Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009742
Report Date: 05/23/2019
Date Signed: 05/23/2019 12:22:14 PM

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:YOU & ME CHILDREN'S CENTER-INFANTFACILITY NUMBER:
493009742
ADMINISTRATOR:DONYA OLOCCO PARHAMFACILITY TYPE:
830
ADDRESS:450 HAYES LANETELEPHONE:
7077628998
CITY:PETALUMASTATE: CAZIP CODE:
94952
CAPACITY:20CENSUS: 16DATE:
05/23/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Rahul BahlTIME COMPLETED:
12:00 PM
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A prelicensing inspection was conducted by Licensing Program Analyst (LPA) J. Velasco. A change of ownership application was received by CCLD on 02/06/2019. LPA met with applicant Petaluma Children's Center authorized representative Rahul Bahl. The applicant is transferring ownership from You and Me Children's Center to Petaluma Children's Center. The location and capacity of the infant center will not be changing. Operating hours will be Mon-Fri, 7:00 a.m.-6:00 p.m. The applicants have requested a capacity of 20 infant children in two classrooms. The buildings were toured and inspected. The two classrooms measured sufficient for a total requested capacity of 20 infant children. Sufficient chairs, tables, and activities were present in the classrooms. There is a sink near the changing station. Separate staff bathrooms are available. The applicant intends to have parents bring food/formula/milk. Storage containers for waste have tight-fitting lids and food is protected from contamination. There is sufficient outdoor space available for the capacity requested. A minimum four-foot-tall fence surrounds the playground. The outdoor play area is directly outside the infant classrooms. The play equipment is age appropriate and wood chip cushioning material is under and around play equipment to absorb falls. Outdoor drinking water is available (drinking fountain). Shade is available. The classrooms are equipped with a drinking fountain. A fire clearance was obtained on 02/11/19. The sickroom area will be used as the isolation area for a sick child. The facility has a working smoke detector, fire extinguisher, and carbon monoxide detector. The applicant states there will be no poisons stored on the premises. Cleaning supplies were inaccessible to children in key locked cabinets. At least one staff had current pediatric CPR/first aid certification on file; certifications expire in 07/2020.

Continued on LIC 9099-C
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2019
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: YOU & ME CHILDREN'S CENTER-INFANT
FACILITY NUMBER: 493009742
VISIT DATE: 05/23/2019
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This facility is not currently providing Incidental Medical Services (IMS). The Department’s IMS policy was discussed with the Director. There will be a Plan of Operation on file with the Department. 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 and The Effects of Lead Exposure brochures, 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.

The application for an infant license for a capacity of 20 is granted and is effective 06/03/2019.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2019
LIC809 (FAS) - (06/04)
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