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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300747
Report Date: 12/01/2023
Date Signed: 12/01/2023 02:05:09 PM

Document Has Been Signed on 12/01/2023 02:05 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:SHADOWRIDGE MONTESSORI SCHOOLFACILITY NUMBER:
376300747
ADMINISTRATOR:SANDRINE BUNTINFACILITY TYPE:
850
ADDRESS:1940 SHADOWRIDGE DRTELEPHONE:
(858) 922-5128
CITY:VISTASTATE: CAZIP CODE:
92081
CAPACITY: 144TOTAL ENROLLED CHILDREN: 144CENSUS: DATE:
12/01/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Sandrine BuntinTIME COMPLETED:
02:30 PM
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On December 1, 2024 at 1:15PM, Licensing Program Analyst (LPA) William Chancellor arrived and was greeted and granted access to facility by Director (DIR) Sandrine Buntin. The purpose of the case management visit is in response to a Unusual Incident Report (UIR) received by the licensing agency on 11/13/23. DIR also emailed the assigned LPA and the unusual incident email on 11/13/23 to notify CCL of an incident where a child required medical attention.

Documents relevant to the Unusual incident were provided and confidential interview's were conducted with two staff.

Based on information gathered, the facility acted appropriately and no violations have been identified. Parents were immediately notified and child received appropriate medical care in a timely order.

While this is a unprovoked incident that spontaneously occurred, it must be recognized that it was an isolated incident that was unprovoked. The classroom is appropriately furnished and staff acted appropriately to comfort the child and notify the parents when the child showed signs of distress after nap.

There are no deficiencies at this time.

An exit interview was conducted, and a copy of this report was provided to facility staff. Notice of site visit must be posted for 30 consecutive days.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2023
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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