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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010225
Report Date: 09/16/2022
Date Signed: 09/16/2022 05:11:24 PM


Document Has Been Signed on 09/16/2022 05:11 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:LA CASITA DAY SCHOOLFACILITY NUMBER:
493010225
ADMINISTRATOR:IRENE SILVAFACILITY TYPE:
850
ADDRESS:4044 MAYETTE AVENUETELEPHONE:
(707) 536-1241
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY:134CENSUS: 0DATE:
09/16/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Irene Silva and Diana DamianTIME COMPLETED:
05:15 PM
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Licensing Program Analyst (LPA), Glenn Ouye met the applicant Irene Silva and Diana Damian to conduct a case management visit. The construction is almost completed. There are two classroom that need flooring and will be installed next week. All other classrooms are ready for use. The bathrooms need two urinals installed which will be completed next week.

The outdoor activity area will have the outdoor equipment and toys installed next week. There are two outdoor areas for use the children to use.

The applicant will be required to install a knox box to pass the fire safety inspection.

LPA Ouye will return for a final prelicensing inspection on September 22, 2022.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/16/2022
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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