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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493006287
Report Date: 04/22/2024
Date Signed: 04/22/2024 11:30:11 AM

Document Has Been Signed on 04/22/2024 11:30 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:LA PETITE ACADEMY - PRESCHOOL/WINDSORFACILITY NUMBER:
493006287
ADMINISTRATOR/
DIRECTOR:		JAMIE POMAFACILITY TYPE:
850
ADDRESS:9451 SOUTH BROOKS ROADTELEPHONE:
(707) 838-0549
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY: 92TOTAL ENROLLED CHILDREN: 91CENSUS: 51DATE:
04/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:44 AM
MET WITH:Jenny Wittry, Interim Center DirectorTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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A case management visit was made to the facility by Licensing Program Analyst (LPA) Y. Yang at the request of the interim center director, Jenny Wittry to inspect and approve a previously designated "School age classroom" for preschool use. The center relinquished its school age license on 02/23/24. There are no changes to the facility's preschool license capacity. During today's visit, the LPA inspected the classroom and approved its use for the preschool license. The room is listed as the "preschool room" on the updated floor sketch was obtained from the facility. The LPA provided technical assistance and answered questions related to Title 22 regulations.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the interim center director, Jenny Wittry. There were no Title 22 deficiencies cited during today's inspection.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 04/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2024
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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