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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009162
Report Date: 08/07/2019
Date Signed: 08/07/2019 11:45:53 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:LE PETIT ELEPHANT NURSERYFACILITY NUMBER:
283009162
ADMINISTRATOR:PAL PINTACSI, MILLIFACILITY TYPE:
830
ADDRESS:2645 LAUREL STREETTELEPHONE:
(707) 690-8797
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY:55CENSUS: 23DATE:
08/07/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Kerry Knight, DirectorTIME COMPLETED:
11:10 AM
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LPA, Kevin O'Connell made an unannounced inspection in request for a decrease in capacity from 55 to 43. This decrease is taking place in room # 4. Room # 4 will now be used for preschool children under license # 283009161 as of today, August 8, 2019.
This decrease is effective today August 8, 2019.

The following information regarding ADA is provided: US Department of Justice 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, www.ada.gov/childqanda.htm.
This report, as well as the AAP Guide to Safe Sleep, Safe Sleep in Childcare brochure, What does a Safe Sleep Environment Look Like brochure & Safe Sleep Concepts handout, were reviewed and discussed with the Director. The Effects of Lead Exposure brochure has been reviewed with and discussed with the Director.

All licensing reports are public information and must be made available upon request for at least three years.
Notice of Site Visit shall be posted for 30 days from today's visit.
Failure to keep this notice posted for 30 days may result in a civil penalty of $100.
No deficiencies were cited today.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019
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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