343623399-12-13-2019-03-CC-SDLA-BJTTA3-20191213133251

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623399
Report Date: 12/13/2019
Date Signed: 12/13/2019 01:32:59 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:	GUIDEPOST MONTESSORI AT FOLSOM		FACILITY NUMBER:	343623399
ADMINISTRATOR:	KOMENTANI, KIARA		FACILITY TYPE:	830
ADDRESS:	777 & 791 LEVY ROAD		TELEPHONE:	(949) 354-2259
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY:	18	CENSUS: 0	DATE:	12/13/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Aaron Bailey		TIME COMPLETED:	02:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Application Specialist (AS) Seychelle De Luca and Licensing Program Analyst (LPA) Tanya Washington met with Applicant Aaron Bailey for the purpose of an announced prelicensing change of ownership inspection. Applicant request an infant license to serve 18 infant children from birth to two years of age. The program will operate Monday through Friday from 7:00 AM to 7:00 PM. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat poster, menus, and daily schedule. AS and LPA discussed the forms that must be in each child's and each staff member's file and AS provided LIC311A, Safe Sleep in Child Care, Effects of Lead Exposure brochure, Healthy Schools Act survey, and new immunization card. Applicant stated the Needs and Services plans will be kept in the classrooms. Parents will provide formula, breast milk, and baby food for their children. INDOOR ACTIVITY SPACE: There are two infant classrooms: Room 7 and Room 8. There is a separate crib room that will be used by both classes. Applicant stated children enrolled in Rooms 7 and 8 will be from birth to 18 months. AS and LPA observed a sufficient amount of equipment, toys, tables, chairs, high chairs, cubbies, and floor beds (Applicant has already submitted a waiver). There is a first aid kit in each of the classrooms. Medications will be stored in the office in a locked box. AS and LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. AS and LPA observed changing tables within arm's reach of a sink. AS and LPA observed a fridge and microwave in each of the classrooms. AS and LPA observed a water jug and cups in the classrooms. AS and LPA observed a functional carbon monoxide detector in the kitchen. AS and LPA observed an electronic sign-in/sign-out system. Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019

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: GUIDEPOST MONTESSORI AT FOLSOM	FACILITY NUMBER: 343623399
	VISIT DATE: 12/13/2019

NARRATIVE

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AS and LPA measured two classrooms. The total classroom space contains a total of 1262.953 square feet, which accommodates Applicant's request for 18 infant children. There are nine toilets, six potty chairs, and 18 sinks for the children, and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one infant outdoor area on the property. The outdoor play area is fenced with a fence that is at least four feet tall and separates the infant yard from the preschool and toddler yards. AS and LPA observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by trees and overhangs.

AS and LPA measured the outdoor activity space. The outdoor play area contains a total of 1598.345 square feet, which will accommodate Applicant’s request for 18 infant children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

The facility's Plan of Operation is located in the facility file. Incidental Medical Services and a Plan of Operation is located in the facility file. 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.

Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: GUIDEPOST MONTESSORI AT FOLSOM	FACILITY NUMBER: 343623399
	VISIT DATE: 12/13/2019

NARRATIVE

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AS and LPA discussed the following: 100% supervision is required at all times; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS and LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

This facility evaluation report was reviewed and discussed with Applicant. Applicant was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

The following items are required before a license will be issued:

1. LPM Bettina Engelman’s final file review

2. Fire Clearance

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019

LIC809 (FAS) - (06/04)

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