343614059-6-20-2023-03-CC-MGON-CSYTR5-20230620145658

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343614059
Report Date: 06/20/2023
Date Signed: 06/20/2023 02:57:03 PM

Document Has Been Signed on 06/20/2023 02:57 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:	343614059
ADMINISTRATOR:	RANATUNGA, SUBASHINI (SUE)		FACILITY TYPE:	850
ADDRESS:	2075 ARENA BLVD		TELEPHONE:	(916) 515-0550
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95834
CAPACITY:	165	CENSUS: 46	DATE:	06/20/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Subashin Ranatunga		TIME COMPLETED:	03:15 PM

NARRATIVE

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At 9:00 AM on Tuesday June 20 2023, Licensing Program Analysts (LPAs) Mandie Goodwin and Jeremey McClain met with Director Subashini Ranatunga, for the purpose of an unannounced 1 year required inspection and to inspect water outlets that tested beyond exceedance for lead. LPA toured the facility, at which time a census of 46 preschool children supervised by 8 staff was observed. All individuals subject to criminal background review have obtained clearance.

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, required publications, menus, and daily schedules. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Medications are stored out of reach and inaccessible to children. Furniture and equipment are in good condition, and toileting facilities are in sanitary, and operating condition. Bins for solid waste have tight fitting lids. The floors appeared clean throughout the facility. LPA observed smoke and carbon monoxide detectors. LPA observed nap equipment to be stored appropriately with bedding separated.

Children have access to water indoors and outdoors using water bottles and drinking fountains. Facility has conducted the required lead testing for consumable water sources. One drinking fountain in the maroon room and one in the red room tested over the 5.5 parts per billion for lead. The drinking fountain in the maroon room tested 13pbb, and according to director hasn’t been used for consumption in many years. The drinking fountain in the red room tested at 8.1ppb and also hasn’t been used for drinking. Since being notified facility has turned off the water to these sources and made them inoperable.

Playground equipment and surfaces are free of loose or sharp parts. LPA observed sufficient cushioning under play structures. Outdoor shade is provided by canopies, trees, and sides of buildings. There are no firearms, poisons, or bodies of water on the premises.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

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 06/20/2023 02:57 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: 343614059
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

10700(b)(1)

WD 101700(b)(1) California Lead Action Level at Child Care Centers (b) Testing results with ... (1) ... "values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. 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 by having 2 drinking faucets test over the exceedance level. One tested at 8.1ppb and one tested at 13ppb which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/20/2023
	Plan of Correction
1 2 3 4	Director ordered new parts to replace the water fountains and will have water retested for lead.

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: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

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: 343614059
	VISIT DATE: 06/20/2023

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LPA reviewed staff files. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience. Upon review, all staff members had current mandated reporter trainings. LPA advised AB 1207 Mandated Reporter training must be renewed every two years and can be renewed at www.mandatedreporterca.com. Facility had a current roster, and children are signed in and out of the facility using a digital application. LPA advised director that emergency disaster drills must be completed every six months.

A sample of 6 children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment, health history, a record of immunization’s and notifications of children’s and parent’s rights. 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 director of their responsibility to stay current in regards to new regulations.

Facility representative 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

LPA discussed Assembly Bill 2370, which will require licensed Child Care facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1st, 2020 to January 1st, 2023 and must be conducted every five years from initial testing.

In the areas that were evaluated a deficiency was observed at the time of the visit and is cited on LIC 809-D. Appeal rights were provided. Exit interview was conducted and report was reviewed with the director Subashini Ranatunga.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

LIC809 (FAS) - (06/04)

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