Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125402275
Report Date: 04/21/2016
Date Signed: 04/21/2016 09:56:07 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:SALMONBERRY PRESCHOOLFACILITY NUMBER:
125402275
ADMINISTRATOR:NUNLEY-MONAHAN, KATHLEENFACILITY TYPE:
850
ADDRESS:300 TRINITY STREETTELEPHONE:
(707) 677-0477
CITY:TRINIDADSTATE: CAZIP CODE:
95570
CAPACITY:30CENSUS: 18DATE:
04/21/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:09 AM
MET WITH:Kathleen Nunley-MonahanTIME COMPLETED:
10:15 AM
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(2) LPA DeAnna Sanders visited this facility today for a random annual. The facility was toured and records were reviewed. There are no water hazards or fire arms present. Cleaning solutions and toxins are inaccessible. There is locking storage for poisons. Furnishings are in good condition. Floors are clean and there is no sign of insects or vermin. The kitchen is in clean condition and food is stored and prepared in a healthful manner. There is covered trash for garbage. The menu is posted. Children are signed in and out and the regular counts are documented. The facility has a central agency fingerprint list. The Director is designated and qualified. There is emergency contact information for children. The facility is within capacity and ratio today. There is drinking water. Children are supervised and interactions between children and staff were observed to be appropriate. The play are is fenced and their is cushioning material under the climber. Surfaces are free of sharp or loose parts. The LPA was allowed to enter and inspect the facility. Fire drills are conducted and documented. No deficiencies are cited today.
SUPERVISOR'S NAME: Linda WalkerTELEPHONE: (707) 588-5034
LICENSING EVALUATOR NAME: Deanna SandersTELEPHONE: (707) 826-9961
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2016
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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