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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490109376
Report Date: 05/30/2023
Date Signed: 05/30/2023 02:48:12 PM


Document Has Been Signed on 05/30/2023 02:48 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:MONTESSORI SCHOOL OF SONOMA-SCHOOL AGEFACILITY NUMBER:
490109376
ADMINISTRATOR:VAUGHN, CATHYFACILITY TYPE:
840
ADDRESS:19675 8TH STREET EASTTELEPHONE:
(707) 996-2422
CITY:SONOMASTATE: CAZIP CODE:
95476
CAPACITY:25CENSUS: 0DATE:
05/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:22 PM
MET WITH:Cathy VaughnTIME COMPLETED:
03:02 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 inspection was made to the facility by Licensing Program Analyst (LPA) Mindy Mohr. The facility file was reviewed prior to this visit.
This program would operate M-F 7:00am-6:00pm. This school age license of this combination center is licensed for 25 children. The Director states that school age care has not been provided for over 2 years but wants to keep the license active. The class is being used for care for preschool children in the afternoon for alternative play. The facility was toured inside and outside with the Director and the floor and yard plan submitted by the licensee were verified. There is a charged fire extinguisher in close proximity to the classroom. There is a working carbon monoxide detector on site. The two bathrooms were stocked and clean. The outdoor play area is separate from the preschool and infant play areas and completely fenced. This includes a large garden area.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

Director stated that no weapons are stored on site and that there are no bodies of water and none were observed.


There were no Title 22 deficiencies cited during today's inspection.

Exit interview conducted and report was reviewed with Assistant Director, Sarah Robertson.

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

Failure to keep this notice posted for 30 days may result in a civil penalty of $100.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melinda MohrTELEPHONE: (707) 494-2125
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2023
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 1