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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009390
Report Date: 08/07/2019
Date Signed: 08/07/2019 01:14:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:NAPA COUNTY THERAPEUTIC CHILD CARE CNTR-INF/TODLRFACILITY NUMBER:
283009390
ADMINISTRATOR:BROWN, TOBIAHFACILITY TYPE:
830
ADDRESS:2751 NAPA VALLEY CORP BLDG BTELEPHONE:
(707) 287-8326
CITY:NAPASTATE: CAZIP CODE:
94559
CAPACITY:16CENSUS: 4DATE:
08/07/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Tobiah BrownTIME COMPLETED:
01:28 PM
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LPA Kevin O'Connell made an unannounced inspection to follow up on an unusual incident and to consult and assist with filling out the (LIC624) Unusual Incident Report Form. The unusual incident consisted of a teacher submitting a CPS report after observing noticeable behavioral changes. When the teacher approached the mother about it the mother stated that she believed that the child was being molested possibly by the babysitter so a CPS report was made. A copy of the CPS report was requested and will be sent to CCL in the next few days.
LPA reviewed the procedure of filling out the unusual incident report in it's entirety with the Director.
The following information regarding ADA is provided: US Department of Justice toll-free ADA Information Line at (800) 514-0301 (voice)/(800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, www.ada.gov/childqanda.htm.
This report, as well as the AAP Guide to Safe Sleep, Safe Sleep in Childcare brochure, What does a Safe Sleep Environment Look Like brochure & Safe Sleep Concepts handout, were reviewed and discussed with the Director. The Effects of Lead Exposure brochure has been reviewed with and discussed with the Director.
All licensing reports are public information and must be made available upon request for at least three years.
Notice of Site Visit shall be posted for 30 days from today's visit.
Failure to keep this notice posted for 30 days may result in a civil penalty of $100.
No deficiencies were cited today.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019
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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