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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283010642
Report Date: 10/22/2025
Date Signed: 10/22/2025 01:25:19 PM

Document Has Been Signed on 10/22/2025 01:25 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 CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:IVY HEIGHTS PRESCHOOLFACILITY NUMBER:
283010642
ADMINISTRATOR/
DIRECTOR:		MYERS, ALEXANDERFACILITY TYPE:
860
ADDRESS:28 HIGHLAND DRIVETELEPHONE:
(707) 200-1182
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 0DATE:
10/22/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Alexander MyersTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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On 10/22/2025, Licensing Program Analyst (LPA) Jaelyn Agbayani and Licensing Program Manager (LPM) Belinda DeVall met with Applicant representative, Alexandar Myers. The purpose of the visit was an announced pre-licensing inspection at the facility to ensure that health, safety and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. This is an application for 12 toddlers ages 18 months to 36 months in the Toddler Area as well as 31 preschoolers ages 2 to 5 years old in the Preschool Area. The childcare center will operate Monday–Friday 7:30 AM – 5:30 PM. The fire clearance was approved on 06/26/2025. There were no children present during this inspection.

LPA toured and measured the on-limits areas and classrooms located at the facility. The facility has 1 large classroom separated into 2 sections that are designated for each component.

Toddler Classroom measurements are:
The indoor total measurements contain a total of 479.40 square feet, which will accommodate applicant’s request for 12 toddler children.

Preschool Classroom measurements are:
The indoor total measurements contain a total of 1166.28 square feet, which will accommodate applicant’s request for 31 preschool children. LPA continued to tour the facility and measured all outdoor activity space.

Toddler/Preschool Outdoor measurements are:
The outdoor total measurements contain a total of 3983.42 square feet, which will accommodate applicant’s request for 43 children. Applicant will be submitting a waiver request for shared use of the playground between the toddler and preschool component.
Report continued on LIC 809C.
NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Jaelyn Agbayani
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: IVY HEIGHTS PRESCHOOL
FACILITY NUMBER: 283010642
VISIT DATE: 10/22/2025
NARRATIVE
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LPA observed all classrooms to be clean, safe, sanitary, and in good repair. A comfortable temperature for children shall be maintained at all times. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children, including toys, shall be free of toxic substances. All play equipment and materials used by children were observed to be age-appropriate. LPA observed a fire place that is screened off with an additional fitted barrier that is restricting direct access causing for the fire place to actively inaccessible to children in care. LPA observed fully charged fire extinguisher, carbon monoxide and smoke detectors in the facility. There are 50 chairs, 2 feeding chairs, 6 tables, 2 cubby stands that contain 32 individual cubby space for children, 45 cots, 2 changing tables, 2 toilets, 1 urinal and 3 sinks for the toddlers and preschoolers. LPA observed cubbies at the entrance of the preschool area, applicant stated that these cubbies will store children’s napping equipment. Per applicant there will be potty training in toddler room. Applicant stated they do not necessarily need to be potty trained, but the facility is able to potty train the children. Staff have separate bathroom that can be utilized by sick children if needed. Sick children will be isolated in the office area of the facility. LPA observed that items that may pose a danger to children were stored in an outdoor storage unit inaccessible to children. LPA observed containers with tight-fitting lids for the disposal of solid waste. LPA advised that applicant maintains first-aid supplies in a location accessible to staff but inaccessible to children.

Per applicant, the facility will provide snacks and parents will provide lunch for their children. Applicant was advised that full-day programs shall ensure that each child has a lunch and children shall be free to drink as they wish. Drinking water is readily available for the children via filtered water jugs. LPA observed a kitchen/ food preparation area kept clean and free of litter and rubbish; Applicant was advised that measures shall be taken to keep kitchen areas free of rodents and other vermin.

Outdoor area for toddler and preschool children were free of hazards including, holes, broken glass dry grasses, and other debris that pose a fire hazard. Shade was provided by large outdoor tree. Applicant informed LPA that during the summer time, extra shade can be provided via canopies. The areas around and under high climbing equipment had cushioned with material (woodchips) that absorb falls. The playground is enclosed by a fence at least four feet high to protect children and to keep them in the outdoor activity area. Any construction or equipment that could pose a hazard in the outdoor activity area shall be made inaccessible to children in care. LPA observed no bodies of water. LPA observed a water table on the play yard. LPA informed applicant to ensure that staff drain the water table after every use to prevent build up of water.
Report continued on LIC 809C.
NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Jaelyn Agbayani
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: IVY HEIGHTS PRESCHOOL
FACILITY NUMBER: 283010642
VISIT DATE: 10/22/2025
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Drinking water from a non-contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. LPA advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.

Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed Applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Applicant representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
Report continued on LIC 809C.
NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Jaelyn Agbayani
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
LIC809 (FAS) - (06/04)
Page: 10 of 11
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: IVY HEIGHTS PRESCHOOL
FACILITY NUMBER: 283010642
VISIT DATE: 10/22/2025
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPA reviewed with applicant representative the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

The following corrections are needed before a licensure will be considered:
1. Review and approval of requested waivers
2. Picture proof of hook setup for wall partition
3. Proof of cubby being mounted to wall
4. Proof of woodchips placed in area 1 of the play yard
5. Proof of office setup
6. Release of director from Little Ivy Preschool
7. Proof of Applicant Representative proof of MMR
8. Final review of application packet by LPM

An exit interview was conducted with the above item discussed.
This report and appeal rights were provided to Alex Myers, Applicant Representative.
Final license determination will be made upon review by the Licensing Program Manager.
NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Jaelyn Agbayani
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
LIC809 (FAS) - (06/04)
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