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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009663
Report Date: 07/06/2023
Date Signed: 07/06/2023 10:47:26 AM

Document Has Been Signed on 07/06/2023 10:47 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:LITTLE IVY PRESCHOOLFACILITY NUMBER:
283009663
ADMINISTRATOR:KAYLEE ANDRESFACILITY TYPE:
850
ADDRESS:2201 PINE STREETTELEPHONE:
(707) 257-1185
CITY:NAPASTATE: CAZIP CODE:
94559
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 26DATE:
07/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Alex MyersTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) met with Alex Myers to conduct a capacity increase case management visit for the facility. There are four toilets and one urinal. One of the toilets is the isolation toilet. There are seven sinks.
There are two classrooms. There is sufficient square footage to support the requested 52 preschool children.

The capacity increase is approved effective July 6, 2023.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2023
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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