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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490110708
Report Date: 10/27/2022
Date Signed: 10/28/2022 04:37:20 PM


Document Has Been Signed on 10/28/2022 04:37 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:BETHLEHEM CHILDRENS CENTER-INFANTFACILITY NUMBER:
490110708
ADMINISTRATOR:MC NALLY, DEBORAHFACILITY TYPE:
830
ADDRESS:1300 ST. FRANCIS RD.TELEPHONE:
(707) 538-2266
CITY:SANTA ROSASTATE: CAZIP CODE:
95409
CAPACITY:8CENSUS: 4DATE:
10/27/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:54 PM
MET WITH:Deborah McNallyTIME COMPLETED:
02:15 PM
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An annual inspection was made to the facility by LPA, Mary Trinh. 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. This is a combination Center with a separate preschool and infant/toddler license. The infant/toddler license operates in rooms called "Precious Ones".
Operating hours are 7:30 am - 4:30pm, Mon-Fri. 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 play yards. The items which could pose a danger to children (detergents and cleaning compounds) were inaccessible to children. The Director, Deborah McNally stated that poisons are not stored on site and none were observed. 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 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. Food prep areas are clean. Food is 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. Full signatures were observed on sign/in, sign-out sheets.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Mary TrinhTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/27/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: BETHLEHEM CHILDRENS CENTER-INFANT
FACILITY NUMBER: 490110708
VISIT DATE: 10/27/2022
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Children’s records were reviewed and contained identification forms with authorized representative information, infant feeding plans and Infant Needs and Services Plans. Staff records were reviewed and contained documentation of education and training, as required.
Infant's records (4) were reviewed at 1:30 pm. Staff records (4) were reviewed at 12:20 pm.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Deborah McNally.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Mary TrinhTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022
LIC809 (FAS) - (06/04)
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