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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283010642
Report Date: 12/18/2025
Date Signed: 12/18/2025 11:09:11 AM

Document Has Been Signed on 12/18/2025 11:09 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: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:
12/18/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Alex MyersTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On December 18, 2025, Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Jaelyn Agbayani and Licensing Program Manager (LPM) Belinda Devall conducted an announced follow up Pre-Licensing inspection for a New License. An initial pre-licensing inspection visit was conducted on October 22, 2025 with LPA Jaelyn Agbayani and LPM Belinda Devall. Upon arrival, LPA and LPM met with Applicant Representative Alex Myers. The purpose of the visit was an announced follow-up prelicensing 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.

LPA and LPM toured the facility to conduct follow up inspection to confirm that applicant Alex Myers was able to correct all necessary items from the initial inspection.

LPA and LPM 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. The isolation room for children will be located in the office. Any child isolated due to sickness/illness/etc will be using the staff/adult restroom. 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 and LPM observed at the initial inspection that there was no hook to mount the partition that separates the toddler and preschool indoor area. At today's inspection, LPA and LPM observed that applicant was able to correct this by mounting the partition to a wall hook to prevent the partition from tipping over. If the facility chooses to change the location of the hook and eye separating the two components, they must notify the department prior to implementation for approval.

Report continued on LIC 809-C.

NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Jaelyn Agbayani
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025
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: 12/18/2025
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LPA and LPM observed at the initial inspection that the children’s cubbies were not mounted to prevent the cubby from possibly falling over. LPA and LPM observed at today’s inspection that the applicant was able to correct this initial correction by mounting the children’s cubbies to the wall to ensure the safety of the children are met.

LPA and LPM observed at the initial inspection for applicant to install proper cushioning for the outdoor area as well. At today's inspection, LPA and LPM were able to confirm through observation that the applicant has fulfilled this correction by installing proper woodchip cushioning.

At the initial inspection, LPA and LPM observed and discussed with applicant that the office space needed to be completely set up and ready to go. LPA and LPM have observed and confirmed that the applicant was able to complete set up of the facility office space.

LPA can confirm that applicant was able to correct all needed physical plant corrections for application purposes and document corrections are pending review with LPA. Once review is complete, application will be passed over to LPM for review. LPA has also received a waiver request for the shared outdoor space for the preschool and toddler component and will submit waiver request for review to LPM upon completion of LPA review.

The following requirement must be completed before licensure will be considered:

1. Approval of waiver for shared outdoor space use for preschool and toddler component.

2. Approval of director's packet
3. Final review of application packet by LPM

An exit interview was conducted with applicant representative, Alex Myers.

This report was provided to applicant representative.

Appeal rights were provided to applicant representative.

Final license determination will be made upon review by Licensing Program Manager.

NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Jaelyn Agbayani
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC809 (FAS) - (06/04)
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