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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
306005495
Report Date:
03/03/2025
Date Signed:
03/03/2025 03:16:45 PM
Document Has Been Signed on
03/03/2025 03:16 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:
BEACH HOMES III
FACILITY NUMBER:
306005495
ADMINISTRATOR/
DIRECTOR:
BEACH, ANDY
FACILITY TYPE:
740
ADDRESS:
2336 COLLEGE DR
TELEPHONE:
(714) 549-1905
CITY:
COSTA MESA
STATE:
CA
ZIP CODE:
92626
CAPACITY:
6
CENSUS:
6
DATE:
03/03/2025
TYPE OF VISIT:
POC
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:
Julius Sevilla
TIME VISIT/
INSPECTION COMPLETED:
03:35 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 corrections for 2 deficiencies have been made from cited sections CCR
87309(a) and
HSC 1569.695(c). Administrators Julius and Sandy Sevilla arrived shortly during the visit. LPA printed Plan of Correction clearance letters for deficiencies 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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