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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444404901
Report Date: 08/15/2019
Date Signed: 08/15/2019 04:00:59 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CIRCLE OF FRIENDSFACILITY NUMBER:
444404901
ADMINISTRATOR:STACEY BOTKINFACILITY TYPE:
850
ADDRESS:111 NORTH NAVARRA DRIVETELEPHONE:
(831) 461-1366
CITY:SCOTTS VALLEYSTATE: CAZIP CODE:
95066
CAPACITY:39CENSUS: 34DATE:
08/15/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Stacey BotkinTIME COMPLETED:
04:14 PM
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An unannounced plan of correction visit was made by Analyst Behbood. Met Stacey, Licensee. Present also were 34 children with 3 staff. Purpose of visit announced. Play ground was inspected. There are now plenty of tan bark covering the area that play equipment and play structure is located. The menu was observed to be posted. Menu indicates the portion size.
All citations are cleared. No additional citation issued.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019
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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