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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 173010488
Report Date: 04/24/2024
Date Signed: 04/24/2024 12:06:09 PM

Document Has Been Signed on 04/24/2024 12:06 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:KONOCTI USD CHILD DEVELOPMENT CENTER-P/SFACILITY NUMBER:
173010488
ADMINISTRATOR/
DIRECTOR:		ANGEL COPPAFACILITY TYPE:
850
ADDRESS:4750 GOLF AVENUETELEPHONE:
(707) 994-6475
CITY:CLEARLAKESTATE: CAZIP CODE:
95422
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 14DATE:
04/24/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Angel CoppaTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 04/24/2024 at 11:00AM, Licensing Program Analysts (LPA) Sebastian Phouthavong conducted an announced Case Management visit to the facility to inspect the newly added outdoor activity area for the daycare children. LPA met with the Director, Angel Coppa today. Previously the outdoor activity area for the preschool program was shared with the infant program while the preschool program's outdoor activity area was under construction. The facility used a rotational waiver with the preschool program until the outdoor area was being completed. On 04/17/2024, the facility notified the department that the outdoor activity area has been completed.

During the inspection facility outdoor activity area was toured. LPA observed the playground equipment and surface areas were aged appropriate and in safe condition. There is wood chip cushioning underneath play equipment to absorb falls.

The facility’s rotational waiver will no longer be needed and will be withdrawn.

The facility is approved for the outdoor activity area effective today's date, 04/24/2024

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with Director, Angel Coppa

There were no Title 22 deficiencies cited during today's inspection
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2024
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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