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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010150
Report Date: 06/03/2022
Date Signed: 06/03/2022 01:53:32 PM

Document Has Been Signed on 06/03/2022 01:53 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:GNOMIESFACILITY NUMBER:
493010150
ADMINISTRATOR:TARA TATEFACILITY TYPE:
850
ADDRESS:7985 VALENTINE AVETELEPHONE:
(415) 515-8178
CITY:SEBASTOPOLSTATE: CAZIP CODE:
95406
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 0DATE:
06/03/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Tara TateTIME COMPLETED:
02:00 PM
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Licensing Program Analyst, (LPA) Glenn Ouye met with Director/Applicant Tara Tate to conduct the prelicensing inspection of the Gnomies application which was submitted on December 10, 2021. The application is for 30 preschool age children. The facility plans to operate Monday through Friday, 9:00am to 5:00pm.

The approved fire inspection was received on April 18, 2022 from the Sebastopol Fire Department.

The facility has three classrooms, an administrative office, a staff break room. There is a bathroom with two toilets for the students, one toilet with a lockable door for the staff. Overall there are five sinks and two toilets for the children in care.
The interior square footage supports required square footage for the 30 children. There are three fire extinguishers rated at 3A40BC. There carbon monoxide and smoke detectors were tested and functional. There is sufficient furniture, equipment, toys for the children. Sleeping mats will be provided for the children. The facility will use a sign in and sign out log. The applicant said that she may change to an electronic version in the future.

the applicant 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.






SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 06/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/03/2022
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: GNOMIES
FACILITY NUMBER: 493010150
VISIT DATE: 06/03/2022
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The outdoor activity has a large lawn and a deck. The outdoor activity area is completely fenced with a five foot see through fence. The fence was recently rebuilt to make a duck pond in accessible to the children in care. The outdoor activity area has sufficient square footage to support the 30 children.

LPA reviewed with the applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

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 applicant, Tara Tate.

The following items must be rectified prior to licensure:

1. The main entry walk path is currently gravel. The facility must ensure that the main entry walk path is paved with asphalt or cement to prevent children from tripping and falling while entering or exiting the facility.

2. The gate to the left of the storage shed will need to be constructed to meet regulation 101238 regarding accessibility to a body of water. A copy of the regulation was provided to the applicant.

3. The outdoor deck and railings have a large quantity of bird and duck feces. The applicant must clean and maintain this outdoor area prior to and while licensed to maintain a hygienic environment for the children in care.

Upon completion of the three items the applicant can notify LPA Ouye who will return to the facility to inspect the repairs and upon review and approval the facility will be approved for licensure.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2022
LIC809 (FAS) - (06/04)
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