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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009161
Report Date: 05/29/2024
Date Signed: 05/29/2024 01:56:28 PM


Document Has Been Signed on 05/29/2024 01:56 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:LE PETIT ELEPHANT PRESCHOOLFACILITY NUMBER:
283009161
ADMINISTRATOR:PAL PINTACSI, MILLIFACILITY TYPE:
850
ADDRESS:2645 LAUREL STREETTELEPHONE:
(707) 690-8797
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY:78CENSUS: 82DATE:
05/29/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Milli PintacsiTIME COMPLETED:
02:05 PM
NARRATIVE
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On 5/29/2024 Licensing Program Analysts (LPAs) Glenn Ouye and Mindy Mohr made an unannounced case management visit and met with Milli Pintacsi to conduct a capacity increase from 78 to 100 preschoolers ages 2 - 6 years. The capacity change application was received on 5/28/2024.

The facility classrooms were measured on 5/29/2024. There is sufficient indoor and outdoor activity square footage to support 100 preschoolers. There are sufficient toilets and hand washing sinks per regulation. An approved fire clearance was received on 5/29/2024 for 100 preschoolers ages 2 - 6 years in classrooms 4, 5, 6, 7, 8, 10 & 12.

LPA's advised the licensee and the assistant director that preschool rooms that have been designated and approved by the department can only be used for preschool age children. Any changes of use must be approved by the department prior to change of use.

In addition, during today's visit LPAs observed 82 children in care. Licensee confirmed 82 children aged 2 - 6 were present today.


Continued on LIC809-C
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 05/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/29/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: LE PETIT ELEPHANT PRESCHOOL
FACILITY NUMBER: 283009161
VISIT DATE: 05/29/2024
NARRATIVE
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The following violation of the Health and Safety Code was issued: see LIC 809D. Appeal Rights were provided.


A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

The capacity change to 100 preschoolers aged 2 -6 years is approved and effective 5/30/2024.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3
Document Has Been Signed on 05/29/2024 01:56 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405


FACILITY NAME: LE PETIT ELEPHANT PRESCHOOL
FACILITY NUMBER: 283009161

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/29/2024
Section Cited
CCR
101161(a)

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(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
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Licensee stated she will not go over a capacity of 100 children present in a day at one time.
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This was not me as evidenced by: The facility was operating with 82 students when licensed for 78.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 05/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/29/2024
LIC809 (FAS) - (06/04)
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