340315188-6-15-2022-03-CC-KGUA-CFERHX-20220615130304

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340315188
Report Date: 06/15/2022
Date Signed: 06/15/2022 01:03:12 PM

Document Has Been Signed on 06/15/2022 01:03 PM - 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:	VILLAGE MONTESSORI SCHOOL		FACILITY NUMBER:	340315188
ADMINISTRATOR:	WILLIS, LISA/AUERING, ERIN		FACILITY TYPE:	850
ADDRESS:	5033 FAIR OAKS BLVD		TELEPHONE:	(916) 488-6500
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	128	CENSUS: 75	DATE:	06/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Lisa Willis		TIME COMPLETED:	01:15 PM

NARRATIVE

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At 10:05 a.m. on Wednesday, June 15th, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Licensee, Lisa Willis, for the purpose of a Required - 1 year inspection. A risk assessment for COVID-19 was conducted. Operating hours of the facility are from 7:00 a.m.-6:00 p.m., Monday thru Friday. Licensee guided LPA on a tour of the facility, at which time a census of 67 preschool children supervised by 9 staff, and 8 toddler children supervised by 2 staff was observed.

LPA reviewed background clearance for staff. Licensee 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.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Licensee stated there are no poisons on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. Bins for solid waste in the have tight fitting lids. The floors appeared clean throughout the facility. The facility provides morning and afternoon snack. Lunch is provided for children on Friday. The food preparation space is free of litter and all food was protected against contamination. Drinking water was readily available to children both indoors and outdoors via drinking fountains and labeled bottles. LPA observed full legal signatures of authorized representatives on sign in and sign out sheets. There are no firearms on the premises. LPA observed a functional carbon monoxide detector. Playground equipment and surfaces are free of loose or sharp parts. LPA observed wood chip cushioning beneath the play structure. Outdoor shade is provided by trees and canopies.

Report continues on 809-C.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2022

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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Document Has Been Signed on 06/15/2022 01:03 PM - It Cannot Be Edited

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: VILLAGE MONTESSORI SCHOOL	FACILITY NUMBER: 340315188
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101217(d)

Personnel Records

(d) All personnel records shall be maintained at the child care center and shall be available to the licensing agency for review. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as multiple staff files were missing some personnel records, including documentation of educational background, training, and/or experience, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/15/2022
	Plan of Correction
1 2 3 4	Licensee will provide evidence of completed files to LPA by POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2022

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: VILLAGE MONTESSORI SCHOOL	FACILITY NUMBER: 340315188
	VISIT DATE: 06/15/2022

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There is a swimming pool on the premises. LPA observed appropriate fencing for pool with a gate that swings away. LPA observed wading pools for water play and reminded Licensee that wading pools shall be emptied after use.

Staff files were reviewed. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and AB 1207 Mandated Reporter training certificates for most staff. Some files were missing documentation including educational background, training, and/or experience.

Children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment and notifications of children’s and parent’s rights, health history, physician's report and immunization records.

LPA did not observe napping logs for infant children in the toddler option. Technical assistance was conducted.

This facility does not provides Incidental Medical Services – IMS. A plan of operation must be on file when IMS is provided. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.

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.

Licensee stated that annual fees are current. A staff interview was conducted with the Licensee, Lisa Willis.

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.

A title 22 deficiency is cited on the subsequent pages of this report. Appeal rights were provided. An exit interview conducted and this report was reviewed with the Licensee, Lisa Willis. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2022

LIC809 (FAS) - (06/04)

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