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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
233008945
Report Date:
05/19/2023
Date Signed:
05/19/2023 04:10:11 PM
Document Has Been Signed on
05/19/2023 04:10 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:
IMAGINATION STATION PRESCHOOL/CHILDCARE CENTER
FACILITY NUMBER:
233008945
ADMINISTRATOR:
RODRIGUEZ, SAPRINA
FACILITY TYPE:
850
ADDRESS:
11 NORTH MARIN STREET
TELEPHONE:
(707) 459-6543
CITY:
WILLITS
STATE:
CA
ZIP CODE:
95490
CAPACITY:
80
CENSUS:
40
DATE:
05/19/2023
TYPE OF VISIT:
Case Management - Licensee Initiated
UNANNOUNCED
TIME BEGAN:
02:00 PM
MET WITH:
Saprina Rodriguez
TIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with licensee Saprina Rodriguez to conduct a capacity determination case management visit to measure the outdoor activity area. The licensee will be submitting an LIC200A to decrease the capacity to 60 preschoolers. There is an existing fire clearance which exceeds 60 preschoolers so no additional fire clearance is required. The licensee will also submit a waiver request for an outdoor rotational waiver. The outdoor area supports 56 preschoolers.
SUPERVISOR'S NAME:
Leslie Lepori
TELEPHONE:
(707) 588-5060
LICENSING EVALUATOR NAME:
Glenn Ouye
TELEPHONE:
(707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE:
05/19/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
05/19/2023
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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