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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010699
Report Date: 02/03/2025
Date Signed: 02/03/2025 02:55:50 PM

Document Has Been Signed on 02/03/2025 02:55 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 CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:NORTH BAY CHILDREN'S CENTER EL COLEGIOFACILITY NUMBER:
493010699
ADMINISTRATOR/
DIRECTOR:
PAIGE NEWTONFACILITY TYPE:
860
ADDRESS:1059 CAMINO CORONADOTELEPHONE:
(707) 522-3272
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY: 43TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
02/03/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:47 AM
MET WITH:Bobbi Cardenas, Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
01:53 PM
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A Case Management inspection was conducted at the facility by Licensing Program Analyst (LPA) Y. Yang in response to an Unusual Incident Report (UIR) received 01/28/2025 involving a child sustaining an injury while in care. During today’s visit, the LPA met with the facility’s site supervisor, Bobbi Cardenas, to discuss the incident and obtain additional details. The site supervisor reported that on 01/24/25, while child C1 and C2 were playing with toy fishing poles on the play yard, C2 swung the fishing pole at C1 and the circular magnet at the end of the pole struck C1 on their head, causing C1 to start bleeding. The site supervisor reported that C1's teacher, staff S1 attended to C1 immediately and provided first aid to the child. The site supervisor reported that the child's authorized representative was notified and transported C1 to be examined by a medical professional; two staples were applied to close the wound.

During today's case management visit, the LPA reviewed with the site supervisor the facility's child supervision policies and made best practice recommendations. The site supervisor reported that the toy fishing poles have been removed from the play area and are no longer used. The site supervisor provided the LPA with a tour of the facility. This incident was reported to CCLD and the child’s authorized representative as required per regulations.

Based on available information, it has been determined that there was no evidence of violations of regulations that occurred that lead to the child's injury. This report was read and reviewed with the site supervisor, Bobbi Cardenas. There were no Title 22 violations cited during today's case management visit. The Notice of Site Visit shall be posted for 30 days.

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2025
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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