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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622013
Report Date: 11/18/2021
Date Signed: 11/18/2021 12:45:29 PM

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:SUNDANCE MONTESSORI SCHOOL, INC.FACILITY NUMBER:
343622013
ADMINISTRATOR:HOLDEN, DOREENFACILITY TYPE:
850
ADDRESS:216 NATOMA STREETTELEPHONE:
(916) 985-6034
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:60CENSUS: 42DATE:
11/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Doreen HoldenTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Kelly Ferrara met with Facility Representative Doreen Holden for an unannounced annual inspection on Thursday, November 18th, 2021. At 10:45 AM, LPA toured the facility including all activity and classroom spaces, restrooms, food service and outdoor play areas. Appropriate ratio and care and supervision were observed during today's inspection. Census included 42 children being supervised by six staff. Facility Representative was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility hours of operation are Monday through Friday from 7:30 AM to 6 PM.

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.

Classrooms all appeared clean including the carpets and floor. Chemicals were kept inaccessible to children in a high cabinet. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to absorb a fall. Uncontaminated drinking water was readily available to children both indoors and outdoors. Bathrooms were clean and all sinks and toilets were in operating condition. There are no firearms or bodies of water on the premises and the facility has at least one functioning smoke and carbon monoxide detector. Menus were posted for AM and PM snack and the children are provided lunches or bring their own. LPA observed all required licensing documentation was posted in each building for parental review. LPA observed that parents are signing their children in and out of the center. LPA discussed current Covid guidelines with the Facility Representative.

Continued on 809-C
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
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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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: SUNDANCE MONTESSORI SCHOOL, INC.
FACILITY NUMBER: 343622013
VISIT DATE: 11/18/2021
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At 12:15 PM, files of present staff were reviewed. LPA reviewed staff transcripts and observed all staff being utilized as teachers were qualified. LPA observed all staff had a current Mandated Reporter certificate and proof of immunizations. At least one staff had a current Pediatric CPR and First Aid certification that expires October 2023. LPA observed all children’s files contained the appropriate documents. LPA observed a current children's roster and a fire/disaster drill log. The facility is equipped with First Aid equipment.

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: http://www.ada.gov/childqanda.htm

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/inspection-process.

Facility Representative was encouraged to the visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, PINs, forms, regulations and legislation pertaining to child care centers.

No deficiencies were issued based on today’s inspection. Exit interview was conducted and report was reviewed with the Facility Representative Doreen Holden. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC809 (FAS) - (06/04)
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