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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 445202258
Report Date: 07/18/2024
Date Signed: 07/18/2024 03:33:07 PM

Document Has Been Signed on 07/18/2024 03:33 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:POPPY HILL HOMEFACILITY NUMBER:
445202258
ADMINISTRATOR/
DIRECTOR:
BILL & DEBI SANCHEZFACILITY TYPE:
735
ADDRESS:331 SAN LUIS AVE.TELEPHONE:
(831) 768-1625
CITY:WATSONVILLESTATE: CAZIP CODE:
95026
CAPACITY: 6CENSUS: 6DATE:
07/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Bill and Debi SanchezTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Bill and Debi Sanchez.

During visit, LPA Marrufo toured the facility inside and out. During visit, LPA Marrufo toured the kitchen area and observed a perishable food supply of two days and a non-perishable food supply of at least seven days. LPA observed a locked storage closet used to store sharps and cleaning supplies. LPA toured 2 out of 2 resident bathrooms and each bathroom had working lights and available soap and paper towels. The water temperatures in the bathrooms measured at 108 F and 110 F. LPA reviewed the first aid kit and found it to be complete. The smoke detector system was tested during visit and found to be functioning properly. 2 out of 2 carbon monoxide detectors functioned properly when tested. The outdoor area was toured and the outdoor exit was clear of obstructions. LPA toured 3 out of 3 resident rooms and each room had available bedding and clothing storage areas as well as working lights.

LPA Marrufo reviewed 6 out of 6 Centrally Stored Medication and Destruction Records and found them to be complete. LPA reviewed 6 out of 6 Personal and Incidental Money Logs and found them to be balanced. LPA reviewed 6 out of 6 resident records and found them to be complete. LPA reviewed 5 staff records and found them to be complete. The last recorded emergency disaster drill was conducted on 06/24/2024.

This report was reviewed with Administrators Debi and Bill Sanchez and a copy of this report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2024
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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