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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 310306626
Report Date: 12/13/2019
Date Signed: 12/13/2019 02:00:58 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 HOUSE OF CHILDRENFACILITY NUMBER:
310306626
ADMINISTRATOR:WICKRAMASINGHE, KUMUDINIFACILITY TYPE:
850
ADDRESS:314 FOLSOM RD.TELEPHONE:
(916) 786-6533
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:24CENSUS: 19DATE:
12/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Kumudini Wickamasinghe - DirectorTIME COMPLETED:
02:30 PM
NARRATIVE
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An unannounced annual/random inspection is made today by Licensing Program Analyst Owens and Habtom. LPA's Owens and Habtom met with Kumudini, Director. A tour of facility was conducted inside and outside. Staff and children were spoken to during inspection.

The following areas are in compliance during inspection: There are no bodies of water. Firearms and ammunition are not on the premises. Storage area for poisons is locked. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. Fire drills are conducted according to Title - 22 Regulations. There is appropriate space for children belongings. The playground equipment and outdoor activity space is maintained and in good condition. There is adequate shade on the playground. Carbon Monoxide detector is on the premises. Wood chips is being used as cushioning around the climbing equipment. Children's toilets, hand washing facilities are sanitary. Rooms are safe and clean. Food preparation area is clean. The parents provides lunch and snack. Drinking water is available both indoors and outside. Napping equipment is in good repair. The facility is in compliance with conditions and limitations specified on the license. Teacher/child ratios are maintained and adequate supervision is being provided during this inspection. Sign in/sign out sheets maintained. No excluded individuals are present. Staff subject to a criminal record clearance or exemption are associated to the facility. First Aid/CPR reviewed and NOT in compliance. Emergency information reviewed for some children. Staff records reviewed and contain documentation of the educational background, training, and/or experience. Operating hours are Monday thru Friday; 7:30 AM to 5:30 PM.

LPA did not observed proof that all staff/ volunteers have met the requirements of SB 792.

Continued on page 2.

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
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 3
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 HOUSE OF CHILDREN
FACILITY NUMBER: 310306626
VISIT DATE: 12/13/2019
NARRATIVE
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LPA did not observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com

LPA discussed the new Safe Sleep in Child Care regulation and gave licensee the brochure. LPA discussed and gave licensee the Effects of Lead Exposure brochure.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.



Incidental Medical Services (IMS) policy was discussed, facility is not currently providing IMS at this time. 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 is cited per Title 22 Div. 12 of the CCR: (see page 2)
Copy of Appeal Rights left with Center Representative/licensee.

A COPY OF THIS REPORT MUST REMAIN IN THE FACILITY FOR PUBLIC REVIEW.

NOTICE OF SITE VISIT FORM POSTED TO PARENT'S BOARD FOR 30 DAYS.

To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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 HOUSE OF CHILDREN
FACILITY NUMBER: 310306626
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/13/2020
Section Cited

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Personnel Requirements
At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.
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This requirement is not met as evidence by LPA did not observe any staff present today having a current CPR card.
This is a potential risk to children.
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Licensee was informed if deficiency is not corrected by due date a civil penalty may be assessed.
Type B
01/13/2020
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a),
This requirement is not met as evidence by LPA did not observe staff having proof of mandated reporter training. This is a potential risk to children.
See confidential names list LIC 811.
Type B
01/13/2020
Section Cited

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Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles.
This requirement is not met as evidence by LPA did not observe staff having proof of immunizations: TDAP/MMR/FLU.
This is a potential risk to children. See confidential names list LIC811.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3