<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009805
Report Date: 08/25/2021
Date Signed: 08/25/2021 10:40:12 AM

Document Has Been Signed on 08/25/2021 10:40 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:4C'S APPLES AND BANANAS CDCFACILITY NUMBER:
493009805
ADMINISTRATOR:CLAUDIA AVALOSFACILITY TYPE:
850
ADDRESS:950 SEBASTOPOL ROADTELEPHONE:
(707) 541-1901
CITY:SANTA ROSASTATE: CAZIP CODE:
95407
CAPACITY: 30TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/25/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:54 AM
MET WITH:Elba RodriguezTIME COMPLETED:
10:15 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 08/25/21 Licensing Program Analyst (LPA) Amy Strother made an unannounced inspection at the facility to verify closure of the preschool program. On 08/12/21, 4C’s Director of Center Programs, Amy McIntyre notified Community Care Licensing Division (CCLD) that the Apples and Bananas CDC facility #493009805 is officially closed and was no longer in operation. On 08/19/21 the Rohnert Park Regional Office (RO) received a copy of the forfeited facility license from the Licensee. The forfeited license included a written statement to inform CCLD that the facility is closed as of 08/04/21. During today's inspection, LPA went to the office on the Roseland Elementary School campus and discuss with Office Manager, Nadia Leal the purpose of the visit. LPA Strother then met with Student Services Manager, Elba Rodriguez who stated that the classroom previously occupied by 4C’s Apples and Bananas CDC is now used for a Kindergarten classroom. Rodriguez lead LPA on a tour of classroom A&B2 where LPA confirmed that the children in attendance were enrolled with Roseland Elementary and attending Kindergarten with teacher Abbie Lebbert. Ms. Lebbert's name and photo was posted on the classroom wall. There was no evidence to indicate that the preschool is still operating. The facility license will be closed by the RO effective 08/04/21.

Because the facility is no longer in operation, a facility representative was not available for signature. This report was emailed to 4C’s Director of Center Programs, Amy McIntyre and a Read Receipt will remain on file in lieu of a signature.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1