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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283006886
Report Date: 04/09/2025
Date Signed: 04/09/2025 11:59:41 AM

Document Has Been Signed on 04/09/2025 11:59 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:NCOE - NAPA PRESCHOOL PROGRAMFACILITY NUMBER:
283006886
ADMINISTRATOR/
DIRECTOR:		MICHELE EGGERTFACILITY TYPE:
850
ADDRESS:74 WINTUN CTTELEPHONE:
(707) 253-6850
CITY:NAPASTATE: CAZIP CODE:
94559
CAPACITY: 136TOTAL ENROLLED CHILDREN: 136CENSUS: 65DATE:
04/09/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Michele EggertTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
NARRATIVE
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An unannounced case management visit was made to the facility by Licensing Program Analyst (LPA) Mindy Mohr in response to a self-reported, personal rights incident involving one Staff (S2) and two Children (C1 & C2) that occurred on 03/20/2025. During today's visit LPA met with Child Development Coordinator Michele Eggert (S1) to discuss the incident and conducted staff interviews.

It was reported that on 03/20/2025 Staff (S2) took Child (C1) hand and hit another Child (C2) in the face with C1’s hand. S1 stated she was informed of the incident immediately by Staff (S3) who witnessed the incident occur. S3 stated the incident occurred on the playground by the red shed, next to the picnic table, which had Magnetic blocks on it. S3 stated they heard something, noticed C1 was crying and C2 was under the picnic table. S3 stated they walked the children over to their teacher S2. S3 then stated they observed S2 take C1’s arm into their hand and hit C2 three times. In addition, S3 further stated C2 started to cry right away and C1 was scared after the incident. S3 also stated during the incident C1's head moved back and forth, causing C1's hair to swing around. S3 stated they spoke with S2 and told them what they had just done was not ok. S3 stated S2 said sorry multiple times.

S2 stated S3 had brought both C1 and C2 over to them, and told them C2 had hit C1 with a magnetic block. S2 stated they took C1’s hand into theirs and said “Don’t touch my body”, which is when C1’s hand hit C2. S2 further stated they were unaware of camera’s on the play yard, but they are aware now.

(Continued on LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Leslie Lepori
NAME OF LICENSING PROGRAM ANALYST: Melinda Mohr
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2025
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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: NCOE - NAPA PRESCHOOL PROGRAM
FACILITY NUMBER: 283006886
VISIT DATE: 04/09/2025
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Evidence received confirmed S2 did grab C1’s hand and hit C2 three times on the upper body forcing C1’s body to move in a back and forth motion. S1 stated S2 was been placed on administrative leave 03/21/2025. S1 further stated S2 spoke with the guardian of C1 on 03/20/2025 and then on 03/21/2025 S2 spoke with the guardian of C2.

The following violation of the California Code of Regulations, Title 22; Division 12, was observed: see LIC 809D. This report was read and reviewed with Child Development Coordinator Michele Eggert. Notice of site visit shall be posted for 30 days. Appeal rights provided

LPA Mohr informed facility representatives Michele Eggert that this report dated 04/09/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Mohr informed Michele Eggert to provide a copy of this licensing report dated 04/09/2025 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

NAME OF LICENSING PROGRAM MANAGER: Leslie Lepori
NAME OF LICENSING PROGRAM ANALYST: Melinda Mohr
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/09/2025 11:59 AM - It Cannot Be Edited


Created By: Melinda Mohr On 04/09/2025 at 11:23 AM
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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: NCOE - NAPA PRESCHOOL PROGRAM
FACILITY NUMBER: 283006886

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/10/2025
Section Cited
CCR
101223(a)(3)

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a)The licensee shall ensure that each child is accorded the following personal rights: (3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
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S1 stated that S2 was placed on administration leave the following day. S1 stated they are having a site meeting today and will have a training on how to deal with frustrations and challenging behaviors with children. LPA also gave S1 the 'Tell Me What to Do Instead' handout to discuss with staff. S1 will email LPA a signed document from all staff they understand the discussion and have recieved the handout.
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This requirement was not met as evidenced by:

Based on interviews and evidence received S2 used C1’s hand to hit C2 three times which poses an immediate health, safety and personal rights risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Leslie Lepori
NAME OF LICENSING PROGRAM MANAGER:
Melinda Mohr
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2025


LIC809 (FAS) - (06/04)
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