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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493002286
Report Date: 02/29/2024
Date Signed: 02/29/2024 12:33:58 PM

Document Has Been Signed on 02/29/2024 12:33 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: 62CENSUS: DATE:
02/29/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Catherine SchlagerTIME COMPLETED:
12:43 PM
NARRATIVE
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On 02/29/24 at 10:30am, Licensing Program Analyst (LPA), Amy Strother made a case management inspection and met with Director Catherine Schlager (D1). The inspection was made in response to water lead testing results provided by the facility representative (F1) after receiving the lab results. LPA was not able to confirm the results with the California State Water Resource Control Board, as the results had not yet been received or recorded. On 02/15/24 LPA informed facility representative (F1) that the certified water sampler should follow up with the lab to ensure the results are electronically submitted to the State Water Board. F1 was informed that the test results showed that the following faucet, tested above the allowable level (5 ppb) of lead in the water: Faucet “D” – Sink Faucet, in Seedling Classroom, tested at 6.2 ppb. On 02/15/24 F1 emailed LPA Strother a photo of faucet D with a sign that read, “Do not use.”

During today’s inspection, LPA observed that the staff have made the faucet inaccessible by placing a plastic bag over the faucet with a sign that reads, “Out of Order”, staff S1 in the Seedlings Classroom stated that the faucet has been replaced and they are following the directives to flush the new faucet prior to retesting. S1 stated that the children in care are receiving drinking water from jugs of water filled from faucets A, B, C or E that all tested within safe levels.

The following deficiency is being cited (see LIC 809D). 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 the Director Catherine Schlager.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE: DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/29/2024
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 02/29/2024 12:33 PM - It Cannot Be Edited


Created By: Amy Strother On 02/29/2024 at 11:20 AM
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: 02/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/30/2024
Section Cited

101700.3(b)(2)

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Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care.


This requirement was not met as evidenced by:
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Licensee has made the faucet “D” temporarily inaccessible by placing a bag over the faucet with an “Out of Order” sign and have replaced the faucet, to be retested after the required flushing period. Children receive drinking water from faucets A, B, C or E transported in water jugs to the Seeding classroom.
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On 02/29/24, licensee failed to maintain a lead value at or below the Action Level for water lead testing resulting with values of 5.5 ppb or greater for Faucet “D” – Sink Faucet, in Seedlings Classroom, with a result of 6.2 ppb. Water testing results identified with Action Level Exceedance as defined in WD section 101700.3. are not deemed safe to drink. This is a potential health and safety risk to children in care.
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The licensee plans to retest the faucet on 3/15/24, submitting new test results once received. F1 posted test results on the bulletin board outside of the classroom and will notify all parents and guardians of the steps taken to correct the deficiency.

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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: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024


LIC809 (FAS) - (06/04)
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