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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 090319030
Report Date: 12/12/2019
Date Signed: 12/12/2019 01:21:50 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:MONTESSORI MANORFACILITY NUMBER:
090319030
ADMINISTRATOR:DILLON, LESLIEFACILITY TYPE:
850
ADDRESS:2222 FRANCISCO DR., STE. 400TELEPHONE:
(916) 933-2420
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY:58CENSUS: 51DATE:
12/12/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Leslie DillonTIME COMPLETED:
01:30 PM
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Licensing Program Analysts (LPA) Michelle Pascual and Licensing Program Manager (LPM) Bettina Engelman, met with owner/director, Leslie Dillon, for the purpose of an unannounced annual required inspection. Upon arrival, there were fifty one (51) children present. All staff had criminal record clearance. The facility is open Monday-Friday from 7:30 am to 6:00Pm. The children bring their lunch and the facility provides snacks.

LPA toured the facility inside and out for a health and safety inspection. Physical plant- There are no firearms or bodies of water on the premises. The facility appeared orderly and suitable for children. Cleaning supplies and hazardous items were inaccessible to children. Medication is stored in a safe place inaccessible to children in care. Outdoor activity space and equipment was in good repair. Uncontaminated drinking water is available both indoors and outdoors. Facility has a current fire/disaster drill log. LPA observed a first aid kit. LPA observed that solid waste storage vessels/bins had tight fitting covers on and in good repair. All toilets and hand washing facility is safe and sanitary operating condition. Facility has license, parent’s rights, emergency evacuation, and car seat safety posted. Facility Administration- The department has inspection authority. LPA observed that at least one staff member has current CPR and Pediatric First Aid. Evaluation of care and supervision- LPA observed that all children were being supervised during the inspection. Capacity and ratio requirements were being met. FACILITY RECORDS REVIEW- children’s records included emergency contact. Staff personnel record contained documentation of the educational backgrounds, training, and or experience.
continued on subsequent page 809C
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: MONTESSORI MANOR
FACILITY NUMBER: 090319030
VISIT DATE: 12/12/2019
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

The facility evaluation report was reviewed and discussed with the licensee. A notice of site visit was provided and should remain posted for a period of 30 days for parental review. Director was encouraged to the visit the department’s website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers. Their signature on this form acknowledges receipt of this form.



Based upon today’s inspection, no Title 22 deficiency was cited.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2