573620279-12-20-2019-53-CC-MSOO-BK2PXQ-20191220104244

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 573620279
Report Date: 12/20/2019
Date Signed: 12/20/2019 10:42:50 AM

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:	PORTSIDE MONTESSORI		FACILITY NUMBER:	573620279
ADMINISTRATOR:	TREADWAY, AMBER		FACILITY TYPE:	830
ADDRESS:	3170 JEFFERSON BLVD. SUITE 175		TELEPHONE:	(916) 372-7838
CITY:	WEST SACRAMENTO	STATE: CA	ZIP CODE:	95691
CAPACITY:	24	CENSUS: 8	DATE:	12/20/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Melinda Hernandez & Rachel Delgado		TIME COMPLETED:	11:00 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 (LPAs), Marissa Soto and Amy Silva met with director Melinda Hernandez and Rachel Delgado for an unannounced annual inspection. LPA toured the facility including activity/classroom areas, food service area and restrooms. LPA observed that furniture and equipment are in good condition, the food preparation area is kept clean and sanitized and the restrooms are safe and sanitary. The Director stated that parents provide all food. LPA reviewed the sign/in-sign/out sheet. LPA observed that at least one staff member present during today’s inspection has current Pediatric CPR/First Aid that expires on 04/11/2020. LPA observed that all staff currently employed at the facility have their criminal record clearances, poisons are located in laundry room, cleaning compounds and medications are inaccessible to children. The Director stated that there are no firearms or bodies of water on the property. LPA observed that the changing table has a one inch padded surface and is located near a sink. LPA reviewed children's medical assessment: Physician Report, Identification and Emergency information, Infant’s Individual Feeding Plan and Infant’s Needs and Services plan. LPA reviewed staff's educational requirements, including the Infant course and observed that the facility had the appropriate staffing to meet the Infant ratio. LPA observed that all infant bottles brought from home are labeled, and returned daily. LPA observed that the infants have sufficient nap equipment that meet Title 22 Regulations, the nap area is separate from the activity area and that the sleeping infants have direct supervision. LPA provided the director with a safe sleeping practices brochure which defines SIDS. report continues on 809-C

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Marissa Soto	TELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019

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: PORTSIDE MONTESSORI	FACILITY NUMBER: 573620279
	VISIT DATE: 12/20/2019

NARRATIVE

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LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised the licensee of their responsibility to stay current in regards to new regulations.

LPA discussed the new Immunization Regulations SB 792, the requirement that all individuals working or volunteering at a licensed Child Care facility must have vaccinations against, Pertussis, Measles and Influenza LPA advised the licensee that they can sign a declaration to be exempt from the influenza vaccinations however; Pertussis and Measles are not exemptible. To be exempt from Pertussis and Measles staff must have a medical exemption signed by a licensed physician.

LPA conducted file reviews and LPA observed proof that the facility staff has been vaccinated against Measles, Pertussis and Influenza.

LPA conducted file reviews and observed that the staff does not have proof that they have been immunization against Measles, Pertussis or Influenza, which is a potential risk to children in care. LPA advised the licensee that if the staff cannot obtain their shot records they can take a blood test to check for immunity or they can get the vaccinations again..

LPA discussed the new Incidental Medical Services (IMS) policies with the licensee. The facility plans to provide IMS, LPA advised the licensee that IMS information can be found in the Evaluator Manual/Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and the Medication Regulations 101226. A Plan of Operation that includes IMS must be submitted to LPA. LPA provided the following information regarding ADA: US Department of Justice (USDOJ), 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: www.ada.gov/childqanda

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Marissa Soto	TELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019

LIC809 (FAS) - (06/04)

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