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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444405736
Report Date: 08/09/2023
Date Signed: 08/09/2023 01:32:34 PM


Document Has Been Signed on 08/09/2023 01:32 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:HURLEY, DEBBIEFACILITY NUMBER:
444405736
ADMINISTRATOR:DEBBIE HURLEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 419-5126
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 10DATE:
08/09/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 AM
MET WITH:Debbie HurleyTIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA), Cortney Nelson, met with Licensee, Debbie Hurley, and explained purpose of visit. LPA was admitted into the home by the Licensee and toured the home upon arrival.

LPA Nelson advised that through the course of interviews with witnesses, who gave consistent statements, that LPA came to know that the Licensee, Debbie, is yelling at and intimidating children in care.

Per Section 102423 Personal Rights, children shall have the right to be treated with dignity in his/her personal relationship with staff and other persons at the day care home. LPA provided copy of Section 102423 Personal Rights from the California Code of Regulations, Title 22, Division 12, Chapter 1 and reminded the Licensee of all rights children shall receive while in care. These rights shall not be waived or abridged by the Licensee regardless of consent or authorization from the child's authorized representative.

LPA informed Licensee, Debbie Hurley, that this report dated 8/9/2023 documents one Type A citation, which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA informed the Licensee to provide a copy of this licensing report dated (8/9/2023) that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

As a result of todays inspection, a deficiency has been cited, see LIC809-D.

Exit interview conducted and report was reviewed with the Licensee, Debbie Hurley.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST BE POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023
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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Document Has Been Signed on 08/09/2023 01:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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, DEBBIE
FACILITY NUMBER: 444405736

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/10/2023
Section Cited
CCR
102423(a)(1)

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102423 Personal Rights (a) Each child receiving services... shall have certain rights that shall not be waived or abridged by the licensee... These rights include... the following: (1) To be treated with dignity in his/her personal relationship with staff and other persons.
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The Licensee states that she will submit a letter to the Department by 8/18/2023 regarding personal rights of children.
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This requirement was not met as evidenced by:

Through interview with witnesses, it has been identified that the Licensee yells at and intimidates children which poses an immediate risk to the health, safety, and personal rights of children in care.
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If Licensee chooses to appeal the deficiency, LPA advised the Licensee that she is still required to remain in compliance and submit POC by due date indicated.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023
LIC809 (FAS) - (06/04)
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