Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009183
Report Date: 10/31/2017
Date Signed 11/01/2017 09:46:35 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:MCDONALD, PAMALLAFACILITY TYPE:
850
ADDRESS:730 NORTH WEBSTER STREETTELEPHONE:
(707) 778-4762
CITY:PETALUMASTATE: CAZIP CODE:
94952
CAPACITY:40CENSUS: 16DATE:
10/31/2017
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Kim Millus, Program DirectorTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) N.Cunningham conducted a case management inspection per the Program Director request. The facility moved it's playground so that it will no longer need to share the the school's kindergarten playground. The Playground was inspected and is free of hazards. The playground has age appropriate play structure and toys. The playground has a fence that is at least 4 feet in height. The climbing structure on the playground has wooden bark to cushion a child's fall. The playground has sufficient shade. There are water fountains inside and staff take water pitchers outside children to drink water. The play area has sufficient space for the requested capacity of 24 children. The Program Director will submit a request to reduce capacity to 24.

This report was reviewed and read with the Program Director.
Notice of site visit must be posted for 30 days from today's date.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5026
LICENSING EVALUATOR NAME: Nicolette CunninghamTELEPHONE: 707-588-5058
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2017
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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