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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010252
Report Date: 08/07/2024
Date Signed: 08/07/2024 11:23:51 AM

Document Has Been Signed on 08/07/2024 11:23 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:HEAD START - GUILLORYFACILITY NUMBER:
493010252
ADMINISTRATOR/
DIRECTOR:		JOSEFINA FIGEROAFACILITY TYPE:
830
ADDRESS:10288 STARR ROADTELEPHONE:
(707) 544-6911
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 0DATE:
08/07/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Kim RodgersTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Glenn Ouye met with Area Manager, Kim Rodgers to conduct a case management visit. The licensee is requesting a change for their infant program with a toddler component. They have requested that their program will provide care for 16 toddlers ages 18 months through 36 months.

There are two distinct areas of the toddler classrooms. The two toddler rooms are separated by an accordion sliding partition. LPA measured the interior and exterior square footage. The interior and exterior square footage supports the licensee's request for 16 toddlers. There are two toilets and three sinks for the toddlers. There is 549 square feet of indoor activity space and 1548 square feet of outdoor activity space.

No fire clearance is required because the toddler component is an extension of the infant license and there is no increase in capacity.

The licensee has a preschool license in an adjacent classroom.

The facility is approved for 16 toddlers ages 18 months to 36 months, effective August 7, 2024. An updated license will be provided to the licensee.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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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