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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 280100646
Report Date: 09/06/2023
Date Signed: 09/06/2023 03:05:49 PM


Document Has Been Signed on 09/06/2023 03:05 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 RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:PRESBYTERIAN DAY SCHOOLFACILITY NUMBER:
280100646
ADMINISTRATOR:BATOR, JENNIFERFACILITY TYPE:
850
ADDRESS:1333 THIRD STREETTELEPHONE:
(707) 224-8941
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY:44CENSUS: 14DATE:
09/06/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Jennifer BatorTIME COMPLETED:
03:10 PM
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An unannounced case management visit was made to the facility by Licensing Program Analyst (LPA) Mindy Mohr in response to a self-reported Unusual Incident Report (UIR) received on 08/22/23. LPA met with Director, Jennifer Bator (D1).

During today's case management visit there were two staff supervising 14 children. LPA met with D1 to discuss the incident and conducted children and staff interviews.


No deficiencies were cited as a result of this case management visit.


Notice of Site Visit to be posted for 30 days.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melinda MohrTELEPHONE: (707) 494-2125
LICENSING EVALUATOR SIGNATURE:
DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/06/2023
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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