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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493006221
Report Date: 10/16/2023
Date Signed: 10/16/2023 01:45:35 PM

Document Has Been Signed on 10/16/2023 01:45 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 RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:TORRI, PETRA FAMILY CHILD CARE HOMEFACILITY NUMBER:
493006221
ADMINISTRATOR:TORRI, PETRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 938-8639
CITY:SONOMASTATE: CAZIP CODE:
95476
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Petra TorriTIME COMPLETED:
01:50 PM
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A case management visit was made to the facility today by Licensing Program Analyst (LPA) Mindy Mohr to conduct a confirmation of facility closure visit. The facility's licensee, Petra Torri submitted a request to close her facility on 09/15/23. During today's case management visit, the LPA observed no children in care or any evidence of childcare being provided at this address. A tour of the home was provided to the LPA by the licensee. The Licensee provided LPA her facility license.

Confirmation of facility closure is complete
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2023
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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