490111657-10-24-2022-01-CC-ASTR-CKJ3HA-20221024181538

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 490111657
Report Date: 10/24/2022
Date Signed: 10/24/2022 06:16:01 PM

Document Has Been Signed on 10/24/2022 06:16 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME:	BRUSH CREEK MONTESSORI SCHOOL		FACILITY NUMBER:	490111657
ADMINISTRATOR:	UNKNOWN		FACILITY TYPE:	850
ADDRESS:	1569 BRUSH CREEK ROAD		TELEPHONE:	(707) 539-7980
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95404
CAPACITY:	78	CENSUS: 42	DATE:	10/24/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Nicole Saladyga		TIME COMPLETED:	06:35 PM

NARRATIVE

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A required annual inspection of the facility was conducted by Licensing Program Analysts (LPAs) Amy Strother and Carla Fernandes-Goes. The facility file was reviewed prior to this inspection. A review of the personnel report on file indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Facility Representative, Admissions Coordinator, Nicole Saladyga 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.

LPA met with the facility’s, Admissions Coordinator, Nicole Saladyga (S1). This program is a preschool with a toddler component. The facility’s operating hours are 8:00am - 5:00 pm, Monday-Friday. The facility was toured inside and outside, and the floor and yard plan submitted by the licensee were reviewed and discussed with S1. LPA requested the facility submit an updated LIC999 to add the nap room and outdoor space added behind Seeding toddler room and nap room. Sign in/out records were reviewed and in compliance. Items which could pose a danger to children were observed accessible to children in three out of four classrooms. Cleaning compounds were accessible in the staff bathroom in the Redwood classroom and on the toddler yard in a storage box located on the ground, sharp knives were observed tucked back in drawers accessible to children in the Seedling and Amber classroom. Both the cleaning compounds and knives were relocated and made inaccessible to children during today's visit. S1 stated there are no poisons in the facility, and none were observed during this inspection. LPA observed the toys, floors, desks and other equipment and surfaces are clean, toxic free, safe, and in good condition. There is drinking water available to children both indoors and outdoors by individual water bottles. The children's bathrooms are in safe and sanitary condition. The center’s isolation area for any child who becomes ill while in care is located in the staff office or porch if weather permits. LPA observed food prep areas are clean. Food is properly stored and refrigerated as needed. There was no contaminated food observed.

Continued on LIC 809-C

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

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 10/24/2022 06:16 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: BRUSH CREEK MONTESSORI SCHOOL	FACILITY NUMBER: 490111657
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(g)

Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in 2 out of 4 classrooms and 1 out of 2 playgrounds. Cleaning compounds were accessible in the staff bathroom in the Redwood classroom and on the toddler yard in a storage box located on the ground, sharp knives were observed tucked back in drawers accessible to children in the Seedling and Amber classrooms, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/02/2022
	Plan of Correction
1 2 3 4	Both the cleaning compounds and knives were relocated and made inaccessible to children during today's visit. S1 stated a staff meeting will be conducted on 10/31/22 and staff will discuss how to ensure cleaning solutions and sharp knives remain inaccessible to children at all times. S1 will submit staff meeting notes and signatures of staff in attendance. Submit to amy.strother@dss.ca.gov by 11/02/22.

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: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: BRUSH CREEK MONTESSORI SCHOOL	FACILITY NUMBER: 490111657
	VISIT DATE: 10/24/2022

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Continued from LIC 809.

LPA observed a working carbon monoxide detector in each classroom. LPAs observed the playground equipment and surface areas were in safe condition. There is either wood chips, pea gravel or rubber mat cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed on the site. S1 stated no weapons are stored on site, and none were observed.

During today's inspection, staffing ratios were being met, 42 children were being supervised by 9 staff. The facility was operating within the licensed capacity and ratio requirements. At least one staff member, S1 present during the inspection possessed current CPR and First Aid certifications, which expires 02/2023. Five children’s records and five staff records were reviewed and contained the required documents.

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

The following violation of the California Code of Regulations, Title 22; Division 12, was observed: see LIC 809D. Appeal Rights were provided.

Notice of Site Visit shall be posted for 30 days from today's visit. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative, Nicole Saladyga.

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/i

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

LIC809 (FAS) - (06/04)

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