<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490109162
Report Date: 08/04/2021
Date Signed: 08/04/2021 01:19:34 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:OLD ADOBE SCHOOLFACILITY NUMBER:
490109162
ADMINISTRATOR:MURRAY, MICHAELAFACILITY TYPE:
850
ADDRESS:252 WEST SPAIN STREETTELEPHONE:
(707) 408-2383
CITY:SONOMASTATE: CAZIP CODE:
95476
CAPACITY:30CENSUS: 14DATE:
08/04/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Michaela Murray, DirectorTIME COMPLETED:
01:35 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
An annual, required- 1 Year inspection was made to the facility by Licensing Program Analyst (LPA), Kevin O'Connell. The facility file was reviewed prior to this visit. A review of the personnel report on 8/04/2021 indicates that facility staff have received criminal record and child abuse index clearances or exemptions. Operating hours 07:30am- 05:30pm, Monday-Friday. The5 three classrooms at this facility.
The facility was toured inside and outside and the floor and yard plan were verified. The facility was clean and orderly. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of reach of the children. The Director states that there are no poisons but can be combination locked in the shed in the parking lot. The toys, floors and other equipment are clean, safe and age appropriate for children. A current snack menu was posted. Food prep areas are clean. Food is properly stored and refrigerated as needed. Children bring their lunches.
Garbage cans containing solid waste have tight fitting lids. There is a working carbon monoxide detector and fire extinguisher in the facility. The playground is completely fenced and free of hazards. There is sand underneath climbing structures and play equipment to absorb falls. Children have access to drinking water indoors and outdoors. The children’s bathrooms were in safe and sanitary condition.
The Director stated no firearms or dangerous weapons are stored on site and none were observed.
During today's inspection, staffing ratios were being met and there were 14 children being supervised by four teachers and the Director in two classrooms . The facility was operating within the licensed capacity and ratio.
The Director stated that there were no bodies of water and none were observed. At least one staff member present possessed current Pediatric CPR and First Aid certifications. Sign in/out procedure was reviewed and in compliance.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: OLD ADOBE SCHOOL
FACILITY NUMBER: 490109162
VISIT DATE: 08/04/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Ten children’s records were reviewed at 12:25pm, and contained identification forms with authorized representative information, as well as medical assessments. Five staff records were reviewed at 12:43pm, and contained immunizations and Mandated Reporting certificates.
This facility is not providing Incidental Medical Services (IMS) to children.
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 was reviewed and discussed with the Director. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

No violations were cited during today's visit.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2