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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493002535
Report Date: 12/01/2023
Date Signed: 12/01/2023 02:22:47 PM


Document Has Been Signed on 12/01/2023 02:22 PM - 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:BETHEL CHILDREN'S CENTER OF SANTA ROSAFACILITY NUMBER:
493002535
ADMINISTRATOR:TORRES, TAMI JOFACILITY TYPE:
850
ADDRESS:1577 GUERNEVILLE ROADTELEPHONE:
(707) 527-0332
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY:75CENSUS: DATE:
12/01/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:TIME COMPLETED:
02:20 PM
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As a result of phone call with on 9/7/23 between LPA Sebastian Phouthavong and Director Tami Jo Torres, LPA conducted a case mgmt visit to confirm the closure of the center. Tami Jo Torres was not on site, a staff of the church which leased the site to Bethel Children's Center of Santa Rosa called Tami Jo Torres who did not answer the call. She left a message to call LPA Ouye to find out the exact date of closure.

The building had no children present and there was no indication that the site is operational.

Upon speaking with Tami Jo Torres, LPA Ouye will follow up and close the facility license.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2023
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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