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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493005602
Report Date: 01/24/2024
Date Signed: 01/24/2024 02:23:03 PM

Document Has Been Signed on 01/24/2024 02:23 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:CASTLE PRESCHOOLFACILITY NUMBER:
493005602
ADMINISTRATOR:REBECCA ROSE WHITEFACILITY TYPE:
850
ADDRESS:7601 HUNTLEY STREET, ROOM 28TELEPHONE:
(707) 829-4579
CITY:SEBASTOPOLSTATE: CAZIP CODE:
95472
CAPACITY: 30TOTAL ENROLLED CHILDREN: 27CENSUS: 12DATE:
01/24/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Director Rebecca WhiteTIME COMPLETED:
02:35 PM
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An unannounced Case Management inspection was performed by Licensing Program Analyst (LPA) Selena Mariani and met with Director (D1), RebeccaWhite to obtain documentation related to no action level accedence of lead and obtain and review documents for shared outdoor play space.

During today's inspection visit, there were 12 children being supervised by 3 staff. LPA provided consultation on Incidental Medical Services (IMS) Plan of Operation requirements and implementation of IMS procedures for individual children.

Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director, Rebecca White.

There were no Title 22 deficiencies cited during today's inspection.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Selena Mariani
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2024
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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