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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 553616388
Report Date: 02/24/2022
Date Signed: 02/24/2022 12:57:22 PM


Document Has Been Signed on 02/24/2022 12:57 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:SIERRA WALDORF SCHOOLFACILITY NUMBER:
553616388
ADMINISTRATOR:HINKEL, BRANDYFACILITY TYPE:
850
ADDRESS:19234 RAWHIDE ROADTELEPHONE:
(209) 984-0454
CITY:JAMESTOWNSTATE: CAZIP CODE:
95327
CAPACITY:16CENSUS: 0DATE:
02/24/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Stefanie Vega StrongTIME COMPLETED:
11:00 AM
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Application Specialist (AS) Alecia Sifuentes met with Facility Representative, Stefanie Vega Strong for the purpose of an announced change of capacity case management inspection. Licensee requests to serve 24 preschool children from 2 years to entry into first grade. The program operates Monday through Friday from 8:00 a.m. to 3:00 p.m. The fire clearance was granted and received on 12/16/2021.

INDOOR ACTIVITY SPACE:
There are two preschool classrooms. AS observed a sufficient amount of equipment, toys, tables, chairs, and cubbies. AS measured two classrooms. The total classroom space contains a total of 1,056 square feet, which will accommodate licensee's request for 24 preschool children. There are 3 toilets and 4 sinks for the children, and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. AS used current outdoor measurements. The outdoor play area contains a total of 2,816 square feet, which will accommodate Licensee's request for 24 preschool children.

AS discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. AS also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Report continues on LIC809-C.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2022
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: SIERRA WALDORF SCHOOL
FACILITY NUMBER: 553616388
VISIT DATE: 02/24/2022
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Licensee was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the facility representative, Stefanie Vega Strong. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Effective today, 2/24/2022, AS will approve the capacity change of 24 licensed to serve children from age 2 years to entry into first grade.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022
LIC809 (FAS) - (06/04)
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