344500368-6-24-2021-53-CC-ASIS-C4AQKZ-20210624121509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 344500368
Report Date: 06/24/2021
Date Signed: 06/24/2021 12:15:27 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:	LITTLE LONDON MONTESSORI SCHOOL		FACILITY NUMBER:	344500368
ADMINISTRATOR:	GODAMUNNE, TAZMIN		FACILITY TYPE:	850
ADDRESS:	9209 TRENHOLM DR		TELEPHONE:	(916) 548-2051
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95758
CAPACITY:	32	CENSUS: 0	DATE:	06/24/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Tazmin Godamunne		TIME COMPLETED:	01:00 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) Alecia Sifuentes met with Applicant, Tazmin Godamunne for the purpose of an announced pre-licensing change of ownership inspection. Applicant requests a preschool license to serve 32 preschool children from age two to entry into first grade. The program will operate Monday through Friday from 7:00 a.m. to 5:30 p.m. The original fire clearance was granted on 8/21/1996. Licensing Program Manager (LPM) Jeanne Smith approved for the facility to use the current fire clearance and Applicant provided AS with the 2020 passing annual fire inspection. 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 discussed the forms that must be in each child's and each staff member's file. AS provided and discussed LIC311A, Effects of Lead Exposure brochure, Healthy Schools Act survey, and new immunization card. The facility will provide morning and afternoon snacks. INDOOR ACTIVITY SPACE: There is one preschool classroom. AS observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. There is a first aid kit in the kitchen cabinet. Medications will be stored in the kitchen cabinet. AS observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. AS observed a water fountain in the classroom. AS observed a functional carbon monoxide detector in the hallway. AS observed sign-in/sign-out binders. Report continues on 809-C.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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: LITTLE LONDON MONTESSORI SCHOOL	FACILITY NUMBER: 344500368
	VISIT DATE: 06/24/2021

NARRATIVE

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AS measured one classroom. The total classroom space contains a total of 1,050.91 square feet and there are two toilets and two sinks for the children. Applicant stated the third toilet was removed back in 2016 and the Library and Nap Room is no longer in use for the children. Due to the square footage and amount of toilets and sinks, the facility can only accommodate 30 preschool children. There is 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 near the front area of the classroom/entrance and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. The outdoor play area is fenced with a wooden fence, chain link fence, and brick wall that is at least four feet tall. AS observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by trees.

AS measured the outdoor activity space. The outdoor play area contains a total of 2,876.91 square feet, which will accommodate 30 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

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: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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: LITTLE LONDON MONTESSORI SCHOOL	FACILITY NUMBER: 344500368
	VISIT DATE: 06/24/2021

NARRATIVE

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AS discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS 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.

AS will issue a provisional license that will expire in 90 days on 9/22/2021. Once the provisional is issued, the following items are remaining prior to expiration of the provisional license for final approval of license:

1. Remaining documents listed on LIC184.
2. Final file review by Licensing Program Manager (LPM) Jeanne Smith.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

LIC809 (FAS) - (06/04)

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