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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493008944
Report Date: 02/09/2023
Date Signed: 02/09/2023 05:02:05 PM

Document Has Been Signed on 02/09/2023 05:02 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:BRIGHT SKIES MONTESSORIFACILITY NUMBER:
493008944
ADMINISTRATOR:AISHWARYA KANCHARLAFACILITY TYPE:
850
ADDRESS:11201 MAIN STREETTELEPHONE:
(707) 665-9830
CITY:PENNGROVESTATE: CAZIP CODE:
94951
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 10DATE:
02/09/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Aishwarya KancharlaTIME COMPLETED:
05:15 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with the licensee to conduct a capacity determination. The plan is to convert one of the classrooms in to an infant program serving children 12-24 months of age. The remaining part of the facility will remain as the preschool program.

There is sufficient square footage in the infant room and the outdoor activity area for 8 infants. There is a toilet and sink and a changing table will be installed within arms reach of the sink in the room.

The preschool license area was also measured and will support up to 26 preschool children. There are two toilets and two sinks for the preschool children.

LPA Ouye will send the licensee a copy of the capacity determination worksheets for the infant and preschool programs.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2023
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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