213000762-10-21-2025-05-CC-NTRN-DMP3JL-20251021181743

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213000762
Report Date: 10/21/2025
Date Signed: 10/21/2025 06:18:04 PM

Document Has Been Signed on 10/21/2025 06:18 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	NORTH BAY CHILDREN'S CENTER		FACILITY NUMBER:	213000762
ADMINISTRATOR/ DIRECTOR:	KRISTINA SISSECK		FACILITY TYPE:	850
ADDRESS:	932 C STREET		TELEPHONE:	(415) 883-6222
CITY:	NOVATO	STATE: CA	ZIP CODE:	94949
CAPACITY: 107	TOTAL ENROLLED CHILDREN: 107	CENSUS: 67	DATE:	10/21/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:40 AM
MET WITH:	Kristina Sisseck and Paige Newton		TIME VISIT/ INSPECTION COMPLETED:	06:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/21/2025, at approximately 9:40AM, Licensing Program Analysts (LPAs) Nicole Tran and Jonathan Tse conducted an unannounced annual visit at the facility. LPAs met with Chief Program Officer, Kristina Sisseck (D1), and Program Director, Paige Newton (D2). LPAs explained the purpose of the visit. Present during the visit was D1, D2, 13 staff, and 67 preschool age children. The facility is operating within staffing and ratio requirements on this day. This facility is a combination center, with an infant license (213000763) located on the same premises. LPAs and D2 inspected the facility for any health or safety hazards. LPAs observed there to be fully charged 2A10BC fire extinguishers present. Smoke detectors were observed to be installed in each classroom. There is a fire alarm system running throughout the facility. Emergency exits are clearly marked and visible. Evacuation routes are posted and accessible for review by staff. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care. There are temperature and ventilation controls available for the comfort and safety of children in care. Outlets are covered or blocked by furniture when not in use. Off-limits areas in classrooms are kept inaccessible with childproof gates. This facility operates in 4 classrooms: Room 102 (Buzy Bees), Room 107 (Hummingbirds), Room 112 (Butterflies), and Room 116 (Ladybugs). Room 127 is also used as an art therapy room. Continued on Page Two

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Nicole Tran
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NORTH BAY CHILDREN'S CENTER	FACILITY NUMBER: 213000762
	VISIT DATE: 10/21/2025

NARRATIVE

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LPAs observed there to be age-appropriate toys and learning materials present. Furniture is age-appropriate and free of rough or sharp edges. Cubbies are labeled and available for children to use as storage. Children have access to art supplies, manipulatives, and toys. The facility provides cots for children to nap on. Cots are labeled with each child’s name. LPAs advised that sheets made for cots be used for napping children. Per D2, sheets are provided by the facility and cleaned at the facility as needed. Bedding is brought from home and taken back once a week for cleaning. Bathrooms and handwashing sinks were observed to be operational.

The facility provides water bottles for children in care. Water bottles are labeled with each child’s name. Drinking water is provided from a non-contaminating fixture. Per D2, the facility provides all meals (breakfast, lunch, and afternoon snack) for children in care. Menus are posted and accessible for review in each classroom. Allergy lists are posted in classrooms where children with food allergies are present and are accessible for review by staff.

LPAs inspected the Kitchen and observed food to be stored separately from cleaning chemicals and products. Food is stored and labeled with expiration dates. No items were observed to be expired. Food allergies are posted and accessible for review by Kitchen staff.

LPAs observed the outdoor play area to be enclosed by a fence that is at least four feet high. The surface of the outdoor play area was observed to be free of debris and other loose articles. There are age-appropriate toys and equipment present. LPAs advised that bikes and other similar equipment be checked to ensure all handlebars and pedals are present. There is resilient padding in the form of woodchips. There is shade available from the building. Water bottles are brought outside with children and kept accessible as needed. There are no swimming pools or other similar bodies of water present. There are no firearms or weapons stored in the facility.

LPAs reviewed 10 staff files, 6 children’s files and facility records. There is at least one staff member present with current Pediatric First Aid/CPR training. LPAs observed that 6 out of 10 staff files did not have current or verifiable Mandated Reporter training. LPAs informed D1 that a deficiency shall be cited today.

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Nicole Tran
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NORTH BAY CHILDREN'S CENTER	FACILITY NUMBER: 213000762
	VISIT DATE: 10/21/2025

NARRATIVE

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All children’s files reviewed were observed to be complete. Sign in/out sheets were reviewed during the visit. The facility has recently reactivated its license and per D1, will be conducting an emergency drill next week. LPAs advised that drills shall be logged and that drill logs must be made available for review upon request. D1 stated that they understood.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a
maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Nicole Tran
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NORTH BAY CHILDREN'S CENTER	FACILITY NUMBER: 213000762
	VISIT DATE: 10/21/2025

NARRATIVE

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Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

See LIC809-D for deficiency cited today regarding Mandated Reporter training.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided and explained.

Exit interview conducted and report was reviewed with the facility representative, Kristina Sisseck.

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Nicole Tran
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/21/2025 06:18 PM - It Cannot Be Edited

Created By: Nicole Tran On 10/21/2025 at 05:07 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NORTH BAY CHILDREN'S CENTER	FACILITY NUMBER: 213000762
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 6 out of 10 staff files, current Mandated Reporter training was not available for review, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/14/2025
	Plan of Correction
1 2 3 4	The facility shall email LPA Tran evidence of all staff completing current Mandated Reporter training. Mandated Reporter training can be completed at https://mandatedreporterca.com/

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:

	Nicole Tran
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/21/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC809 (FAS) - (06/04)

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