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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410958
Report Date: 05/28/2020
Date Signed: 05/29/2020 09:33:08 AM

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:CASTILLO, MARIAFACILITY NUMBER:
444410958
ADMINISTRATOR:CASTILLO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 761-2401
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 5DATE:
05/28/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Maria CastilloTIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Elizabeth Berumen conducted an announced Case Management inspection via video conference call (Facetime) with Licensee, Maria Castillo. Licensee was informed that due to COVID-19 situation and "Shelter in Place" Order, this LIC809 Facility Evaluation Report will be emailed to the facility. Facility’s reply to the email will serve as acknowledgement that the report was received.

The Case Management Tele-Inspection is in response to licensee's request to include a side yard to her license. The side patio is currently off limits to children.


The facility was toured during the tele-inspection. The off limit areas inside the home are: all bedrooms (three), master bathroom, and attached garage.
Licensee was previously using the front fenced yard for outdoor play space; she is now requesting to place it as off limits due to a neighbor who smokes near the area.

The gated side yard will be approved as part of the day-care area pending the receipt of the following:
1) Updated facility sketch to show the off-limit and on-limit areas
2) Manager approval

There were no deficiencies cited.


NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2020
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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