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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
283009162
Report Date:
02/10/2023
Date Signed:
02/10/2023 09:15:51 AM
Document Has Been Signed on
02/10/2023 09:15 AM
- 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:
LE PETIT ELEPHANT NURSERY
FACILITY NUMBER:
283009162
ADMINISTRATOR:
PAL PINTACSI, MILLI
FACILITY TYPE:
830
ADDRESS:
2645 LAUREL STREET
TELEPHONE:
(707) 690-8797
CITY:
NAPA
STATE:
CA
ZIP CODE:
94558
CAPACITY:
59
CENSUS:
43
DATE:
02/10/2023
TYPE OF VISIT:
Case Management - Licensee Initiated
UNANNOUNCED
TIME BEGAN:
08:30 AM
MET WITH:
Adrean Takemoto
TIME COMPLETED:
09:15 AM
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Licensing Program Analyst (LPA) Glenn Ouye met with Adrean Takemoto to conduct a capacity decrease from 59 infant to 50 infants. This is a result of one infant classroom being changed to a preschool classroom. The capacity change application was received on 2/6/2023.
The facility classrooms were measured on 2/3/2023. There is sufficient indoor activity square footage to support 50 infants
An outdoor rotational waiver will be required due to the measured square footage of 2800 square feet which supports 37 infants.
The capacity change to 50 infants is approved and effective 2/13/2023.
LPA Ouye will follow up with the licensee to complete the outdoor rotational waiver for this infant program.
SUPERVISOR'S NAME:
Leslie Lepori
TELEPHONE:
(707) 588-5060
LICENSING EVALUATOR NAME:
Glenn Ouye
TELEPHONE:
(707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE:
02/10/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
02/10/2023
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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