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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493002526
Report Date: 04/13/2023
Date Signed: 04/13/2023 04:59:35 PM


Document Has Been Signed on 04/13/2023 04:59 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:SONOMA STATE UNIVERSITY CHILDREN'S SCHOOL-INFANTFACILITY NUMBER:
493002526
ADMINISTRATOR:NELSON,MELISSAFACILITY TYPE:
830
ADDRESS:1801 E. COTATI AVENUETELEPHONE:
(707) 664-2230
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY:12CENSUS: 9DATE:
04/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:08 PM
MET WITH:Melissa Nelson TIME COMPLETED:
04:41 PM
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An annual required inspection was made to the facility by Licensing Program Analyst (LPA), Y. Yang. The facility file was reviewed prior to this inspection. During today's inspection visit, the LPA met with Center Director, Melissa Nelson. A review of the personnel report on 04/13/23 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The 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 is a combination center with an infant and preschool license. The infant facility’s operating hours are 07:30am-05:30pm Monday, Tuesday, Wednesday, and Friday and 07:30am-03:45pm on Thursday. The facility was toured inside and outside and the floor and yard plan submitted by the licensee were verified. The infants are physically separated from the preschool age children. The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. The toys, floors and other equipment are clean, safe and age appropriate for infants. There was a crib available for each infant still napping in a crib. Cribs at the facility are in compliance with the Department's new safe sleep regulations. The vinyl padded changing table is within arm's reach of a sink. A current menu was posted. Food prep areas are clean. Food is properly stored and refrigerated and labeled as needed. There are no poisons or firearms and ammunition stored on the premises. The facility was free of flies, insects and rodents. There is drinking water available to children both indoors in the classrooms and outdoors on the playground. Garbage cans containing solid waste have tight fitting lids. The playground was free of hazards. The playground equipment and surface areas were in safe condition. There is wood chip cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed. During today's inspection, staffing ratios were being met. The facility was operating within the licensed capacity. At least one staff member present during the visit possessed current CPR and First Aid certifications. Ten children’s records were reviewed and contained identification forms with authorized representative information, as well as medical assessments, infant 15-minute sleep check logs, and infant safe sleep plans (LIC 9227) when applicable. Ten staff records were reviewed and contained the required documents as specified in the entrance checklist. Continued on LIC 809-C
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2023
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: SONOMA STATE UNIVERSITY CHILDREN'S SCHOOL-INFANT
FACILITY NUMBER: 493002526
VISIT DATE: 04/13/2023
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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.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Center Director, Melissa Nelson. There were no Title 22 deficiencies cited during today's inspection.

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/process

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC809 (FAS) - (06/04)
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