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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493007939
Report Date: 02/03/2022
Date Signed: 02/03/2022 03:22:22 PM

Document Has Been Signed on 02/03/2022 03:22 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:LITTLE SCHOOL HOUSE - INFANTFACILITY NUMBER:
493007939
ADMINISTRATOR:JENNIFE THEOBALDFACILITY TYPE:
830
ADDRESS:2323 CHANATE ROADTELEPHONE:
(707) 544-8118
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY: 16TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/03/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Vacant BuildingTIME COMPLETED:
03:21 PM
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On 02/03/22 Licensing Program Analyst (LPA) Amy Strother made an unannounced inspection at the facility to verify closure of the preschool and infant program. On 11/19/21 License, Durelle Finster (L1) notified LPA Strother that the last day care will be provided at the facility will be 11/30/21. On 12/22/21 L1 stated that the center is currently closed, and the building is in escrow. On 01/22/22, L1 notified LPA Strother by email that the building has officially been sold and that she is forfeiting license #493007937 and #493007939. L1 submitted a “Certification of Non-Operation” marking “other” writing in “closed”, with a signature and date of 01/15/22. During today's inspection, LPA observed an empty parking lot at the facility. LPA was able to look into the windows of the facility, observing a vacant building. Although LPA Strother did not have access to the inside of the building, there was no evidence of any children on the premises during LPAs visit. The facility license will be closed by the RO effective 01/15/22, the date L1 signed the Certificate of Non-Operation.

Because the facility is no longer in operation and vacant, a facility representative was not available for signature.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2022
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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