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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490109162
Report Date: 08/26/2021
Date Signed: 08/26/2021 03:38:13 PM

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:OLD ADOBE SCHOOLFACILITY NUMBER:
490109162
ADMINISTRATOR:MURRAY, MICHAELAFACILITY TYPE:
850
ADDRESS:252 WEST SPAIN STREETTELEPHONE:
(707) 408-2383
CITY:SONOMASTATE: CAZIP CODE:
95476
CAPACITY:30CENSUS: 15DATE:
08/26/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Michaela MurrayTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Glenn Ouye arrived to conduct a capacity determination case management visit. The facility submitted a capacity increase application to the department on August 23, 2021. The current capacity is 30 children. The licensee is seeking an increase to 45 children.

There are three classrooms and an outdoor activity area. There are a total of four toilets and three sinks for the children. There is a separate staff restroom in the Yellow Room. The interior square footage for each classroom was measured. The outdoor activity area was also measured. There is sufficient square footage in both the interior classrooms and the outdoor activity area to support the capacity increase of 45 children.

The Director is aware of the staff to child ratio and will maintain appropriate ratios at all times.

The facility is approved the increased capacity of 45 children effective August 26, 2021.
An updated license will be sent to the facility.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
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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