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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283008069
Report Date: 09/20/2023
Date Signed: 09/20/2023 10:08:59 AM

Document Has Been Signed on 09/20/2023 10:08 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 RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:NAPA VALLEY MONTESSORI LEARNING CENTER - P/SFACILITY NUMBER:
283008069
ADMINISTRATOR:SMITH, TERESITAFACILITY TYPE:
850
ADDRESS:120W AMERICAN CANYON ROAD M 11TELEPHONE:
(707) 853-9580
CITY:AMERICAN CANYONSTATE: CAZIP CODE:
94503
CAPACITY: 37TOTAL ENROLLED CHILDREN: 37CENSUS: 20DATE:
09/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Todd PetersonTIME COMPLETED:
10:15 AM
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A case management visit was made to the facility by LPA M. Mohr to confirm the outdoor play structure was fully removed and to discuss options for a new play structure.

LPA Mohr observed the play structure has been removed. The facility has not replaced the play structure at this time as they are researching the best option for the school.

Additionally, LPA Mohr delivered an amended report previously issued on 8/30/23.


No deficiencies were cited as a result of this case management visit.

Notice of Site Visit to be posted for 30 days.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2023
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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