Upon LPA's arrival at 9:10 a.m. LPA observed the signs in the front of the building remain the same: Pacifica Senior Living Oxnard. Signs and calendars inside the facility have not changed either.

LPA spoke with the Executive Director (ED) Rick Olds, who stated their management company is in the process of changing the facility's name but it has not been completed yet. LPA explained to ED that any name change must go through a process with Community Care Licensing (CCL).

LPA will provide the licensee with the documents that will be needed in order to change the facility's name at a later date.

No deficiencies observed. Exit interview conducted and report issued.
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 593-4347
LICENSING EVALUATOR NAME: Teresa CamaraTELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:
DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2024
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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