Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009183
Report Date: 07/18/2019
Date Signed: 07/18/2019 10:48:47 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
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: 17DATE:
07/18/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Pamalla McDonaldTIME COMPLETED:
10:30 AM
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At 8:30 a.m. on 07/18/2019, Licensing Program Analyst (LPA) J. Velasco conducted an unannounced case management inspection re: an Unusual Incident Report (UIR) filed by director Pamalla McDonald (D1) about an incident in which a child (C1) in care was stung by a bee and was later taken to the Emergency Room by parents.

During the inspection, there were 17 children receiving care and supervision from three staff. The facility was operating within licensed capacity and ratio requirements. LPA observed staff providing adequate supervision to children. At 9:00 a.m., LPA interviewed two staff, D1 and S4, obtained a current roster of children in care and other facility documents, reviewed facility records, and reviewed with D1 the facility's procedures for preventing and responding to injuries to children. At LPA's request, D1 called C1's parent, A1, to ask whether the child had been prescribed an epinephrine dispenser subsequent to the bee sting at the facility. LPA advised and D1 agreed she will call 911 if C1 is stung by a bee.

Interviews corroborated that staff took reasonable precautions to ensure children in care were safe, contacted C1's parents in a timely manner when the bee sting was discovered to ask if C1 was allergic to bee stings, provided timely care and monitoring, and requested C1's parent pick up C1 immediately. In order to minimize risk of additional bee stings, D1 stated staff are no longer using the on-limits grassy field as an outdoor play area in order to minimize risk of children sustaining bee sting injuries. No deficiencies were cited during this inspection.
A Notice of Site Visit was posted.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019
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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