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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 173007616
Report Date: 07/07/2021
Date Signed: 07/12/2021 09:05:32 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:LEARNING HOUSE - P/S, THEFACILITY NUMBER:
173007616
ADMINISTRATOR:ANNA ROSE MONTANEZFACILITY TYPE:
850
ADDRESS:14840 BURNS VALLEY ROADTELEPHONE:
(707) 995-2076
CITY:CLEARLAKESTATE: CAZIP CODE:
95422
CAPACITY:65CENSUS: 0DATE:
07/07/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
06:35 AM
MET WITH:Anna Rose Montanez, DirectorTIME COMPLETED:
07:00 AM
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A case management licensee initiated inspection was conducted by Licensing Program Analyst (LPA) N. Cunningham in response to a request for a toddler option for four (4) children, total capacity to remain at 65 children. The toddler option application was received on 08/30/2020. In the Fall of 2020, the director requested to place the request on hold due to staffing. Today’s inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak. On 09/22/20, a fire clearance was granted for four toddlers and 61 preschoolers. The designated toddler room was inspected and measured. The room provides sufficient space for four toddlers. There is a changing table and a pad that meets Title 22 regulations. The parent handbook has been updated to provide information regarding the toddler program.

The report was reviewed and discussed with the director. All licensing reports are public information and must be made available upon request.

The toddler option is granted, total capacity remains at 65.

Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Nicolette CunninghamTELEPHONE: (707) 588-5056
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021
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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