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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
306001675
Report Date:
02/20/2025
Date Signed:
02/20/2025 01:47:23 PM
Document Has Been Signed on
02/20/2025 01:47 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
CCLD Regional Office
,
770 THE CITY DR., SUITE 7100
ORANGE
,
CA
92868
FACILITY NAME:
SEAVIEW CARE HOME II
FACILITY NUMBER:
306001675
ADMINISTRATOR/
DIRECTOR:
RENE LAFIGUERA
FACILITY TYPE:
740
ADDRESS:
2827 CALLE GUADALAJARA
TELEPHONE:
(949) 218-5719
CITY:
SAN CLEMENTE
STATE:
CA
ZIP CODE:
92673
CAPACITY:
6
CENSUS:
5
DATE:
02/20/2025
TYPE OF VISIT:
POC
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:
Mercy Ang
TIME VISIT/
INSPECTION COMPLETED:
02:05 PM
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced Plan of Correction (POC) visit to follow up on deficiencies cited on 01/16/2025. LPA was greeted and granted entry into the facility and explained the reason for the visit. Administrator Mercy Ang arrived during the visit.
Deficiency cited under Title 22 Regulation 87303(a) pertaining to Maintenance and Operation has been cleared. LPA observed fence is operational during today's visit. Licensee has complied with the POC.
Exit interview conducted and a copy of this report was provided.
SUPERVISORS NAME
:
Alisa Ortiz
LICENSING EVALUATOR NAME
:
Kimberly Lyman
LICENSING EVALUATOR SIGNATURE
:
DATE:
02/20/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
02/20/2025
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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