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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493008637
Report Date: 02/19/2021
Date Signed: 02/23/2021 07:36:25 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:ACORN PRESCHOOL, OAK GROVE UNION SCHOOL DISTRICTFACILITY NUMBER:
493008637
ADMINISTRATOR:ROBISON, REBECCAFACILITY TYPE:
850
ADDRESS:8760 BOWER STREETTELEPHONE:
(707) 823-4930
CITY:SEBASTOPOLSTATE: CAZIP CODE:
95472
CAPACITY:30CENSUS: DATE:
02/19/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Danielle DonahueTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with Danielle Donahue to measure out and inspect classroom 23 for use as part of Acorn Preschool. Due to COVID-19 pandemic, LPA Ouye drafted the facility evaluation report off site and will email a copy of the report to Danielle Danahue.

The room was inspected and measured. The square footage of the room is 776 square feet. There is no change in capacity, however this will allow the program to have multiple cohorts if they feel it is necessary. A capacity determination worksheet with the dimensions of room 23 will be placed in the facility file.

The room has received a fire clearance for occupancy on 10/23/2020. A copy of the fire clearance is in the facility file.

Room 23 has been approved for use as part of Acorn Preschool under license 493008637.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2021
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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