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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340314880
Report Date: 11/19/2019
Date Signed: 11/19/2019 10:41:46 AM

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 COUNTRY DAY AT RIVERLAKEFACILITY NUMBER:
340314880
ADMINISTRATOR:MARTHA RUIZFACILITY TYPE:
850
ADDRESS:7575 RUSH RIVER DR.TELEPHONE:
(916) 427-1900
CITY:SACRAMENTOSTATE: CAZIP CODE:
95831
CAPACITY:94CENSUS: 71DATE:
11/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
07:15 AM
MET WITH:Martha RuizTIME COMPLETED:
11:00 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Mai Lor and Christopher Bello conducted an unannounced random annual inspection and met with Director Martha Ruiz. Census included 71 children and nine staff. Hours of operation are Monday thru Friday; 7:00 AM to 6:00 PM.

A tour of the facility was conducted inside and outside. The following areas are in compliance during the inspection. There are no bodies of water. Firearms and ammunition are not on the premises. Director stated there are no poisons on the premises. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. A current disaster drill log and children's roster were observed. Carbon Monoxide detector was present. The playground equipment and outdoor activity space is maintained and in good condition. Wood chips are being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. Children's toilets, hand washing facilities are sanitary. Floors are clean and free of debris. Food preparation area is clean, food is protected from contamination, storage containers for solid waste are covered and all food or beverages are stored in covered containers and labeled. Drinking water is available both indoors and outside. The facility provides snacks. The facility is in compliance with conditions and limitations specified on the license. Electronic sign in/sign out have full legal signature and record of time of day. Staff subject to a criminal record clearance or exemption are associated to the facility. At least one staff have current Pediatric First Aid/CPR reviewed that expires in 09/2021. A random sample of children and staff records were reviewed and contained all of the required documentation. Staff education and experiences were verified.

(Report continued on page 2)
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
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 COUNTRY DAY AT RIVERLAKE
FACILITY NUMBER: 340314880
VISIT DATE: 11/19/2019
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The facility is providing Incidental Medical Services. 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: www.ada.gov/childqanda.

LPA provided the Community Care Licensing’s 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.



No Title 22 Regulations cited during this inspection. Exit interview conducted. Notice of Site Visit was provided and posted.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2