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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490106572
Report Date: 11/21/2019
Date Signed: 11/21/2019 09:54:24 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:HEAD START - BARBARA DANIELS-LOVEFACILITY NUMBER:
490106572
ADMINISTRATOR:ALFAHEL, SUHAFACILITY TYPE:
850
ADDRESS:1330 TEMPLE STREETTELEPHONE:
(707) 544-6318
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY:20CENSUS: 16DATE:
11/21/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lisa Grocott and David RagenTIME COMPLETED:
10:10 AM
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A case management inspection was conducted at the facility by Licensing Program Analyst (LPA) Amy Strother in response to an increase of capacity application received by the Department on 10/21/19. LPA Strother met with Head Start Program Director, Lisa Grocott and Head Start Support Services Manager, David Ragen. The licensee is requesting an increase in capacity from 20 to 30 preschool age children. Operating hours are 8:00am-2:30pm, Monday-Thursday and some Fridays.

A fire clearance from the local fire authority was obtained for the requested capacity on 11/14/19. There are a total of 3 toilets and 3 sinks available for the children to use in the classrooms. The outdoor space measured sufficiently for the requested capacity. The classroom measured sufficiently for the requested capacity of 30 preschool children.

During today's visit, there were 16 children in care being supervised by 2 teachers. The facility was operating within the licensed capacity. The facility was toured and inspected. No deficiencies were observed. This report was reviewed and discussed with Lisa Grocott. All licensing reports are public information and must be made available upon request for at least three years.

The increase capacity to 30 preschool children is approved and effective as of today, 11/21/19.

Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy StrotherTELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019
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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