Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493006543
Report Date: 01/30/2017
Date Signed: 01/30/2017 12:35:29 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:NORTH BAY CHILDREN'S CENTER - SCHOOL-AGEFACILITY NUMBER:
493006543
ADMINISTRATOR:BULLARD, MARLENEFACILITY TYPE:
840
ADDRESS:1001 A CHERRY STREETTELEPHONE:
(707) 763-6222
CITY:PETALUMASTATE: CAZIP CODE:
94952
CAPACITY:45CENSUS: 0DATE:
01/30/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Marisa Scheinberg, Site SupervisorTIME COMPLETED:
01:00 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
(3) A visit was made to the facility by LPA N.Cunningham. The facility file was reviewed prior to this visit. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Operating days and hours are Monday through Friday, 7:30am-8:15am and 1:30pm-6:00pm. The facility was toured inside and outside; the floor and yard plan were verified. The facility appeared clean and orderly. The items that could pose a danger to children (cleaning compounds, sharps, and medications) were inaccessible to children. The licensee stated poisons are locked in a shed. The toys, floors, desks and other equipment appeared clean and safe. There was drinking water available to children both indoors and outdoors. The children's bathrooms appeared in safe and sanitary operating condition. Food is provided at the facility; a current menu was posted. Food was protected from contamination and foods prone to spoilage were refrigerated at an appropriate temperature. Containers for solid waste had a tight-fitting lid. There is a working carbon monoxide detector, smoke detector and fire extinguisher in the facility. The playground was completely fenced and free of hazards. The playground equipment appeared in safe condition. There were no bodies of water on the premises. The sign in/out procedure was reviewed; authorized representatives are signing children in/out. At least one staff member present possessed current CPR and First Aid certifications which expire 6/17. All licensing reports are public information and must be made available upon request.

There were no Title 22 deficiencies cited during today's visit.
Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5026
LICENSING EVALUATOR NAME: Nicolette CunninghamTELEPHONE: 707-588-5058
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2017
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1