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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623436
Report Date: 03/24/2022
Date Signed: 03/24/2022 02:18:08 PM

Document Has Been Signed on 03/24/2022 02:18 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 RANCH MONTESSORIFACILITY NUMBER:
313623436
ADMINISTRATOR:PUREWAL, AMANFACILITY TYPE:
830
ADDRESS:4149 ROCKLIN ROADTELEPHONE:
(916) 715-0255
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY: 52TOTAL ENROLLED CHILDREN: 41CENSUS: 31DATE:
03/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Aman PurewalTIME COMPLETED:
02:45 PM
NARRATIVE
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At 11:00am, Licensing Program Analyst (LPA) Amanda Blesi arrived at the facility and met with Director/owner Aman Purewal for a required 1-year unannounced Annual inspection. LPA toured the facility inside and out including all activity and classroom spaces, restrooms, food service and outdoor play areas. At 11:15am, LPA observed 10 infants being cared for by 3 staff and Two infants were observed sleeping in the bed boxes. There were 21 toddlers on the playground outside supervised by 4 staff.

Toxic and hazardous items are appropriately stored and inaccessible to infants. Furniture and materials are in good condition. Playground equipment and surfaces are free of loose or sharp parts. Infant changing table is in safe/sanitary condition, and within arms reach of a sink. Sufficient napping equipment was available. LPA reminded the Director that napping infants must have 100% visual supervision at all times.Trash cans containing solid waste had lids. Uncontaminated drinking water was readily available to children both indoors and outdoors. Bottles, sippy cups and breast milk were observed labeled and dated. LPA also discussed the requirement of washing children's bedding at least once daily. LPA observed proper storage of medication, equipment and supplies.

Licensee 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 licensee 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 licensee [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

Report continued on 809 C
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2022
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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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 RANCH MONTESSORI
FACILITY NUMBER: 313623436
VISIT DATE: 03/24/2022
NARRATIVE
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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 A sample of six infant and toddler children's records were reviewed. Quarterly updated Needs & Services plans were observed. A sample of staff records were reviewed. All staff currently present at the facility has obtained a criminal record clearance. A health screening report, and three child development units in infant/toddler care for an infant teacher was observed. At least one staff member present today has current Pediatric CPR and First Aid training certification. Completion of AB1207 Mandated Reporter Training was verified for staff. here are no firearms or bodies of water on the premises.

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. Director was encouraged to the visit the departments website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers.

Exit interview conducted and report was reviewed with the licensee Aman Purewal. 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.

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

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: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 03/24/2022 02:18 PM - It Cannot Be Edited


Created By: Amanda Blesi On 03/24/2022 at 01:06 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 RANCH MONTESSORI
FACILITY NUMBER: 313623436

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on a record review, the licensee did not comply with the section cited above in the majority of staff did not have proof of immunization to measles, pertussis or flu in their file which poses a potential health, safety or personal rights risk to persons in care if not corrected.
POC Due Date: 04/14/2022
Plan of Correction
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By POC due date 4/14/22, director shall submit proof that staff have proof of measles, pertussis and flu immunizations in their employee file. Proof of immunizaiton shall remain in the employee file for the period of employement.
Type B
Section Cited
CCR
101419.2(b)(2)
Infant Needs and Services Plan
(b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in of the 3 infant files reviewed none of the files contained a LIC 9227 Infant Sleep Plan which poses a potential health, safety or personal rights risk to persons in care if not corrected.
POC Due Date: 04/14/2022
Plan of Correction
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Director states she did not know about the Infant Sleep Plan requirement. During the inspeciton, director emailed parents of infants under 12 months and requested they fill out the form. **Deficiency corrected during the inspection.
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: 03/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 03/24/2022 02:18 PM - It Cannot Be Edited


Created By: Amanda Blesi On 03/24/2022 at 01:06 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 RANCH MONTESSORI
FACILITY NUMBER: 313623436

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101429(a)(2)(C)(4)
Responsibility for Providing Care and Supervision for Infants
(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: (4) Initials of person who conducted each check

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in six out of six files reviewed did not contain the infant sleep checks every 15 mintues which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/14/2022
Plan of Correction
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To correct the deficiency, director shall submit to LPA a copy of a completed infant sleep log showing the employees are checking on sleeping infants every 15 mintues and putting the initials of the staff who is doing the checks. This shall be done by 4/14/22.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: 03/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022


LIC809 (FAS) - (06/04)
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