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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493010295
Report Date: 01/06/2023
Date Signed: 01/06/2023 10:36:03 AM

Document Has Been Signed on 01/06/2023 10:36 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:HOGELAND STUSSER, DONNA FCCHFACILITY NUMBER:
493010295
ADMINISTRATOR:HOGELAND STUSSER, DONNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 293-3400
CITY:SEBASTOPOLSTATE: CAZIP CODE:
95472
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
01/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Donna Hogeland StusserTIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Glenn Ouye returned to meet with the licensee after her fire inspection was approved. The fire clearance was approved on December 22, 2022. The facility has a pull station alarm and a functional carbon and smoke detectors. The fire extinguisher is rated at 3A40BC.

All of the branches have been removed from the fencing around the pool and the gates now self latch.

The prelicensing was completed on 9/30/22 and 12/1/22. The facility now meets all of the requirements and is approved for licensure as a large family child care home effective today (January 6, 2023).
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 01/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2023
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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