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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483007755
Report Date: 10/01/2024
Date Signed: 10/01/2024 02:11:38 PM

Document Has Been Signed on 10/01/2024 02:11 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:VUSD - COOPER CHILD DEVELOPMENT CENTER - P/SFACILITY NUMBER:
483007755
ADMINISTRATOR/
DIRECTOR:		MOLINA, FABIOLAFACILITY TYPE:
850
ADDRESS:612 DEL MAR AVENUETELEPHONE:
(707) 556-8374
CITY:VALLEJOSTATE: CAZIP CODE:
94589
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 0DATE:
10/01/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Fabiola MolinaTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with Site Supervisor, Fabiola Molina and Corine Calica, Coordinator of Child Development Program to inspect classroom 22B. The VCUSD plans to reactivate the facility license. Classroom 22B may be the only class associated with the license. Classroom 22A may not be part of the license. The classroom of 22B was inspected and can be approved for use.

The outdoor activity area to support this site does need to have one piece of equipment removed or repaired. The X-Wave toy is rusted and needs to be replaced or removed prior to reactivating the license.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2024
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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