<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493008113
Report Date: 08/07/2024
Date Signed: 08/07/2024 11:25:23 AM


Document Has Been Signed on 08/07/2024 11:25 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:HEAD START - MARTINEZ & GUILLORY CENTERFACILITY NUMBER:
493008113
ADMINISTRATOR:LISA GROCOTTFACILITY TYPE:
850
ADDRESS:10288 STARR ROADTELEPHONE:
(707) 837-0917
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY:40CENSUS: 0DATE:
08/07/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Kim RodgersTIME COMPLETED:
11:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Glenn Ouye met with Area Manager, Kim Rodgers to conduct a capacity decrease case management visit. The licensee is requesting a change of capacity from 40 preschoolers to 20 preschoolers.

LPA measured the interior and exterior square footage. The interior and exterior square footage supports the licensee's request for 20 preschool children. There are two toilets and three sinks for the children. There is 897 square feet of indoor activity space and 4,275 square feet of outdoor activity space.

With a decrease of capacity, a fire inspection is not required.

The licensee has a infant/toddler license in an adjacent classroom.

The facility is approved for 20 preschool children ages two years old through entry into first grade, effective August 7, 2024. An updated license will be provided to the licensee.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1