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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490107083
Report Date: 11/02/2022
Date Signed: 11/02/2022 05:02:42 PM


Document Has Been Signed on 11/02/2022 05:02 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:J.X. WILSON EXTENDED CHILD CAREFACILITY NUMBER:
490107083
ADMINISTRATOR:JASON RIGGSFACILITY TYPE:
840
ADDRESS:246 BRITTAIN LANETELEPHONE:
(707) 575-6988
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY:96CENSUS: 17DATE:
11/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:57 PM
MET WITH:Genevieve McDowellTIME COMPLETED:
05:15 PM
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A required one year inspection was made to the facility by Licensing Program Analyst (LPA), Amy Strother. LPA met with Facility Representative and Director, Genvieve McDowell (D1). Fingerprint clearances are all associated to the Wright facility #490107325. The facility file was reviewed prior to this visit. A review of the personnel report on file indicates that all facility staff have received criminal record and child abuse index clearances or exemptions. Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

This program is operated by Extended Child Care, a nonprofit agency. The facility provides care to the children in rooms 25 and 26 (and 24 when school is not in session) on the J.X. Wilson Elementary School Campus. The facility receives funding from the California Department of Education, and operates under title 5 and title 22. D1 stated that all staff files are stored off site at the Extended Child Care main office located at 1745 Copperhill Pkwy Ste. #5 Santa Rosa, CA 95403. LPA requested that files be brought to the facility for review. Files were brought over in a timely fashion.

The facility’s operating hours are 7:00am - 8:30am, Monday-Friday, 1:30pm-6:00pm Mon., Tues, Thurs. & Fri., and 11:40am-6:00pm on Wednesdays during the school year and is closed during the summer months. The facility was toured inside and outside, and the floor and yard plan submitted by the licensee were verified. Sign in/out records were reviewed and in compliance. Items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children located on high shelves out of reach of children. D1 stated there are no poisons in the facility, and none were observed during this inspection. LPA observed the toys, floors, desks and other equipment and surfaces are clean, toxic free, safe, and in good condition. There is uncontaminated drinking water available to children both indoors and outdoors using drinking fountains or individuals water bottles. A cart is brought outside during outdoor play with their water bottles on the cart.

Continued on LIC 809-C

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy StrotherTELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:
DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/02/2022
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: J.X. WILSON EXTENDED CHILD CARE
FACILITY NUMBER: 490107083
VISIT DATE: 11/02/2022
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The children's bathrooms are in safe and sanitary condition. The center’s isolation area for any child who becomes ill while in care is located in the office or cozy area in classroom #26. LPA observed food prep areas are clean. Food is properly stored and refrigerated as needed. There was no contaminated food observed. Garbage cans containing solid waste have tight fitting lids. Menus are posted in room #26 on the parent board. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the facility. LPA observed the playground equipment and surface areas were in safe condition. D1 stated that although there is a climbing structure on the playground, Extended Child Care does not use it during outside play.

There were no bodies of water observed on the site. D1 stated no weapons are stored on site, and none were observed.

During today's inspection, staffing ratios were being met, a total of 17 children were being supervised by 3 teachers/aides. The facility was operating within the licensed capacity and ratio requirements. At least one staff during the visit D1, possessed current CPR and First Aid certifications, expiring 1/2024.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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: http://www.ada.gov/childqanda.htm

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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative, Genevieve McDowell.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy StrotherTELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC809 (FAS) - (06/04)
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