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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009824
Report Date: 09/06/2023
Date Signed: 09/06/2023 12:39:24 PM

Document Has Been Signed on 09/06/2023 12:39 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:NAPA VALLEY COLLEGE CHILD & FAMILY-INFANT BY NCOEFACILITY NUMBER:
283009824
ADMINISTRATOR:DE LA CRUZ, MAYRAFACILITY TYPE:
830
ADDRESS:2277 NAPA VALLEJO HWY BLD 3000TELEPHONE:
(707) 256-7040
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: 21DATE:
09/06/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Mayra De La CruzTIME COMPLETED:
12:45 PM
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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 Unusual Incident Report (UIR) received on 08/02/23. LPA met with site coordinator Mayra De La Cruz.

The facility reported that on 07/28/23 at approximately 11:50 am, a child (C1) was at the fence in the toddler play yard, which connects to the preschool play yard. C1 was talking to their sibling through the fence. At that time children from C1's class were brought into the classroom in small groups to wash their hands. At approximately 11:53am a teacher walked C1 into the classroom.


During today's case management visit there were nine staff supervising 21 children. LPA met with S1 to discuss the incident and make observations. During LPA's investigation it was noted that C1 was never left unsupervised as staff from the adjoining play yard had visual on C1 at all times.


No deficiencies were cited as a result of this case management visit.


Notice of Site Visit to be posted for 30 days.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2023
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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