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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009877
Report Date: 03/02/2022
Date Signed: 03/02/2022 03:15:13 PM

Document Has Been Signed on 03/02/2022 03:15 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:FULTON COMMUNITY SCHOOL & FARMFACILITY NUMBER:
493009877
ADMINISTRATOR:ALIA KENYONFACILITY TYPE:
850
ADDRESS:1225 FULTON ROADTELEPHONE:
(707) 523-8035
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY: 75TOTAL ENROLLED CHILDREN: 67CENSUS: 53DATE:
03/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:Alia "Jenny" KenyonTIME COMPLETED:
03:30 PM
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A required annual inspection of the facility was conducted by Licensing Program Analyst (LPA) Amy Strother. The facility file was reviewed prior to this inspection. A review of the personnel report on file indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Center Director was reminded that all adults 18 and over, 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.

LPA met with the facility’s Center Director, Alia “Jenny” Kenyon. The facility’s operating hours are 7:00 a.m. - 6:00 p.m., Monday-Friday, year-round. The facility was toured inside and outside, and the floor and yard plan submitted by the licensee were verified. Sign in/out records were reviewed and in compliance. The facility uses the 1Core digital system with QR codes or unique PINs for sign in/out. A print out of the sign in system was reviewed by LPA. Items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children positioned on tall shelves out of reach of children. Director stated there are no poisons in the facility, and none were observed during this inspection. LPA observed the toys, floors, desks and other equipment and surfaces are clean, toxic free, safe, and in good condition. There is drinking water available to children both indoors and outdoors by use of pitchers of water and individually labelled water glasses or cups outdoors. The children's bathroom is in safe and sanitary condition. The center’s isolation area for any child who becomes ill while in care is located in the staff office. LPA observed food prep areas are clean. Food is properly stored and refrigerated as needed. There was no contaminated food observed. Garbage cans containing solid waste have tight fitting lids. Menus are posted in the front entrance of the facility at least one week in advance, as required. LPA observed a working carbon monoxide detector in the facility. LPA observed the playground equipment and surface areas were in safe condition.

Continued on LIC 809-C.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2022
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: FULTON COMMUNITY SCHOOL & FARM
FACILITY NUMBER: 493009877
VISIT DATE: 03/02/2022
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Continued from LIC 809.

There is wood chip cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed on the site. Director stated no weapons are stored on site, and none were observed.

During today's inspection, staffing ratios were being met, 53 children were being supervised by 9 staff. The facility was operating within the licensed capacity and ratio requirements. At least one staff member present during the inspection possessed current CPR and First Aid certifications, which expire 4/2023. Ten children’s records were reviewed at 12:30pm and contained all required documents. Nine staff records were reviewed and contained the required documents.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

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.

There were no Title 22 deficiencies cited during today's inspection.

Exit interview was conducted and report was reviewed with facility representative, Alia “Jenny” Kenyon.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
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