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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408958
Report Date: 10/06/2023
Date Signed: 10/06/2023 01:52:07 PM

Document Has Been Signed on 10/06/2023 01:52 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LAMORINDA MONTESSORI LLCFACILITY NUMBER:
073408958
ADMINISTRATOR:ANTONIO BETTSFACILITY TYPE:
850
ADDRESS:350 RHEEM BLVDTELEPHONE:
(925) 377-0407
CITY:MORAGASTATE: CAZIP CODE:
94556
CAPACITY: 82TOTAL ENROLLED CHILDREN: 85CENSUS: 67DATE:
10/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Antonio BettsTIME COMPLETED:
02:00 PM
NARRATIVE
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On 10/06/2023 at 12:15PM Licensing Program Analyst (LPA), A. Curry conducted an unannounced case management inspection. LPA met with the Director, Antonio Betts, to explain the purpose of today's visit. LPA toured the facility, made observations, and reviewed documentation. Upon arrival, LPA observed 37 children with 2 staff (See 809D) on the outside middle yard. The Director pulled two additional teachers to assist with the children on the yard. The director was advised that one teacher shall not supervise more than 12 children in attendance. Type B deficiency is being cited today.

Exit interview conducted, appeal rights were given, and report was reviewed with the Director, Antonio Betts.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2023
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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Document Has Been Signed on 10/06/2023 01:52 PM - It Cannot Be Edited


Created By: Ashley Curry On 10/06/2023 at 11:27 AM
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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LAMORINDA MONTESSORI LLC
FACILITY NUMBER: 073408958

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/03/2023
Section Cited
CCR
101216.3(a)

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101216.3Teacher-Child Ratio (a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance...

This requirement was not as evidence by:
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The director will conduct an all staff training on ratio. By 11/03/2023 send LPA the sign in sheet for the staff who were attendance for the training.
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Based on observation the facility did not comply with the above regulation by operation out of ratio, which is a potential risk to the health, safety, and personal rights to children in care. LPA observed 37 children with 2 staff.
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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:Loretta Dyson
LICENSING EVALUATOR NAME:Ashley Curry
LICENSING EVALUATOR SIGNATURE:
DATE: 10/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/06/2023


LIC809 (FAS) - (06/04)
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