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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010225
Report Date: 09/04/2024
Date Signed: 09/04/2024 04:24:48 PM

Document Has Been Signed on 09/04/2024 04:24 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 CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:LA CASITA DAY SCHOOLFACILITY NUMBER:
493010225
ADMINISTRATOR/
DIRECTOR:		IRENE SILVAFACILITY TYPE:
850
ADDRESS:4044 MAYETTE AVENUETELEPHONE:
(707) 536-1241
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY: 134TOTAL ENROLLED CHILDREN: 58CENSUS: 41DATE:
09/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Irene Silva and Wendy VelazquezTIME VISIT/
INSPECTION COMPLETED:
04:38 PM
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Licensing Program Analyst (LPA), Amy Strother made an unannounced Case Management visit to the facility today and met with Director, Wendy Velazquez (D1) and Licensee, Irene Silva (L1). LPA Strother received a voicemail from L1 on 08/28/24, requesting a return call. LPA Ouye returned the call to L1 on 08/29/24 and provided consultation to L1. On 08/30/24, LPA Ouye recommended that L1 submit an Unusual Incident Report (UIR) for an incident that occurred on 08/23/24. On 09/03/24 L1 submitted the UIR to LPA Ouye, which was forwarded to LPA Strother earlier this morning, 09/04/24.

The purpose of the visit was to review reporting requirements. Specifically, Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report to: cclrpregionalofficegeneral@dss.ca.gov, within seven days. Additionally reporting requirements to parents was also discussed. LPA reviewed the facilities discipline and biting policy during the visit. LPA consulted on biting behaviors, providing multiple handouts and provided Licensee with information about the resource, Infant and Early Childhood Mental Health Consultation (IECMHC) Network for staff.

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

Exit interview conducted and report reviewed with L1. A 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.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE: DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/04/2024
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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