313616815-5-25-2022-03-CC-ABLI-CERRSB-20220525131628

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313616815
Report Date: 05/25/2022
Date Signed: 05/25/2022 01:16:33 PM

Document Has Been Signed on 05/25/2022 01:16 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	ROCKLIN MONTESSORI		FACILITY NUMBER:	313616815
ADMINISTRATOR:	OERTLY, DOROTHY		FACILITY TYPE:	850
ADDRESS:	5250 5TH STREET		TELEPHONE:	(916) 632-1977
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95677
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 15	DATE:	05/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Maria Schwartz (Teacher)		TIME COMPLETED:	01:30 PM

NARRATIVE

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All times on this report are approximations. At 12pm on Wednesday, May, 25, 2022, Licensing Program Analyst (LPA) Amanda Blesi met with teacher Maria Schwartz for the purpose of an unannounced 1 year Required inspection. Director, Dorothy Oertly was not present during today's inspection. LPA observed 15 preschool age children supervised by Maria Schwartz and Tanika Pumphry.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Medications are stored, inaccessible to children. Ms. Schwartz stated there are no poisons on the premises. Furniture and equipment are in good condition, and toileting facilities are in sanitary, and operating condition. Bins for solid waste in the kitchen have tight fitting lids. The floors appeared clean throughout the facility. Children bring their own lunch and snacks.

Playground equipment and surfaces are free of loose or sharp parts. LPA observed wood chip cushioning being used. Outdoor shade is provided by trees. LPA observed a functional carbon monoxide detector.

LPA reviewed staff files. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience. LPA reviewed AB 1207 Mandated Reporter training certificates. LPA advised that Mandated Reporter training must be renewed every two years and can be renewed at www.mandatedreporterca.com. (Report continues on 809-C)

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

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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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: ROCKLIN MONTESSORI	FACILITY NUMBER: 313616815
	VISIT DATE: 05/25/2022

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At 12:15 p.m., LPA reviewed children's records. Each child's file contained an emergency card, consent for emergency medical treatment, health history and notifications of children’s and parent’s rights.

Facility representative 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 discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 Center Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 513-0301 (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.ht

tions about Child Care Centers and the ADA, available at: http?//www.ada.gov/childqanda.htm

LPA discussed Assembly Bill 2370, which will require licensed Child Care facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1st, 2020 to January 1st, 2023 and must be conducted every five years from initial testing.

Title 22 Deficiency has been cited on the attached LIC 809-D. Appeal Rights given.

Exit interview conducted and report was reviewed with the facility representative Maria Schwartz. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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/process

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/25/2022 01:16 PM - It Cannot Be Edited

Created By: Amanda Blesi On 05/25/2022 at 12:52 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: ROCKLIN MONTESSORI	FACILITY NUMBER: 313616815
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101220.1(g)

Immunizations

(g) The licensee shall document each child's immunizations and shall maintain such documentation in the center for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, child #1, has not received all required immunization. Records indicate the child has received only one immunization since birth which presents a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/25/2022
	Plan of Correction
1 2 3 4	LPA discussed with Ms. Schwartz that the child only has one immunization on record. To correct the deficiency, the director shall submit a completed immunization card for Child 1 or, if needed, request a medical exemption from a licensed physician. Proof of correction should be sent to LPA by correction date of 6/25/2022 to clear the deficiency.

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:

Keven Peters

LICENSING EVALUATOR NAME:

Amanda Blesi

LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

LIC809 (FAS) - (06/04)

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