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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493002286
Report Date: 10/02/2019
Date Signed: 10/02/2019 02:52:03 PM

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:SUMMERFIELD WALDORF SCHOOLFACILITY NUMBER:
493002286
ADMINISTRATOR:CATHERINE SCHLAGERFACILITY TYPE:
850
ADDRESS:655 WILLOWSIDE ROADTELEPHONE:
(707) 575-7194
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY:58CENSUS: 40DATE:
10/02/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Catherine SchlagerTIME COMPLETED:
03:20 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
LPA Strother made an unannounced inspection and met with Director, Catherine Schlager and HR Coordinator Carrie Wooldridge for the purpose of remeasuring the 3 buildings used for the facilities Preschool license, four classrooms and two outdoor spaces. Two buildings contain 1 classroom each and the third building contains two classrooms. The four classrooms measured were the Rosebud room referred to as the Preschool classroom, the Red Rose room, White Rose room and Yellow Rose room referred to as the Kindergarten classrooms. LPA Strother measured classrooms and yards and documented the measurements on form LIC9024 Capacity Worksheet. Based on measurements, the capacity limitation based on the 3 buildings/4 classrooms is 84 children. During today's inspection LPA requested that Carrie Wooldridge submit the following documents to Community Care Licensing Regional Office (CCLRO): LIC999, facility sketches for the classrooms and the two yards, an updated LIC200A application for a child care center license requesting an increase capacity of 84, a check for $25 and form LIC9054 local fire inspection authority information. Carrie stated that once the above forms have been completed she will fax them into CCLRO. Once CCLRO receives the above forms a request for a fire clearance will be submitted to the local Fire Marshall and the total capacity will be determined.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy StrotherTELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2019
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