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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010694
Report Date: 08/29/2024
Date Signed: 08/29/2024 06:30:39 PM

Document Has Been Signed on 08/29/2024 06:30 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:STORYBOOK VILLAGE PRESCHOOLFACILITY NUMBER:
493010694
ADMINISTRATOR/
DIRECTOR:		NICOLE MONACHELLOFACILITY TYPE:
860
ADDRESS:4295 MONTGOMERY DRIVETELEPHONE:
(707) 843-7704
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 0DATE:
08/29/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Nicole Monachello TIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On August at 11:30am Licensing Program Analyst (LPA), Snow conducted an announced Pre-Licensing inspection for a new license. Upon arrival, LPA met with Applicant/Facility Representative Nicole Monachello & LPA Amy Strother arrived after. Applicant is requesting to be licensed for 30 preschoolers 2-6 in classrooms A&B. Hours of operation will be M-F 7:30-5pm.
All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Nicole Monachello that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. When medications are on site, Nicole Monachello stated that they will be in a higher cabinet located in the lock box in the kitchen. A fully equipped first aid kit is located in kitchen. There is an operational carbon monoxide detector on site located on the ceiling in classroom A. All required licensing documents were observed posted on the wall. Children will be signed in and out at the entry.
LPA continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space in room A&B measured 1381.5 which is sufficient to accommodate the requested capacity of 30 Children. LPA observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, napping cots/mats, bookshelves. There is a loft with a door to secure block access to the stairs, and other activity supplies for the children.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: STORYBOOK VILLAGE PRESCHOOL
FACILITY NUMBER: 493010694
VISIT DATE: 08/29/2024
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Drinking water is available in the classrooms via canister and cups the filled in the kitchen sink. LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance was granted on 8/21/2024.
LPA observed a total of 4 sinks and 4 toilets available for children’s use. These are sufficient to accommodate the requested capacity of 30 children. There is a separate staff restroom equipped with a toilet and a sink. The isolation area for children who are ill will be the office.
Facility will provide snacks. The kitchen area currently includes sink refrigerator, stovetop what is inaccessible with child locks. The kitchen area and food storage areas were observed free of rodents and/or vermin. Food was observed to be properly stored separate from cleaning materials.
The facility currently has a fully fenced playground area. Fencing is 4-foot chain link surrounding the property. On one side of the property the fence has 3 ropes of barbed wire above the 4-foot fence; the applicant will remove prior to licensing. The total square footage for all the outdoor activity space is 4844.38 square feet, which is sufficient to accommodate the requested capacity. Shade is provided via pop up pergola and trees. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. There are no climbing structures on the playground LPA observed all hazardous items on the playground to be inaccessible to children. Applicant Nicole Monachello was reminded that any changes to the facility must be reported to and approved by Community Care Licensing. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: STORYBOOK VILLAGE PRESCHOOL
FACILITY NUMBER: 493010694
VISIT DATE: 08/29/2024
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The following corrections are needed prior to the issuance of the license:
Photo proof of the removed barbed wire fencing

Applicant/Licensee Representative Nicole Monachello understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.
Criminal Record Clearance - Child Care Centers:
“[Applicant, Licensee, or Facility representative] 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.”

APPLICANT KNOWS PROSPECTIVE CLIENTS WILL NEED IMS:


“This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: STORYBOOK VILLAGE PRESCHOOL
FACILITY NUMBER: 493010694
VISIT DATE: 08/29/2024
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APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS:
“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”

Review of records to be maintained - Child Care Centers:


“LPA reviewed with [applicant, licensee, or facility representative] the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.”

Safe Sleep (for infant centers)– Child Care Centers and Family Child Care Homes:


“LPA discussed the safe sleep regulations with [applicant, licensee, or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.”
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: STORYBOOK VILLAGE PRESCHOOL
FACILITY NUMBER: 493010694
VISIT DATE: 08/29/2024
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MyChildCarePlan.org--Child Care Centers and Family Child Care Home:
“[Applicant, or Licensee] 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. “

Notice of Site Visit (for licensed facilities only) - Child Care Centers and Family Child Care Homes:
“A notice of site visit was given to [applicant, licensee or facility representative] and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. “

Exit Interview - Child Care Centers and Family Child Care Homes:
“Exit interview conducted and report was reviewed with the [applicant, licensee, or facility representative]. Please include their name.”

Subscribe to CCLD important information - Child Care Centers and Family Child Care Homes:


“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.”
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC809 (FAS) - (06/04)
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