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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493000703
Report Date: 04/13/2023
Date Signed: 04/13/2023 04:59:05 PM

Document Has Been Signed on 04/13/2023 04:59 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:REED, NONA FAMILY CHILD CARE HOMEFACILITY NUMBER:
493000703
ADMINISTRATOR:REED, NONAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 762-6607
CITY:PETALUMASTATE: CAZIP CODE:
94954
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/13/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:33 AM
MET WITH:Nona ReedTIME COMPLETED:
11:04 AM
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A case management visit was made to the facility today by Licensing Program Analyst (LPA) Y.Yang to conduct a confirmation of facility closure visit. The facility's licensee, Nona Reed submitted a request to close her facility on 03/22/23. During today's case management visit, the LPA observed no children in care or any evidence of childcare being provided at this address.The LPA provided the licensee with a confirmation of facility closure receipt letter during this visit.

Confirmation of facility closure is complete.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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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