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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493002535
Report Date: 08/23/2023
Date Signed: 08/23/2023 01:55:30 PM


Document Has Been Signed on 08/23/2023 01:55 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
SANTA ROSA RO, 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: 0DATE:
08/23/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Tami Jo TorresTIME COMPLETED:
02:00 PM
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Today, an unannounced visit was made to the facility by Licensing Program Analyst (LPA), Mindy Mohr to confirm closure. On 07/12/2023 Director Tami Jo Torress contacted CCLD that the facility will be closing at the end of July.

At 1:20 pm LPA Mohr arrived at the facility address to confirm that licensed child care is no longer being provided. LPA observed four staff present working to close the facility. No children were present during today’s visit. LPA did not observe evidence that care was being provided at the facility.

A copy of this report, was provided to Tami Jo Torres. A closure letter will be mailed to the mailing address on file. Effective, 08/01/23 facility #493002535 is no longer licensed and can no longer provide licensed care to children.

LPA Mohr will process the closure with the effective closure date of 08/01/23

SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melinda MohrTELEPHONE: (707) 494-2125
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2023
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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