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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 233008824
Report Date: 03/11/2025
Date Signed: 03/11/2025 11:21:13 AM

Document Has Been Signed on 03/11/2025 11:21 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:GREENWOOD PRESCHOOLFACILITY NUMBER:
233008824
ADMINISTRATOR/
DIRECTOR:		BALLARD, JESSICAFACILITY TYPE:
850
ADDRESS:5700 HIGHWAY 1TELEPHONE:
(707) 877-3361
CITY:ELKSTATE: CAZIP CODE:
95432
CAPACITY: 15TOTAL ENROLLED CHILDREN: 10CENSUS: 5DATE:
03/11/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:19 AM
MET WITH:Jessica BallardTIME VISIT/
INSPECTION COMPLETED:
11:26 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
Licensing Program Analyst (LPA) Robert Maciel made a case management visit to the facility for the purpose of following up on an Unusual Incident Report submitted to the department on 3/3/25 and met with Site Supervisor Jessica Ballard (S1).

On 3/3/25 at 11:40 PM, a child (C1) damaged the latch on the gate leading from the outdoor play area to the front yard, allowing her to exit the outdoor play area and run away from staff. Staff 2 (S2) followed C1 who had run from the front yard into the classroom to hide. S2 stated that she could not find C1 so the facility's site supervisor, Jessica Ballard (S1), began looking and found C1 in the classroom.

During today's inspection, the facility was toured LPA spoke with staff. S2 showed LPA the gate latch that had been broken which LPA observed had been replaced, higher than the previous latch. S1 stated that the latch was replaced on 3/4/25. LPA observed that the front yard was separated from the driveway with a fence which was latched and signs had been posted reminding adults to close the latches on the gate to the outdoor play area as well as the gate to the front yard.

No deficiencies were observed during today's visit. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
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