Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009183
Report Date: 02/01/2019
Date Signed: 02/01/2019 02:20:52 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 CHILDRENS CENTER-VALLEY VISTAFACILITY NUMBER:
493009183
ADMINISTRATOR:MCDONALD, PAMALLAFACILITY TYPE:
850
ADDRESS:730 NORTH WEBSTER STREETTELEPHONE:
(707) 778-4762
CITY:PETALUMASTATE: CAZIP CODE:
94952
CAPACITY:24CENSUS: 15DATE:
02/01/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Pamalla "Pam" McDonaldTIME COMPLETED:
02:25 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
An inspection of the facility was conducted by Licensing Program Analyst (LPA), Jennifer Velasco. LPA met with the facility site supervisor/director Pamalla "Pam" McDonald (Supervisor). The facility file was reviewed prior to this inspection. A review of the personnel report indicated that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The facility’s operating hours are 7:30 AM - 4:30 PM, Monday-Friday, year-round. The facility was toured inside and outside, and the floor and yard plan submitted by the licensee were verified. The items which could pose a danger to children (such as detergents, cleaning compounds, and medications) were observed to be stored in a locked cabinet in the kitchen and inaccessible to children. Supervisor stated there are no poisons in the facility, and none were observed. The toys, floors, desks, and other equipment and surfaces were clean, toxic free, safe, and in good condition. There was uncontaminated drinking water available to children indoors and outdoors with accessible and operable water fountains indoors and outdoors. The children's bathrooms were in safe and sanitary condition. Food prep areas were clean. Food was properly stored and refrigerated as needed. There was no contaminated food observed. Garbage cans containing solid waste had tight fitting lids. LPA observed a working carbon monoxide detector, smoke alarm, and fire extinguisher rated at least 2A10BC in the facility. The fully fenced playground was free of hazards. The playground equipment and surface areas were in safe condition. There were wood chips to provide cushioning underneath climbing structures to absorb falls. There were no swimming pools or other bodies of water observed on the property. Supervisor stated no weapons are stored on site and none were observed.

During today's inspection, staffing ratios were being met. Three staff were supervising 15 children. The facility was operating within the licensed capacity. At least one staff member present during the inspection possessed current CPR and First Aid certifications, which expire in 01/2021.

Continued on LIC 809-C.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (707) 588-5026
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2019
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
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 CHILDRENS CENTER-VALLEY VISTA
FACILITY NUMBER: 493009183
VISIT DATE: 02/01/2019
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
26
27
28
29
30
31
32
Continued from LIC 809.

The sign-in/sign-out procedure was reviewed and was in compliance. Five children’s records were reviewed at 1:30 PM and contained signed Admission Agreements and Parents' Rights forms. Three staff records were reviewed at 1:50 PM and contained documentation of education and training as required.

This facility is not currently providing Incidental Medical Services (IMS). The Department’s IMS policy was discussed with the Director. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.

The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: www.ada.gov/childqanda.htm. This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed and discussed with the Director. All licensing reports are public information and must be made available upon request for at least three years.


There were no Title 22 deficiencies cited during today's inspection.

Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (707) 588-5026
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2