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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444405736
Report Date: 02/20/2020
Date Signed: 02/20/2020 03:02:51 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:HURLEY, DEBBIEFACILITY NUMBER:
444405736
ADMINISTRATOR:DEBBIE HURLEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 724-3066
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 9DATE:
02/20/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Debbie HurleyTIME COMPLETED:
03:15 PM
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An unannounced random visit made by Analyst Mahvash Behbood. Met Debbie licensee. Present were 9 children, including 3 infants and 5 preschooler and 2 school age and her helper. Living in this facility is licensee, Debbie. She understands that all adults that live in the home or help with the children must have a clearance before they can be present. Failure to do so will result in a fine. Hours of operation is Monday through Friday from Monday through Friday 6:45 to 5:30. Inside and outside of the facility was toured. Off limit area inside the home: garage. Her 2 bedrooms are only used for children napping in playpen during nap time. The entire outside area is part of day care.
No children with IMS need. No bodies of water observed. Debbie stated there are no weapons in the home. Cleaning supplies, medicines & similar items stored inaccessible to children. There is a Fireplace with a waiver, there are no wall heater or stair case. There is a fully charged correct size fire extinguisher, working smoke alarm and carbon monoxide detector. Home is clean, with working central heat.
Licensee has working land line/ telephone. Children were supervised during the visit.
Discussed with Debbie regarding supervision of children and she understand her ratio.
Children play in the backyard which is fenced. There are plenty of age appropriate toys and play equipment.
Debbie has a current children roster. Last fire/disaster drills are documented is 09/02/19
Debbie and her helper has current pediatric 1st aid/CPR which expires on 01/25/22.
Licensee doesn't transport children.
Children's file were review and they all contained LIC 700 (identification and emergency information). Debbie and her helper have copies of their required immunization on file. Debbie's Mandated Child Abuse Reporter Training expires in March of 2020. She is planning to renew it soon.
She and her helper are up to date with the required immunization.
No deficiency issued during today's visit.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020
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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