<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
493009534
Report Date:
02/09/2023
Date Signed:
02/09/2023 05:00:29 PM
Document Has Been Signed on
02/09/2023 05:00 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:
RAINBOW BRIDGE MONTESSORI
FACILITY NUMBER:
493009534
ADMINISTRATOR:
KANCHARLA, AISHWARYA
FACILITY TYPE:
850
ADDRESS:
21 WILLIAM STREET
TELEPHONE:
(707) 795-6666
CITY:
COTATI
STATE:
CA
ZIP CODE:
94931
CAPACITY:
54
CENSUS:
12
DATE:
02/09/2023
TYPE OF VISIT:
Case Management - Licensee Initiated
UNANNOUNCED
TIME BEGAN:
03:00 PM
MET WITH:
Aishwarya Kacharla
TIME COMPLETED:
04:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Glenn Ouye met with the licensee to conduct a capacity determination for the location which will be changing from a preschool to infant program.
The interior square footage can support up to 17 infants. LPA Ouye will draft a capacity determination worksheet and will send a copy of the worksheet to the licensee to submit with her application.
The licensee anticipates that the program will be converted to the infant program in the summer of 2023.
SUPERVISOR'S NAME:
Leslie Lepori
TELEPHONE:
(707) 588-5060
LICENSING EVALUATOR NAME:
Glenn Ouye
TELEPHONE:
(707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE:
02/09/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
02/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
1