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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009469
Report Date: 08/15/2022
Date Signed: 08/15/2022 11:29:17 AM


Document Has Been Signed on 08/15/2022 11:29 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:NORTH BAY CHILDRENS CENTER FITCH MOUNTAINFACILITY NUMBER:
493009469
ADMINISTRATOR:SMITH, JOLEYNNFACILITY TYPE:
850
ADDRESS:520 MONTE VISTA AVEUNE, RM 8&9TELEPHONE:
(707) 473-4382
CITY:HEALDSBURGSTATE: CAZIP CODE:
95448
CAPACITY:54CENSUS: DATE:
08/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Kristina Sisseck & Joleynn SmithTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Glenn Ouye met with Kristina Sisseck and Joleynn Smith regarding a capacity increase for 66 children. The classrooms and the outdoor activity areas were measured on July 25, 2022. The indoor sq. footage along with the number of sinks and toilets supports 99 children. The outdoor activity area is large enough for 112 children.

Due to a mis-communication the application was not submitted. The application for the capacity increase along with the facility sketch and a check for $25 was given to LPA Ouye who will drop the capacity increase application to the Santa Rosa Child Care Office on 8/15/22.

LPA Ouye will follow up with the director once the fire clearance for the capacity increase is approved.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2022
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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