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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493007940
Report Date: 01/14/2020
Date Signed: 01/15/2020 08:40:31 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:LITTLE SCHOOL HOUSE INC.FACILITY NUMBER:
493007940
ADMINISTRATOR:WILLIAMS, LISAFACILITY TYPE:
850
ADDRESS:270 MARK WEST STATION ROADTELEPHONE:
(707) 527-8118
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY:48CENSUS: 38DATE:
01/14/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Lisa WilliamsTIME COMPLETED:
12:07 PM
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A case management visit was made to the facility by Licensing Program Analyst (LPA) Y. Yang. During today's visit, LPA consulted with center director Lisa Williams regarding Title 22 regulations and best practices at a child care center. LPA spoke to Williams regarding a self-reported incident that occured at the facility on 01/02/2020 involving child C1. Williams reported that C1's guardian alleged that C1 was bit by another child (name unknown) while in care. Williams stated that staff interviews were conducted and staff all corroborated that they did not observe C1 being bit by another child and did not observe any bite marks on C1's person. Williams reported that C1 is no longer attends the center.

This incident was reported to Community Care Licensing as required. During today's visit, interviews were conducted and staff were observed to be providing appropriate care and supervision and operating within ratio. There is not a preponderance of evidence to support that this incident occurred or resulted resulted from a lack of supervision or any other Title 22 regulation. This report was read and reviewed with the center director. There were no Title 22 deficiencies cited during today's inspection. Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020
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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