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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343611396
Report Date: 11/15/2023
Date Signed: 11/15/2023 04:38:24 PM

Document Has Been Signed on 11/15/2023 04:38 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LINCOLN PLAZA MONTESSORIFACILITY NUMBER:
343611396
ADMINISTRATOR:JACOBSON, BRENDAFACILITY TYPE:
830
ADDRESS:400 Q STREET #1704TELEPHONE:
(916) 795-4111
CITY:SACRAMENTOSTATE: CAZIP CODE:
95811
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 10DATE:
11/15/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Kristen Miller and Brenda JacobsonTIME COMPLETED:
04:45 PM
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At 1:00 p.m. on Wednesday, November 15th, 2023, Licensing Program Analyst (LPA) Pa Dao Vang and Mandie Goodwin met with Directors, Kristen Miller and Brenda Jacobson, for the purpose of an unannounced, required annual inspection. LPA observed a census of 10 infants supervised by 3 staff. Facility hours of operation are from 6:30 a.m. - 6:00 p.m., Monday thru Friday.

A census was conducted at 1:00 p.m. LPA observed 10 infants in two separate classrooms supervised by 3 staffs.

Director 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 conducted a health and safety inspection of the classroom, restrooms, and food service 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. Director stated that there are no firearms nor poisons on the premises.

Infant food is provided by Center. Parents provide breast milk from home. Center offers breakfast, lunch and two snacks for children. Other food in the facility was properly stored to prevent contamination in the fridge located in the front office room. Facility utilizes an electronic sign in and sign out program. They also use it to communicate with parents regarding children’s daily activities.

Continue report on LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2023
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LINCOLN PLAZA MONTESSORI
FACILITY NUMBER: 343611396
VISIT DATE: 11/15/2023
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LPA observed that each child had a Needs and Service plan. LPA observed an Individual Infant Sleep Plan (LOC9227) for each child under 12 months of age in the file and the classrooms. LPA observed documentation that sleep checks were being conducted by staff every 15 minutes for all children under 2 years through the electronic app. Bottles and baby food were kept in refrigerator inside the classrooms and were properly labeled with the child’s name and date. All furnishings were in good condition. Infant diaper changing area is clean. Changing table was observed to be within arms reach from sink. There is a mat for the changing table with vinyl surface that is at least 1 inch thin and has raised sides. Toys are appropriate size with no small parts for the safety of infants.

Facility provides Incidental Medical Services. 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.

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 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. Napping logs were observed.

LPA conducted a health and safety inspection of the outdoor space. Playground equipment and surfaces were free of loose or sharp parts. Outdoor shade was provided by canopies. Water is accessible via labeled bottles.

LPA reviewed staff and children's records. Each child's file contained an admission agreement, emergency card, health history, immunization, and acknowledgement of receipt of personal rights, consent for emergency medical treatment, and parent’s rights. LPA observed CPR and First aid certification for at least one staff on the facility premises. LPA observed verified staff’s unofficial transcripts to be a fully qualified teachers with proper ECE/CHDV units.

Continue report on LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LINCOLN PLAZA MONTESSORI
FACILITY NUMBER: 343611396
VISIT DATE: 11/15/2023
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for


drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No deficiencies are cited today. An exit interview was conducted with the Directors Kristen Miller and Brenda Jacobson. Appeal rights and a notice of site visit were provided. Notice of site visit shall remain posted for a period of 30 days.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
LIC809 (FAS) - (06/04)
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