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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009958
Report Date: 09/21/2023
Date Signed: 09/21/2023 12:10:14 PM

Document Has Been Signed on 09/21/2023 12:10 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:CLOVERDALE EAGLETS PRESCHOOL & DAYCARE CENTERFACILITY NUMBER:
493009958
ADMINISTRATOR:BOEHM, JEANETTEFACILITY TYPE:
850
ADDRESS:530 NORTH CLOVERDALE BLVDTELEPHONE:
(707) 894-6037
CITY:CLOVERDALESTATE: CAZIP CODE:
95425
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 10DATE:
09/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jeanette Boehm TIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with Jeanette Boehm for the purpose of a capacity change due to a floor plan reconfiguration. The licensee has requested a capacity for the preschool with toddler option to increased from 30 to 40 children. The licensee's intention is to have two toddler groups with a maximum of 18 toddlers. One group of toddlers for younger toddlers starting at 18 months and another toddler group from 24 to 36 months depending on the child's development. The toddlers will use the front right rooms and the front left room. The licensee was made aware that the maximum group size for toddlers is 12 toddlers. The toddlers have a toilet and three sinks that are physically separated from the preschool children's area. There is also a staff rest room in the toddler area. The approved fire clearance was granted on August 25, 2023.

The preschool indoor activity area consists of the large classroom at the rear of the building as well as the dining area just off the kitchen and an interior classroom.

There are a total of four toilets (one in the outdoor activity area) and six sinks for preschool/toddlers use.

There is a toddler outdoor activity area as well as a preschool and school age outdoor activity areas.

There is sufficient indoor and outdoor activity area to support the 40 preschool/toddler program.

LPA Ouye has requested an updated sketch to be submitted.

The license is approved for 40 preschool children, 18 of which may be in the toddler option effective September 21, 2023..
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2023
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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