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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009441
Report Date: 11/21/2019
Date Signed: 11/21/2019 11:23:40 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:HEAD START-COOKFACILITY NUMBER:
493009441
ADMINISTRATOR:GROCOTT, LISAFACILITY TYPE:
850
ADDRESS:2480 SEBASTOPOL ROADTELEPHONE:
(707) 544-6911
CITY:SANTA ROSASTATE: CAZIP CODE:
95407
CAPACITY:28CENSUS: 23DATE:
11/21/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:13 AM
MET WITH:Lisa Grocott and David RagenTIME COMPLETED:
11:38 AM
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A case management inspection was conducted at the facility by Licensing Program Analyst (LPA) Amy Strother in response to an increase of capacity application received by the Department on 10/21/19. LPA Strother met with Head Start Program Director, Lisa Grocott and Head Start Support Services Manager, David Ragen. The facility is currently licensed for 8 toddlers and 20 preschool age children, for a total capacity of 28. The licensee is requesting an increase in total capacity from 28 to 34; 8 toddlers and 26 preschool age children. Operating hours are 7:30am-4:30pm, Monday-Friday. This facility is located on the South East corner of Lawrence Cook Middle School. The facility is located off of Gardner Ave at the back of Lawerence Cook Middle School. This is a combination center with an infant license #493009803 in classroom #67.

A fire clearance from the local fire authority was obtained for the requested capacity on 11/14/19. There are a total of 4 toilets and 6 sinks available for the children to use in the classrooms. The outdoor space measured sufficiently for the requested capacity. Classrooms #68 and #69 measured sufficiently for 34 preschool children with a toddler option. Indoor space for the preschool program shall be physically separated from space provided for the toddler option, infant license and all other programs located on the middle school campus.

During today's visit, there were 23 children in care, supervised by 4 teachers. The facility was toured and inspected. No deficiencies were observed. This report was reviewed and discussed with Lisa Grocott and David Ragen. All licensing reports are public information and must be made available upon request for at least three years.

The increase for a total capacity of 34, 8 toddlers and 26 preschool children is approved and effective as of today, 11/21/19.
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: Amy StrotherTELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019
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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