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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009176
Report Date: 08/04/2022
Date Signed: 08/04/2022 01:39:55 PM


Document Has Been Signed on 08/04/2022 01:39 PM - 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:HUMBOLDT COMMUNITY PRESCHOOLFACILITY NUMBER:
493009176
ADMINISTRATOR:RIEGEL, JULIANEFACILITY TYPE:
850
ADDRESS:2000 HUMBOLDT STREETTELEPHONE:
(707) 521-9959
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY:26CENSUS: 0DATE:
08/04/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:No person presentTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Amy Strother received a letter dated 07/25/22 from facility co-licensee Jenny Kenyon (L1), stating that they had to close their school located at the above address permanently. The letter further stated the last day of operation was 07/15/2022. Included with the notification of closure letter was the original copy of the facility license. Today, an unannounced visit was made to the facility by LPA Strother to confirm closure.

At 1:30pm LPA Strother arrived to the facility address to confirm that licensed child care is no longer being provided. LPA observed the front playground void of play equipment and empty classrooms through the glass doors and windows. LPA did not observe evidence that care was being provided at the facility.

A copy of this report, along with a closure letter will be mailed to L1. Effective, 07/15/22 facility #493009176 is no longer licensed and can no longer provide licensed care to children.

LPA Strother will process the closure with the effective closure date of 07/15/22.

L1 was not available for a signature. No signature is on file.

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy StrotherTELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:
DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/04/2022
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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