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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490111744
Report Date: 11/30/2022
Date Signed: 11/30/2022 11:03:13 AM


Document Has Been Signed on 11/30/2022 11:03 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:CALI CALMECAC EXTENDED CHILD CAREFACILITY NUMBER:
490111744
ADMINISTRATOR:JASON RIGGSFACILITY TYPE:
840
ADDRESS:9491 STARR ROADTELEPHONE:
(707) 838-3859
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY:0CENSUS: 0DATE:
11/30/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:18 AM
MET WITH:N/ATIME COMPLETED:
09:44 AM
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A case management visit was made to the facility today by Licensing Program Analyst (LPA) Y.Yang to conduct a confirmation of facility closure visit. The facility's licensee, Extended Child Care Coalition of Sonoma County, Inc submitted a request to close the facility on 11/15/22. During today's case management visit, the LPA observed no children in care or any evidence of childcare being provided at this location. This facility was located on the Cali Calmecac school premises.

Confirmation of facility closure is complete.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2022
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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