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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 480111107
Report Date: 03/05/2020
Date Signed: 03/05/2020 12:49:35 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:MOTHER'S DAY OUT-INFANT CENTERFACILITY NUMBER:
480111107
ADMINISTRATOR:SALM-JACOBS, MARGARETFACILITY TYPE:
830
ADDRESS:425 HEMLOCKTELEPHONE:
(707) 448-5159
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY:16CENSUS: 5DATE:
03/05/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Margaret JacobsTIME COMPLETED:
01:10 PM
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An inspection was made to the facility by LPA Martinez. The facility file was reviewed prior to this visit. A review of the personnel report on file indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Operating hours are 9- 1pm, Mon-Thu and closed on Friday. The facility was toured inside and outside and the floor and yard plan were verified. Activity space for infants is separate from other age groups. Infant and toddlers each have separate classrooms and shared play yard. The items which could pose a danger to children (detergents and cleaning compounds) were inaccessible to children. The director stated that poisons are located in a janitorial closet for the church. The facility was free of flies, insects and rodents. The toys, floors, and other equipment and surfaces appeared clean, toxic free, safe for infants and in good condition. There is uncontaminated drinking water available to children both indoors and outdoors. The infant changing tables have at least 3" sides and sanitary vinyl pads that are at least 1" thick. The toddler bathroom and hand washing area appeared to be in safe and sanitary operating condition. There was sufficient napping equipment (cribs and cots) available that meet requirements. A current menu was posted. Bottles are properly stored and refrigerated as needed. Garbage cans containing solid waste have tight fitting lids. The playground was free of hazards. The playground equipment and surface areas appeared in safe condition. There were no bodies of water observed. The director stated no weapons are stored on site and none were observed. During today's inspection, infant/toddler staffing ratios were being met and children were being directly supervised. The facility was operating within the licensed capacity. At least one staff member present possessed current CPR and First Aid certifications. Children’s records were reviewed and contained identification forms with authorized representative information, infant feeding plans and Infant Needs and Services Plans were being updated with the schools current update period being conducted this week. Staff records were reviewed and contained documentation of education and training, as required.
This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed 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.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
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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