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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 210104528
Report Date: 02/10/2022
Date Signed: 02/10/2022 02:02:58 PM

Document Has Been Signed on 02/10/2022 02:02 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: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: 95DATE:
02/10/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Administrator, Lauren SocklerTIME COMPLETED:
02:10 PM
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Licensing Program Analyst (LPA), Farhaan Sarangi arrived at Textile Arts Collaborative unannounced for the purpose of conducting a Case Management-Licensee initiated inspection. Facility added a new kitchen located across from the facility.

LPA toured the kitchen on February 10, 2022 with Administrator, Lauren Sockler. Kitchen was found to be appropriate with working gas stoves, sinks and a dishwasher. LPA also observed the fire extinguisher with a last service date of January 2022. Hazardous items such as knives and utensils were locked up and inaccessible to clients in care. LPA has received Fire Safety Inspection approving the addition of the new kitchen. New construction was completed on May 2021. During the Case Management inspection, LPA requested that the facility sketch be emailed.

No deficiencies were observed or cited in the areas toured by LPA. Exit interview was conducted and a copy of this report was signed and emailed to the Administrator.
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE: DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2022
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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