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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009825
Report Date: 04/25/2024
Date Signed: 04/25/2024 02:42:05 PM

Document Has Been Signed on 04/25/2024 02:42 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:NAPA VALLEY COLLEGE CHILD & FAMILY P/S BY NCOEFACILITY NUMBER:
283009825
ADMINISTRATOR/
DIRECTOR:		DE LA CRUZ, MAYRAFACILITY TYPE:
850
ADDRESS:2277 NAPA VALLEJO HWY BLD 3000TELEPHONE:
(707) 256-7040
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY: 68TOTAL ENROLLED CHILDREN: 68CENSUS: 20DATE:
04/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Mayra De La CruzTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst Glenn Ouye arrived to amend the licensing report dated 2/28/24. This is for the LIC9099C and LIC9099D. On 2/28/24, the LPA who conducted the visit mistakenly cited the facility a civil penalty. LPA is removing language referencing the civil penalty.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
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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