493010450-8-28-2023-01-CC-GOUE-CV5SBM-20230828134411

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 493010450
Report Date: 08/28/2023
Date Signed: 08/28/2023 01:44:24 PM

Document Has Been Signed on 08/28/2023 01:44 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:	JEWISH COMMUNITY CENTER SOCO PRESCHOOL		FACILITY NUMBER:	493010450
ADMINISTRATOR:	BURG-SCHNIRMAN, DEBORAH		FACILITY TYPE:	850
ADDRESS:	3421 BONITA VISTA LANE		TELEPHONE:	(707) 528-4222
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95404
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS:	DATE:	08/28/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Sarah Welton		TIME COMPLETED:	02:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Glenn Ouye met with Sarah Welton to conduct a prelicensing inspection for this child care center. The application for the center was received on June 2, 2023 for 24 preschool age children. The fire clearance was approved on August 4, 2023. The center has three primary classroom that will be used for indoor activity. There is also a kitchen that is off limits via use of a child safety gate. There are two offices that are also off limits. There are two toilets and five sinks for the children in care. There is a sufficient number of furniture, equipment and toys for the children in care. The interior was measured and will support up to 20 children. There are functioning smoke detector and a carbon monoxide detector. There are three fire extinguisher and a pull station alarm in one of the rooms closure to the font door. Sign in and sign out will be done through ProCare. The outdoor activity area has a deck and play yard. Both area are used for outdoor activity space. The center currently will use ground based activities There is sufficient shade for the children. The Director 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

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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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: JEWISH COMMUNITY CENTER SOCO PRESCHOOL	FACILITY NUMBER: 493010450
	VISIT DATE: 08/28/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

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

The Director was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms. 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.

A notice of site visit will be given to a facility representative at the time of visit and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. No notice of site visit will be issued during the prelicensing visit.

The facility will be approved for licensure when the licensee's background clearance is approved by the Guardian.

Exit interview conducted and report was reviewed with Director, Sarah Welton

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

LIC809 (FAS) - (06/04)

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