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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483010481
Report Date: 10/24/2024
Date Signed: 10/24/2024 05:19:05 PM

Document Has Been Signed on 10/24/2024 05:19 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:BAYNORTH LEARNING CENTER - PRESCHOOLFACILITY NUMBER:
483010481
ADMINISTRATOR/
DIRECTOR:		JACKSON, JACQUELINEFACILITY TYPE:
850
ADDRESS:2100 PENNSYLVANIA AVENUETELEPHONE:
(707) 720-5278
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY: 53TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
10/24/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:25 PM
MET WITH:Center Director Sabrina OldaniTIME VISIT/
INSPECTION COMPLETED:
05:25 PM
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Licensing Program Analyst ( LPA) Elpidia Hernandez Torres arrived to the facility to conduct a case management visit and ask additional questions regarding a self reported incident that occurred during nap time. On 09/24/24, a child was not able to be woken up by their siblings, staff was able to wake up child.

While LPA was present, LPA reminded Center director of the regulations regarding Unusual incident reports and reporting requirements.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2024
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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