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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093622019
Report Date: 06/05/2024
Date Signed: 06/05/2024 03:19:57 PM

Document Has Been Signed on 06/05/2024 03:19 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:CAMERON PARK MONTESSORI SCHOOL, INC.FACILITY NUMBER:
093622019
ADMINISTRATOR/
DIRECTOR:		BEEMAN, KIMBERLY ANNEFACILITY TYPE:
850
ADDRESS:4140 MOTHERLODE DR. SUITE 100TELEPHONE:
(530) 677-1776
CITY:SHINGLE SPRINGSSTATE: CAZIP CODE:
95682
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 26DATE:
06/05/2024
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Kimberly BeemanTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Erwina Pascual-Golamco and Licensing Program Manger (LPM) Natalie Dunaway, met with Licensee, Kimberly Beeman, for an announced technical support, change of capacity visit. The purpose of the visit was explained. All individuals subject to criminal background review have obtained a criminal record clearance. Facility hours of operation are Monday - Friday, from 7:00am to 5:00pm.

In Suite 104, Licensee would like to change the infant license with toddler option to a preschool license with toddler option, same capacity of 12. In Suite 100, Licensee would like to decrease capacity to 40 preschool children and remove the toddler option.

Exit interview conducted and report was reviewed with Licensee, Kimberly Beeman. A notice of site visit was provided and must remain posted for 30 days

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024
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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