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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444405736
Report Date: 01/23/2025
Date Signed: 01/23/2025 04:11:22 PM

Document Has Been Signed on 01/23/2025 04:11 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:HURLEY, DEBBIEFACILITY NUMBER:
444405736
ADMINISTRATOR/
DIRECTOR:		DEBBIE HURLEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 419-5126
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
01/23/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Debbie HurleyTIME VISIT/
INSPECTION COMPLETED:
04:25 PM
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On January 23, 2025 at 1:30pm, Licensing Program Analysts (LPAs) Darnella Barnes and Marilou Monico conducted an unannounced Annual Random inspection at the residence of Debbie Hurley, Licensee. The purpose of the inspection was explained. LPAs were granted access to the home by Licensee's Assistant (S1). LPAs observed S1 alone with eight (8) children: 2 infants and 6 preschool age. Licensee, Debbie Hurley, and a school age child arrived during the inspection and met with LPAs. Licensee received the Entrance Checklist (LIC 126).

The facility operates Monday to Friday from 7:00 a.m. to 5:30 p.m. LPAs observed required postings, including the Facility License, Notification of Parent's Rights (PUB 393), Emergency Disaster Plan (LIC610A), and Earthquake Preparedness Checklist (LIC 9148) were visible near the front entrance to the daycare. The last fire/disaster drill was documented as completed on 8/5/2024. The Licensee was reminded that fire/disaster drills must be conducted and documented every six months.

Supervision policies were reviewed with the licensee, who acknowledged that she must be present during daycare hours and ensure children are always supervised. Licensee was reminded that children must not stay in parked vehicles, car seats are for transport only, and reporting requirements for suspected child abuse and incidents are mandatory. Children's rights cannot be waived, even with consent from their authorized representative.

The Licensee confirmed that licensee is the only adult residing in the home. Fingerprint clearance has been obtained and verified by LPAs on 1/17/25.

Continuation on next pages:

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HURLEY, DEBBIE
FACILITY NUMBER: 444405736
VISIT DATE: 01/23/2025
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Licensee, Debbie Hurley, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPAs toured the indoor and outdoor areas of the single story home during today’s inspection. Licensee stated that there are no off limit areas in the home. The off-limit outdoor: detached garage (converted rental unit) and fenced area behind rental unit. LPAs advised licensee that prior to using off limits areas for daycare, licensee needs to notify Licensing and arrange for an inspection. LPAs observed a fully charged 3A-40B-C fire extinguisher but did not have a punch date or purchase receipt. There is working smoke and carbon monoxide detectors, and a working telephone 831-419-5126. The home was clean, well-ventilated, and stocked with toys and playthings that are safe and age-appropriate for the children. LPAs observed all poisons were locked, and hazardous items were securely stored out of reach of children. No bodies of water were observed. Licensee was reminded that smoking is not allowed, and baby walkers, bouncers, jumpers, or similar items cannot be used. And that care must be taken to keep these items inaccessible. The home has a barricaded fireplace in the living room. The Licensee confirmed that no firearms or ammunition were on the premises. The Licensee was reminded to notify the department prior to any alterations or additions to the home or grounds. Licensee has two cats that are vaccinated.

Licensee’s CPR/First expires 12/30/2025, Mandated Reporter Training expires: 4/5/2026. S1's CPR/First Aid expires: 12/30/25, Mandated Report Training Expires: 4/5/2026. . LPAs reminded Licensee that the Mandated Reporter training and CPR/1st Aid requires renewal every two years. Licensee has the required vaccines (MMR, Pertussis, & flu). LPAs reviewed the facility roster (LIC 9040) and nine (9) children's files confirming they were complete with the required forms, including the Affidavit Regarding Liability Insurance (LIC282). Licensee stated that a child will be isolated from the other children in the kitchen area if necessary due to illness or communicable disease until a parent/guardian is able to pick them up.

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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HURLEY, DEBBIE
FACILITY NUMBER: 444405736
VISIT DATE: 01/23/2025
NARRATIVE
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LPAs discussed the safe sleep regulations with licensee, Debbie Hurley, and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (8004314-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Licensee was reminded Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Child Care option to receive email communication.

During the exit interview, the Licensee confirmed no Registered Sex Offenders reside at the facility. The LPA completed the RSO profile in FAS on January 15, 2024. A search of the California Attorney General-Megan’s Law website found no registered sex offenders at the facility address.

Continuation on next page
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HURLEY, DEBBIE
FACILITY NUMBER: 444405736
VISIT DATE: 01/23/2025
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

During today’s inspection, Type A and Type B deficiencies were issued on attached 809-D’s. Appeal rights provided.

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

LPAs informed licensee, Debbie Hurley, that this report dated 01/23/25 documenting a Type A citation 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, LPAs informed the Licensee, Debbie Hurley, to provide a copy of this licensing report dated 01/23/25 that documents any 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.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
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Document Has Been Signed on 01/23/2025 04:11 PM - It Cannot Be Edited


Created By: Darnella Barnes On 01/23/2025 at 03:09 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: HURLEY, DEBBIE
FACILITY NUMBER: 444405736

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/23/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation, Licensee's assistant (S1) was alone with eight (8) children: 2 infants and 6 preschool age which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/24/2025
Plan of Correction
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Licensee agreed to submit a written Plan of Correction on how she will maintain the required ratio and capacity at all times.

Licensee submitted a written Plan of Correction during the inspection.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Susy Cervantes
LICENSING EVALUATOR NAME:Darnella Barnes
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/23/2025 04:11 PM - It Cannot Be Edited


Created By: Darnella Barnes On 01/23/2025 at 03:09 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: HURLEY, DEBBIE
FACILITY NUMBER: 444405736

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/23/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation, the 3A40BC fire extinguisher does not have a punch date or purchase date which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/30/2025
Plan of Correction
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Licensee states that she will purchase a new required size fire extinguisher and will submit proof of purchase/photos to Licensing by 01/30/25.
Type B
Section Cited
CCR
102425(b)(3)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects. (3) There shall be no objects hanging above or attached to the side of the crib.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation, there were hanging blankets on the cribs which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/30/2025
Plan of Correction
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Licensee states that she will submit a written Plan of Correction to stop hanging blankets or any objects on the crib.
Licensee submitted written Plan of Correction during the inspection.
Deficiency corrected.
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:Susy Cervantes
LICENSING EVALUATOR NAME:Darnella Barnes
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2025


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