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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009775
Report Date: 04/02/2024
Date Signed: 04/02/2024 05:00:55 PM

Document Has Been Signed on 04/02/2024 05:00 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:DEASON, ANDREA FCCHFACILITY NUMBER:
493009775
ADMINISTRATOR:DEASON, ANDREAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 328-5086
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY: 14TOTAL ENROLLED CHILDREN: 20CENSUS: 12DATE:
04/02/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:22 PM
MET WITH:Andrea DeasonTIME COMPLETED:
04:08 PM
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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 licensee to inspect and approve a previously designated off limits area for child care use. The licensee is requesting permission to use the converted workshop in the backyard for childcare purposes. The workshop is listed as "Classroom/Office" on the facility's updated facility sketch. The LPA observed sufficient heating and cooling elements in the workshop. This area is fully fenced. This workshop has been approved for childcare use.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Andrea Deason. There were no Title 22 deficiencies cited during today's inspection.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/02/2024
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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