493002286-10-9-2020-01-CC-ASTR-BU8SZ3-20201009141827

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 493002286
Report Date: 10/09/2020
Date Signed: 10/09/2020 02:18:33 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 SCHOOL		FACILITY NUMBER:	493002286
ADMINISTRATOR:	CATHERINE SCHLAGER		FACILITY TYPE:	850
ADDRESS:	655 WILLOWSIDE ROAD		TELEPHONE:	(707) 575-7194
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95401
CAPACITY:	60	CENSUS: 0	DATE:	10/09/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Catherine Schlager		TIME COMPLETED:	01:44 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	The facility inspection was conducted via tele-inspection due to the COVID-19 state of emergency pandemic. The department has suspended all field operations and the applicant has agreed to conduct a video conference tele-visit with Licensing Program Analyst (LPA), Amy Strother. LPA Strother met with Center Director, Catherine Schlager to conduct the case management tele-visit in 10/09/20. During today's inspection, no children were present due to poor air quality from recent fires in the surrounding area. The application received by the department on 02/19/20 requested an increase from a capacity of 60 to a capacity of 90, adding an additional room to the license. An updated LIC999 facility sketch indicates that an additional room, named Roots & Shoots will be used. During a prior visit on 10/02/2019, LPA Strother measured 3 buildings used for the facilities current license, four classrooms and two outdoor spaces. Based on LPA Strother’s measurements, the capacity limitation based on the 3 buildings/4 classrooms and outdoor space was a maximum of 84 children. During a subsequent visit on 02/05/20 LPA Strother measured and inspected the Roots & Shoots classroom. The Roots and Shoots room measures sufficient for a capacity of 8 children. LPA Strother determined that the total indoor/outdoor space, along with numbers of sinks and toilet available will allow for the requested capacity of 90. The Fire Marshall approval was made for the requested capacity of 90 on 03/01/2020. During today’s tele-visit, the Center Director toured LPA Strother through all 5 classrooms. LPA observed in each classroom a hard wired smoke detector/fire alarm system, a carbon monoxide detector verified to work during the tour, and a fire extinguisher rated at a minimum 2A10BC . Continue on LIC809-C

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2020

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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: SUMMERFIELD WALDORF SCHOOL	FACILITY NUMBER: 493002286
	VISIT DATE: 10/09/2020

NARRATIVE

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The use of the Roots & Shoots classroom and the increase for 30 additional children bringing the total capacity to 90 is approved as of today 10/09/2020.

This report was read and discussed with Center Director, Catherine Schlager. Schlager’s signature was not recorded on this report; however, Schlager was provided with a copy of the LIC809 Facility Evaluation Report in an email dated 10/09/20 and confirmation of Schlager’s read receipt of the report is on file in place of a signature.

A new license will be sent to the licensee.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2020

LIC809 (FAS) - (06/04)

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