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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340314880
Report Date: 11/06/2024
Date Signed: 11/06/2024 10:50:23 AM

Document Has Been Signed on 11/06/2024 10:50 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MONTESSORI COUNTRY DAY AT RIVERLAKEFACILITY NUMBER:
340314880
ADMINISTRATOR/
DIRECTOR:		MARTHA RUIZFACILITY TYPE:
850
ADDRESS:7575 RUSH RIVER DR.TELEPHONE:
(916) 427-1900
CITY:SACRAMENTOSTATE: CAZIP CODE:
95831
CAPACITY: 94TOTAL ENROLLED CHILDREN: 94CENSUS: 87DATE:
11/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Martha RuizTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Christopher Bello met with Director, Martha Ruiz, regarding an Unusual Incident that took place October 24th, 2024. LPA made observations and interviewed the director regarding the incident.

Director stated the facility has taken preventative measures to ensure future accidents from taken place.

No Title 22 Deficiencies observed in the areas that were evaluated. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director [or facility representative] Martha Ruiz.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
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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