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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006042
Report Date: 01/03/2025
Date Signed: 01/03/2025 02:16:47 PM

Document Has Been Signed on 01/03/2025 02:16 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:DANA POINT MANORFACILITY NUMBER:
306006042
ADMINISTRATOR/
DIRECTOR:		DE LOS SANTOS, RAMILFACILITY TYPE:
740
ADDRESS:32591 SEVEN SEAS DRIVETELEPHONE:
(714) 227-6557
CITY:MONARCH BEACHSTATE: CAZIP CODE:
92629
CAPACITY: 6CENSUS: 5DATE:
01/03/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Cristy ValerioTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Kimberly Lyman made an unannounced visit to the facility for the purpose of a Plan of Correction (POC) visit, based upon the deficiencies cited in LIC form 809D on 12/16/2024. LPA was greeted and granted entry into the facility and explained the reason for the visit.

*Deficiency cited under Title 22 Regulation 87303(a) pertaining to Maintenance and Operation has been cleared. During today's visit, all noted items have been repaired. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87455(h)(2) pertaining to Centrally Stored Medications has been cleared. During today's visit, LPA observed medications have been secured. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87309(a) pertaining to Storage Space has been cleared. LPA observed toxins are secured during today's visit. Licensee has complied with the terms of the POC.


Licensee has been advised to maintain all items especially those that were previously deficient in the facility in accordance with Title 22 Regulations.

Copy of this report was provided to the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2025
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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