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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009162
Report Date: 12/19/2019
Date Signed: 12/19/2019 09:58:54 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:43CENSUS: 26DATE:
12/19/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Kerry Knight, DirectorTIME COMPLETED:
09:30 AM
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LPA Kevin O'Connell made an unannounced case management inspection in response to an increase in capacity from 43 to 59 children in rooms 5 and 7 which are currently used by the preschool license 283009161.
These rooms have been approved for infant/ toddler use in the past. The Fire Marshall is scheduled to make an inspection on 12/27/19.
There is a charged fire extinguisher of at least 2A 10:BC in the hallway leading to the rooms. Each room has a working carbon monoxide detector.
The interior and exterior measure out for the numbers requested.
The increase of capacity cannot be approved until the Fire Marshall has given approval.
No Title 22 deficiencies were issued today.
Notice of Site Visit to be posted for 30 days from today.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019
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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