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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493008637
Report Date: 01/20/2023
Date Signed: 01/20/2023 11:14:47 AM


Document Has Been Signed on 01/20/2023 11:14 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:ACORN PRESCHOOL, OAK GROVE UNION SCHOOL DISTRICTFACILITY NUMBER:
493008637
ADMINISTRATOR:CONNOR POWELLFACILITY TYPE:
850
ADDRESS:8760 BOWER STREETTELEPHONE:
(707) 823-4930
CITY:SEBASTOPOLSTATE: CAZIP CODE:
95472
CAPACITY:30CENSUS: 18DATE:
01/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Connor PowellTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Glenn Ouye met with Site Supervisor/Director Connor Powell regarding a capacity determination and the physical plant's toilet functionality. The plumbing contractor cleared a tree root from the sewer line.

The two classrooms were measured which can support up to 50 children.
There are six toilets, one urinal and eight sinks available for the children.

The facility's current capacity is 30 children.
LPA discussed the process if the director wishes to increase the capacity.
A new LIC200A for the new capacity will be required. Also, a $25 fee for the capacity increase. A new fire clearance will be required to increase the capacity up to any capacity to 50 children.




SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/20/2023
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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