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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010486
Report Date: 12/17/2024
Date Signed: 12/17/2024 02:53:46 PM

Document Has Been Signed on 12/17/2024 02:53 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:LITTLE MONARCHSFACILITY NUMBER:
493010486
ADMINISTRATOR/
DIRECTOR:		DANA POWELLFACILITY TYPE:
860
ADDRESS:3273 AIRWAY DRIVE SUITE ETELEPHONE:
(707) 479-5577
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 19DATE:
12/17/2024
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Zoe TeeterTIME VISIT/
INSPECTION COMPLETED:
03:05 PM
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On 12/17/2024, Licensing Program Analyst LPA, Sebastian Phouthavong arrived at the facility to conduct a case management inspection and met with Licensee, Zoe Teeter to review the facility’s plan to change the napping room.

The facility was toured inside and outside. LPA observed the space for the change. Licensee stated the facility plan to remove a section of the napping room's wall and review the requirements for supervision. LPA requested Licensee to inform the department when the facility as made the change and submit an updated facility sketch.

Exit interview conducted and report was reviewed with the Licensee, Zoe Teeter.

A notice of site visit was given and must remain posted for 30 days.

There were no Title 22 deficiencies cited during today's inspection.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2024
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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