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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009533
Report Date: 05/22/2023
Date Signed: 05/22/2023 11:02:23 AM


Document Has Been Signed on 05/22/2023 11:02 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:RAINBOW BRIDGE MONTESSORI IIFACILITY NUMBER:
493009533
ADMINISTRATOR:KANCHARLA, AISHWARYAFACILITY TYPE:
850
ADDRESS:70 WILLIAM STREETTELEPHONE:
(707) 795-6666
CITY:COTATISTATE: CAZIP CODE:
94931
CAPACITY:23CENSUS: 12DATE:
05/22/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Aishwarya KancharlaTIME COMPLETED:
11:15 AM
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Licensing Program Analyst Glenn Ouye met with the licensee who will be reducing the capacity of the preschool program to 10 children. A front portion of the building will be used for an infant program. The licensee has already submitted the application for the infant program with the name Flying Clouds at Rainbow Bridge Montessori, application number 493010422.

The applicant will submit an application for the capacity change and the licensee and the department expect the change to take place on June 29, 2023.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2023
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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