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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283010138
Report Date: 12/10/2021
Date Signed: 12/10/2021 11:44:35 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:HOPPER CREEK MONTESORRIFACILITY NUMBER:
283010138
ADMINISTRATOR:WOODIWISS, CAROLFACILITY TYPE:
850
ADDRESS:2141 2ND STREETTELEPHONE:
(707) 252-8775
CITY:NAPASTATE: CAZIP CODE:
94559
CAPACITY:35CENSUS: 0DATE:
12/10/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Brenna Lee Rothj and Matthew ChrzanowskiTIME COMPLETED:
11:45 AM
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Licensing Program Analyst LPA Glenn Ouye met with the applicant to conduct a capacity determination measurement of the interior activity area and outdoor play area of the facility

The interior has 4 rooms of activity space. The restroom has three toilets and three sinks. There is also a separate staff bathroom. The smoke and carbon monoxide detectors were checked and functional There are three fire extinguishers in the facility. The outdoor play area does not meet the required square footage for 35 children but a rotational waiver can be approved for use.

The applicants have paperwork that must be submitted to complete the application. Upon completion LPA will be able to license the new owners as licensees of the facility.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021
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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