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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009162
Report Date: 10/08/2024
Date Signed: 10/08/2024 11:28:40 AM

Document Has Been Signed on 10/08/2024 11:28 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:LE PETIT ELEPHANT NURSERYFACILITY NUMBER:
283009162
ADMINISTRATOR/
DIRECTOR:		PAL PINTACSI, MILLIFACILITY TYPE:
830
ADDRESS:2645 LAUREL STREETTELEPHONE:
(707) 690-8797
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 19DATE:
10/08/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Milli PintacsiTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
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On 10/08/2024 Licensing Program Analyst (LPA) Mindy Mohr made an unannounced case management visit and met with Milli Pintacsi to conduct a capacity increase from 28 infants to 32 infants. The capacity change application was received on 07/12/2024.

The facility classrooms were measured on 09/11/2024.

An approved fire clearance was received on 10/08/2024 for 32 infants in classrooms 1, 2, 4 & 9.

LPA advised the licensee that infant rooms that have been designated and approved by the department can only be used for infant care. Any changes of use must be approved by the department prior to change of use.

The capacity change to 32 infants is approved and will be effective 10/09/2024.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
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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