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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493002286
Report Date: 11/30/2023
Date Signed: 11/30/2023 04:54:38 PM

Document Has Been Signed on 11/30/2023 04:54 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:SUMMERFIELD WALDORF SCHOOLFACILITY NUMBER:
493002286
ADMINISTRATOR:CATHERINE SCHLAGERFACILITY TYPE:
850
ADDRESS:655 WILLOWSIDE ROADTELEPHONE:
(707) 575-7194
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 49DATE:
11/30/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
12:04 PM
MET WITH:Catherine SchlagerTIME COMPLETED:
05:10 PM
NARRATIVE
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An initial required 3-Year inspection was made to the facility by Licensing Program Analyst (LPA), Amy Strother on 11/15/23. The purpose of today's visit was to conduct a Case-Management - Annual Continuation visit. LPA met with Center Director, Catherine Schlager. Five children’s (C1-C5) records were reviewed and contained complete and current information as required. Five staff (D1 & S1-S4) files were reviewed. S2's file did contain transcripts, however the transcripts on file did not contain documentation of Early Childhood Education/Child Development units and S2 was observed during today's visit working in the role of teacher with 9 children outdoors without another staff present. At least one staff person present (D1) possessed a current CPR and First Aid certificate, which expires 08/2025.

The following violation of the California Code of Regulations, Title 22; Division 12, was observed: see LIC-809D. Appeal Rights were provided.

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.

Exit interview conducted and report was reviewed with Facility Representative, Catherine Schlager.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2023
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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Document Has Been Signed on 11/30/2023 04:54 PM - It Cannot Be Edited


Created By: Amy Strother On 11/30/2023 at 04:24 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: SUMMERFIELD WALDORF SCHOOL
FACILITY NUMBER: 493002286

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.1(c)(1)
Teacher Qualifications and Duties
(c) To be a fully qualified teacher, a teacher shall have one of the following: (1) Twelve postsecondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, at an accredited or approved college or university; and at least six months of work experience in a licensed child care center or comparable group child care program.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in one out of five staff. Staff 2 (S2) was observed working in the role of teacher with 9 children outdoors without another staff present and did not have documentation of Early Childhood Education/Child Development units on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/30/2023
Plan of Correction
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Center Director stated that she will work with S2 and the Human Resources (HR) Coordinator to obtain S2's documetation of teacher qualifications, submit them to LPA Strother and add them to S2's file by 12/30/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Alexis Hollon
LICENSING EVALUATOR NAME:Amy Strother
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2023


LIC809 (FAS) - (06/04)
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