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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573620811
Report Date: 12/13/2024
Date Signed: 12/13/2024 10:10:59 AM

Document Has Been Signed on 12/13/2024 10:10 AM - 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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LITTLE FRIENDS MONTESSORIFACILITY NUMBER:
573620811
ADMINISTRATOR/
DIRECTOR:		BOGOLLAGAMA, SHRIMAFACILITY TYPE:
850
ADDRESS:1101 &1103 F STREETTELEPHONE:
(530) 753-0300
CITY:DAVISSTATE: CAZIP CODE:
95616
CAPACITY: 41TOTAL ENROLLED CHILDREN: 41CENSUS: 8DATE:
12/13/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH: Selin KizilelmaTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
NARRATIVE
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On December 13, 2024, Licensing Program Analyst (LPA) Lauren Scott met with teacher, Selin Kizilelma for the purpose of a case management inspection due to deficiencies.

Upon arrival, LPA reviewed staff schedules and staff files. Through file review and interview, LPA learned one staff was opening alone without valid CPR certification.

LPA Scott informed facility that this report dated December 13, 2024, documents one Type B citation, stating there is a potential risk to the health, safety, or personal rights of children in care.

Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit must remain posted for 30 days.
Chayntel HunterTELEPHONE: (916) 917-8620
Lauren ScottTELEPHONE: (916) 926-9488
DATE: 12/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 12/13/2024 10:10 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: LITTLE FRIENDS MONTESSORI
FACILITY NUMBER: 573620811

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Day care center directors... shall ensure that at least one staff member who has a current course completion card in pediatric first aid and pediatric CPR... Shall be onsite at all times when children are present at the facility
This requirement was not met as evidenced by:
Deficient Practice Statement
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POC Due Date: 01/13/2025
Plan of Correction
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Facility will submit an updated staff schedule to ensure all staff left alone, have valid CPR certifcation. Facility will also submit proof of certifcations. If needed, facility will have all staff certified in CPR
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.
Chayntel HunterTELEPHONE: (916) 917-8620
Lauren ScottTELEPHONE: (916) 926-9488

DATE: 12/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2024

LIC809 (FAS) - (06/04)
Page: 2 of 2