340308598-8-23-2022-03-CC-ATIY-CHKPB6-20220823110948

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340308598
Report Date: 08/23/2022
Date Signed: 08/23/2022 11:13:54 AM

Document Has Been Signed on 08/23/2022 11:13 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	MC KINLEY MONTESSORI SCHOOL-WEST		FACILITY NUMBER:	340308598
ADMINISTRATOR:	KATHLEEN/REBECCA/SARA		FACILITY TYPE:	850
ADDRESS:	3008 H STREET		TELEPHONE:	(916) 447-5331
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95816
CAPACITY:	34	CENSUS: 14	DATE:	08/23/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Sara Collins		TIME COMPLETED:	11:25 AM

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On August 23, 2022, at approximately 8:15 PM, Licensing Program Analyst (LPAs ) Alize Tillery and Mandie Goodwin met with Director Sara Collins for the purpose of an unannounced required 1 year annual inspection. Upon arrival, LPA observed 9 children supervised by 2 staff in the Preschool Room and 5 kids supervised by 2 staff in the Twos’ Room. The facility hours of operation are Monday through Friday from 7:30 AM to 5:30 PM. The facility does not offer transportation services.

LPAs toured all activity and classroom spaces (Preschool Room and Two’s Room), restrooms and outdoor play area. LPAs observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster and daily schedule. Cleaning disinfectants, medications and hazardous items are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary and operating condition, and the floors appeared to be clean throughout the facility. LPAs observed a functional carbon monoxide detector, smoke detector and fire extinguisher. LPA discussed COVID19 guidelines with Director.

The program does not provide meal services. Director stated that if a child forgets their lunch they will contact the parents to have food dropped off. LPA observed trash bins with tight fitted lids. Drinking water is readily available to children both indoors and outdoors. Director stated that they use personal cups and use their filtered water fountain. LPAs observed the facility’s sign in and out sheet. Facility has record of conducting fire drills at least every six months; last fire drill was conducted on 08/18/2022. Playground equipment and surfaces are free of loose or sharp parts. There are sufficient equipment and toys, and there are shaded areas supplied by large tents, and there is rubber bark under the play equipment for cushioning.

Report continues on 809-C.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize Tillery	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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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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: MC KINLEY MONTESSORI SCHOOL-WEST	FACILITY NUMBER: 340308598
	VISIT DATE: 08/23/2022

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4 staff and 6 children records were reviewed. Staff files were observed to be complete and included: Education Verification, LIC 501 Personnel Record, LIC 503 Health Screenings, LIC 508 Criminal Record Statements, LIC 9052 Employee Rights, Immunizations (Tdap, MMR, Influenza). At least one staff member present today has a current Pediatric CPR and First Aid certification that expires in 03/2024. Director was reminded that all staff are to take the Mandated Reporter Training every 2 years.

Children Files were also observed to be complete and included: Admission Agreements, Physician and Parent Health History Reports, Emergency Cards, Consent for Medical Treatment forms, Personal and Parent Rights Forms, and immunizations. LPA observed a current Children’s Roster. LPA reminded Licensees that 100% supervision is required at all times. LPA reviewed the Department's inspection authority and discussed with designee any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

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 is 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

Report continues...

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize Tillery	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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: MC KINLEY MONTESSORI SCHOOL-WEST	FACILITY NUMBER: 340308598
	VISIT DATE: 08/23/2022

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Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

During todays inspection, no deficiencies were observed.

A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted and the report was reviewed with the Director, Sara Collins.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize Tillery	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

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