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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093622019
Report Date: 12/16/2024
Date Signed: 12/16/2024 01:56:24 PM

Document Has Been Signed on 12/16/2024 01:56 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: 24DATE:
12/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Kimberly BeemanTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Arianna Manabat met with the Director Kimberly Beeman for the purpose of a pre-licensing inspection. The Licensee is requesting a capacity of 40 preschoolers ages two years to entry into first grade. The facility's previous capacity was 56 preschool children. The program currently operates Monday through Friday from 7:00 a.m. to 5:00 p.m. The fire clearance was granted and received on 12/13/2024.

INDOOR ACTIVITY SPACE:
There preschool program operates in suite 100 and the infant program operates in suite 104 with the toddler option. LPA Manabat observed a sufficient amount of equipment, toys, napping cots, tables, chairs, and cubbies for all classrooms. There is a first aid kit in the classroom. Medications are stored in a locked box by the fridge. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. LPA observed a paper sign-in/sign-out system.

The preschool classroom contains a total of 2154.45 square feet which will accommodate Licensee’s request for 40 preschoolers. There are four sinks and four toilets in the preschool room. LPA Manabat observed a separate restroom for staff located inside suite 100. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There are two outdoor areas on the property for the facility. The preschool outdoor area was previously measured by LPAs Erwina Pascual-Golamco and Soleil Marx on 07/15/2024 for 2,404.83 sqft. This will not accommodate the requested capacity of 40 preschool children. Please see page two for more information regarding the outdoor waiver. The outdoor play area is fenced with a fence that is at least four feet tall. LPA observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by trees. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Report continues on LIC809-C page 2..
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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
VISIT DATE: 12/16/2024
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During today's case management inspection, LPA Manabat collected additional documentation including the addendum for the commercial lease, parent and employee handbooks, and the admission agreement. Additionally, LPA Manabat and the Director discussed the need for a insufficient and shared outdoor space waiver. The Director stated that she would send the request for the outdoor waiver after today's visit. Finally, the Director requested that the toddler option share the playground with the preschool program. LPA Manabat stated that this request would need to be mentioned in the request sent to LPA Manabat.

An exit interview conducted and report was reviewed with the Director Kimberly Beeman.

The following item is required before a license will be issued:
1. An approved outdoor waiver.
2. Pending manager approval.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC809 (FAS) - (06/04)
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