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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 210104528
Report Date: 12/09/2021
Date Signed: 12/09/2021 01:04:57 PM

Document Has Been Signed on 12/09/2021 01:04 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:TEXTILE ARTS COLLABORATIVEFACILITY NUMBER:
210104528
ADMINISTRATOR:SOCKLER, LAURENFACILITY TYPE:
775
ADDRESS:2470 5TH AVENUETELEPHONE:
(415) 453-4240
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY: 110CENSUS: 97DATE:
12/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Administrative Assistant, Carol WrightTIME COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA), Farhaan Sarangi arrived at Textile Arts Collaborative for the purpose of conducting a Required 1 year inspection. LPA was met at the door by Administrative Assistant, Carol Wright. Administrative Assistant, Carol Wright directed me to Staff Members, Nicole Lipton and Trudy Castle.

LPA toured the facility with Staff Member, Trudy Castle. All buildings were inspected. Grounds free of any apparent hazards. Smoke; Fire; Carbon Monoxide all current. All exits unobstructed. Building at a comfortable temperature. Bathrooms clean and sanitary. Hot water within range. Medications and disinfectants locked and stored away. Medications are locked in inaccessible to clients. Some clients bring their own lunches. Staff prepare lunch for clients who do not bring food. Kitchen and food prep area inspected and found to be in compliance. However, an additional kitchen is still awaiting a dishwasher. CCL was notified about this. No firearms or bodies of water. Lockers for clients personal belongings observed. Each building was inspected. Bathrooms were inspected. Water temperature measured within regulation between 105 and 120 degrees F at faucets accessible to clients. All cleaning toxins are centrally stored and locked. The facility has functioning fire sprinklers in main textile building. LPA observed fire detectors and carbon monoxide detectors in each building. Fire extinguishers observed dated 02/2021. Last disaster drill was conducted on November 5, 2021.

LPA advised facility to contact County Public Health and Community Care Licensing immediately if symptoms or COVID-19 + in the facility. Facility has PPE in the storage. Facility has been N95 Fit tested.

No deficiencies were observed or cited during today's Required 1- Year inspection. Exit interview was conducted and a copy of this report was emailed to the Administrator, Lauren Sockler.
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2021
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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