<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621606
Report Date: 03/15/2023
Date Signed: 03/15/2023 11:39:11 AM


Document Has Been Signed on 03/15/2023 11:39 AM - 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:STOCKTON MONTESSORI SCHOOLFACILITY NUMBER:
393621606
ADMINISTRATOR:WANG, LILIFACILITY TYPE:
850
ADDRESS:1606 HAMMERTOWN DRIVETELEPHONE:
(209) 954-9793
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:119CENSUS: 0DATE:
03/15/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Director, Lilli WangTIME COMPLETED:
11:50 AM
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
Licensing Program Analyst (LPA) Mariya Melnichuk met with Director , Lili Wang on 3/15/2023 at 10:40am for the purpose of an unannounced plan of correction inspection to clear a Type B deficiency, which was issued on 2/16/23 for medication not being properly stored.

All individuals subject to criminal background review have obtained a criminal record clearance. Facility representative was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.



During today's inspection LPA observed proper storage of children’s medication. The medication is stored in a closed lock box inaccessible to children. The medication has the doctor’s information and prescription instructions along with the child’s full name.

Deficiency cited on 2/16/23 is cleared effective today. Proof of correction letter was provided. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Mariya MelnichukTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1