Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009183
Report Date: 02/09/2016
Date Signed 02/09/2016 11:30:55 AM

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:GILMORE, SUSANFACILITY TYPE:
850
ADDRESS:703 NORTH WEBSTER STREETTELEPHONE:
(707) 778-4762
CITY:PETALUMASTATE: CAZIP CODE:
94952
CAPACITY:16CENSUS: 0DATE:
02/09/2016
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Kimberlie Milus, ApplicantTIME COMPLETED:
10:15 AM
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A prelicensing visit was conducted today by LPA S. Keehn. Michelle Panizzera, Operations Manager is also present. Interviews are being conducted to hire a director for this site. This is a Title V program with one room, #18, that is on the Valley Vista Elementary School site. Hours will be M-F 7:30 to 4:30. Classrooms have furniture and equipment that is age appropriate. Heating, lighting, and ventilation is adequate. Drinking water is readily available by fountain both inside and out. There is adequate storage for the children's belongings. There is 35 square feet of indoor space per child based on the total requested capacity of 16. The nurse office and staff restroom will be used as an isolation area for the care of an ill child. NBCC staff will remain with the child until the parent arrives. A waiver is requested to use the school bathroom down the hall. It has several toilets and one sink with a spray faucet for multiple children's use. Toilets flush and faucets work. Toilet paper and paper towels are available. There is another sink in the classroom and play yard. Food preparation area is inaccessible to children. All food will be prepared by the school district and brought to this classroom. Solid waste will be disposed in a can that has a tight fitting lid. The school district has poisons locked. There are no firearms. Cots and mats have been ordered and will be stored properly. There is a working telephone on the premises. First aid supplies are inaccessible to children. At least 1 staff person with current pediatric First Aid/CPR cards and Preventative Health will be present at all times when children are in care.
The outdoor play area is inspected. There is more than 75 square feet per child based upon requested capacity and this is shared with Kindergarten children but not at the same time. A waiver is requested. Climbing structure is securely anchored and cushioning material is adequate. Shade is provided by a overhang and by trees in summer and the climbing structure has a little shade. Fencing is at least 4 feet high around the perimeter of the play yard.
Kimberly is aware of posting requirements and forms required to operate a Child Care Center. A fire clearance has been granted. There is a carbon monoxide detector. Updated information such as IMS-Plan of Op and other information has been given.
A license will be issued after:
Director and other staff are hired. Napping equipment is received. Waivers are approved.
SUPERVISOR'S NAME: Linda WalkerTELEPHONE: (707) 588-5034
LICENSING EVALUATOR NAME: Susan KeehnTELEPHONE: (707) 588-5056
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2016
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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