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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493005994
Report Date: 08/28/2020
Date Signed: 08/28/2020 08:26:51 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:WILLOW TREE SCHOOL - PRESCHOOLFACILITY NUMBER:
493005994
ADMINISTRATOR:STILL, CHERYL M.FACILITY TYPE:
850
ADDRESS:137 PAYRAN STREETTELEPHONE:
(707) 763-2546
CITY:PETALUMASTATE: CAZIP CODE:
94952
CAPACITY:22CENSUS: 0DATE:
08/28/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Cherie StillTIME COMPLETED:
08:30 AM
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The facility inspection was conducted via tele-inspection due to the Covid-19 state of emergency pandemic. The department has suspended all field operations and the applicant has agreed to conduct the video conference with LPA, (Licensing Program Analyst) Glenn Ouye.

LPA Ouye conducted a site visit on August 11, 2020 after the center had closed for the day. During the visit on August 11, 2020 LPA met with licensee Cherie Still to make a capacity determination for preschool age children. During the visit it was determined that a maximum capacity is 27 preschool age children. The visit occurred due to the licensee second location facing closure because the lessor's intent to sell the property. The facility has a functioning carbon monoxide and smoke detectors. There are sufficient toilets and hand washing sinks to meet the capacity load.

The application to increase the capacity was received on August 21, 2020 and the fire inspection was received on August 27, 2020. The fire inspector approved the capacity based on her physical inspection on July 16, 2020.

The center capacity is approved for a maximum capacity of 27 children, three of which can be under the toddler option if the need is present. The capacity increase of 27 children is effective as of August 28, 2020. A copy of the new license and this report will be emailed to the licensee.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2020
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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