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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500265
Report Date: 03/02/2023
Date Signed: 03/02/2023 02:29:05 PM

Document Has Been Signed on 03/02/2023 02:29 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:MONTESSORI ON THE PRAIRIEFACILITY NUMBER:
394500265
ADMINISTRATOR:TENNAKOON, SHANIKAFACILITY TYPE:
850
ADDRESS:89 WEST 7TH STREETTELEPHONE:
(209) 831-7872
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 28DATE:
03/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:47 AM
MET WITH:Shanika TennakoonTIME COMPLETED:
01:00 PM
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On March 2, 2023, Licensing Program Analyst (LPA) Stacey Williams met with Facility Representative for the purpose of an unannounced required1 year inspection. Program hours are Monday through Friday 7:30AM-5:00PM. The program operates a full day program with a toddler option. Upon arrival, LPA observed sixteen (16 ) children supervised by two staff in the primary classroom and twelve (12 ) toddlers supervised by three staff in the Toddler Classroom. Criminal record clearances were verified. Facility fees are current.

LPA conducted a health and safety inspection for all areas accessible to children. Staff stated there are no poisons on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. LPA observed a functional smoke/carbon monoxide detector and a fully charged 2A :10BC fire extinguisher. The floors appeared clean throughout the facility. Outdoor play area is free from dangerous conditions and playground equipment is securely anchored to the ground. Facility has bark under the play equipment to absorb falls. Facility has an outdoor space waiver on file.

Program provides a morning and afternoon snack. Children bring their own lunches. Menu was posted at the main entrance of the facility. Facility offers drinking water by utilizing a water dispenser where each child’s individual cup is filled. Sign in/out sheet are done electronically.

Eight child files were reviewed. Each child’s file contained an admission agreement, identification and emergency information, notification of parent rights, medical assessment, immunization record, and personal rights form. Files for staff who were present at the facility were reviewed. Staff have a criminal record clearance, health screening report, mandated reporter training, immunization records, and documentation of their educational background, training, and/or experience. CPR certification was verified for staff present. Expiration date of 8/2024 for the Director.

LPA reviewed the Department's inspection authority and discussed with staff any changes that may occur regarding Director/Site Supervisor or an employee acting in the director's absence must be reported to department within 10 working days.

Report continues on 809-C

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: MONTESSORI ON THE PRAIRIE
FACILITY NUMBER: 394500265
VISIT DATE: 03/02/2023
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Per facility representative there are no children that require medication. Facility has an Incidental Medial Service Plan on file. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

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.

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.

There were no Title 22 deficiencies observed during this inspection.

LPA reviewed report with the Director Shanika Tennakoon and provided copies of the report along with Appeal Rights. A notice of site visit was provided and posted by LPA Williams and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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