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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 445202381
Report Date: 12/12/2024
Date Signed: 12/12/2024 11:31:54 AM

Document Has Been Signed on 12/12/2024 11:31 AM - 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:SVS WATSONVILLE ADULT DAY PROGRAMFACILITY NUMBER:
445202381
ADMINISTRATOR/
DIRECTOR:		ALISON NOBLEFACILITY TYPE:
775
ADDRESS:1875 MAIN STREETTELEPHONE:
(831) 707-2280
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 60CENSUS: DATE:
12/12/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Masai DavisTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 10/23/2024 San Bruno Regional Office - San Jose Unit conducted a non-compliance conference meeting with Program Director Ruby Duran, Regional Director Merita Amituanai, Case Manager Daniel Rabrorar, and Director of Regional Administration Masai Davis.

Present in the meeting were Regional Manage Vivien Helbling, Licensing Program Manager Romeo Manzano, and Licensing Program Analysts David Marrufo and Simi Rai.

During the non-compliance meeting, the following serious violations were discussed: 82088(e)(1) Fixtures, Furniture, Equipment, and Supplies.

During this meeting, the compliance plan was developed and discussed with the licensee which includes more frequent monitoring inspection visits to ensure compliance with this compliance plan and Title 22 Regulations for 2 years. Licensee was provided the link below for resources and guidance to improve facility operations:

https://www.cdss.ca.gov/inforesources/community-care/resource-guide-for-providers.

This report was reviewed with Program Director Ruby Duran, Regional Director Merita Amituanai, Case Manager Daniel Rabrorar, and Director of Regional Administrator Masai Davis and a copy of the report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2024
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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