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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009536
Report Date: 10/08/2024
Date Signed: 10/08/2024 02:54:06 PM

Document Has Been Signed on 10/08/2024 02:54 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:ST. ROSE PRESCHOOLFACILITY NUMBER:
493009536
ADMINISTRATOR/
DIRECTOR:		LOUGHNER, TAMIFACILITY TYPE:
850
ADDRESS:4300 OLD REDWOOD HIGHWAYTELEPHONE:
(707) 526-9844
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY: 43TOTAL ENROLLED CHILDREN: 43CENSUS: 38DATE:
10/08/2024
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Tami LoughnerTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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On 10/08/2024, Licensing Program Analyst (LPA's) Glenn Ouye and Sebastian Phouthavong arrived to conduct a case management inspection requested by Director, Tami Loughner to verify the facility’s outdoor area and review the plan to add an additional portable classroom for Transitional Kindergarten children. Director notified the department of the plan on 09/26/2024.

The facility was toured inside and outside, and the floor and yard plan submitted by the licensee were verified. LPAs measured the outdoor activity space and reviewed the square footage of the area. Director stated the facility does not plan to change the facility’s capacity and reviewed at a possible waiver may be required if the outdoor activity space is being used by the Transitional Kindergarten children with the Prechool children. Director also reviewed the bathroom requirements as well.

LPAs requested the facility to notify the department once the plan for the change is initiated.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Tami Loughner.

There were no Title 22 deficiencies cited during today's inspection.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE: DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2024
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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