343613062-6-20-2024-03-CC-MGON-D6EUV3-20240620155430

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343613062
Report Date: 06/20/2024
Date Signed: 06/20/2024 03:54:41 PM

Document Has Been Signed on 06/20/2024 03:54 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	LITTLE BLOSSOM MONTESSORI SCHOOL, INC.		FACILITY NUMBER:	343613062
ADMINISTRATOR:	RANATUNGA, SUBASHINI (SUE)		FACILITY TYPE:	830
ADDRESS:	2075 ARENA BLVD.		TELEPHONE:	(916) 515-0550
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95834
CAPACITY:	40	CENSUS: 8	DATE:	06/20/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Sue and Lucky Ranatunga		TIME COMPLETED:	04:15 PM

NARRATIVE

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On Thursday June 20th 2024, Licensing Program Analysts (LPAs) Mandie Goodwin and Loraine Perez met with Director Sue Ranatunga and administrator Lucky Ranatunga for the purpose of an unannounced required inspection. Operating hours of the facility are from 7:00am-5:30pm Monday through Friday. Director guided LPA on a tour of the facility, at which time a census of 3 infants with two teachers and 5 toddlers with one teacher under the toddler option were observed between 2 classrooms.

LPA observed that each child had a Needs and Services plan. LPA observed an Individual Infant Sleeping Plan (LIC9227) for each child under 12 months of age. LPA observed documentation that sleep checks were being conducted by staff every 15 minutes for all children under two years old. Bottles were kept in refrigerators inside the classrooms and labeled with the child’s name. LPA gave a technical violation and advised facility that the bottles must also be labeled with the date. All furnishings were in good condition. Infant diaper changing area is clean. Changing table was observed to be within arm’s reach from sink. There is a mat for the changing table with a vinyl surface that is at least 1 inch thick and has raised sides. Toys are appropriate size with no small parts for the safety of the infants.

The infant classrooms appeared clean including the carpets and floor. Chemicals and cleaning materials were kept inaccessible to children. Playground equipment and surfaces were inspected. Equipment was in good condition. Facility stated they will be filling the spaces between the ground cover outside. There are no firearms or bodies of water on the premises and the facility has at least one functioning smoke and carbon monoxide detector. LPA observed the appropriate postings were visible to parents and that children were signed in and out of the center using an online application. LPA observed a current roster and record that fire drills are being conducted at least every 6 months. Per record the last fire drill was conducted on 4/23/2024.

All present staff files were reviewed. LPA reviewed staff transcripts and observed all staff being utilized as teachers were qualified.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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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Document Has Been Signed on 06/20/2024 03:54 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LITTLE BLOSSOM MONTESSORI SCHOOL, INC.	FACILITY NUMBER: 343613062
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) 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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. 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 in 3 out of 3 infant teacher files which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/05/2024
	Plan of Correction
1 2 3 4	Director will send proof of immunizations (MMR, TDAP) for all teachers. Flu shot can be a letter declining.

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: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LITTLE BLOSSOM MONTESSORI SCHOOL, INC.	FACILITY NUMBER: 343613062
	VISIT DATE: 06/20/2024

NARRATIVE

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LPA observed a current Mandated Reporter certificate for each staff and director was reminded the certificate must be renewed every two years and can be renewed at mandatedreporterca.com. LPA did not observe immunizations in 3 out of 3 infant teacher files. At least one staff had a current Pediatric CPR and First Aid certification. LPA observed a sample of 3 infant files and observed required documentation.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA referred licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. Continue on 809-C

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LITTLE BLOSSOM MONTESSORI SCHOOL, INC.	FACILITY NUMBER: 343613062
	VISIT DATE: 06/20/2024

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The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Administrator Lucky Ranatunga. Based on the areas evaluated, a title 22 deficiency was cited today.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

LIC809 (FAS) - (06/04)

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