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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
300611827
Report Date:
03/03/2025
Date Signed:
03/03/2025 03:57:55 PM
Document Has Been Signed on
03/03/2025 03:57 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
ORANGE COUNTY RO
,
770 THE CITY DR., SUITE 7100
ORANGE
,
CA
92868
FACILITY NAME:
SONIA'S CARE HOME
FACILITY NUMBER:
300611827
ADMINISTRATOR/
DIRECTOR:
PEREZ, MANUEL
FACILITY TYPE:
740
ADDRESS:
292 HANOVER DRIVE
TELEPHONE:
(714) 662-0637
CITY:
COSTA MESA
STATE:
CA
ZIP CODE:
92626
CAPACITY:
6
CENSUS:
5
DATE:
03/03/2025
TYPE OF VISIT:
POC
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
03:37 PM
MET WITH:
Manuel Perez
TIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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Licensing Program Manager (LPA) Fred Arias made an unannounced visit to conduct a plan of correction visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. LPA verified correction for 1 deficiency has been made from cited section CCR 87465(d)(3). Administrator Manuel Perez arrived shortly during the visit. LPA printed Plan of Correction clearance letter for deficiency cleared.
This report was discussed with the facility representative and a copy was provided.
SUPERVISORS NAME
:
Alisa Ortiz
LICENSING EVALUATOR NAME
:
Fred Arias
LICENSING EVALUATOR SIGNATURE
:
DATE:
03/03/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/03/2025
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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