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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313615881
Report Date: 09/11/2023
Date Signed: 09/11/2023 01:36:47 PM

Document Has Been Signed on 09/11/2023 01:36 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:MARIA MONTESSORI CHARTER ACADEMY - PRESCHOOLFACILITY NUMBER:
313615881
ADMINISTRATOR:BOOTHBY, BRENTFACILITY TYPE:
850
ADDRESS:1850 WILDCAT BLVD.TELEPHONE:
(916) 630-1510
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 27DATE:
09/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Brent BoothbryTIME COMPLETED:
01:45 PM
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On 09/11/2023 Licensing Program Analyst (LPA) Jeremey McClain met with Licensing Representative Brent Boothby for an unannounced required annual random inspection.
LPA observed care and supervision of 27 preschool children by three staff.
LPA inspected all activity and classroom spaces, restrooms, food service, and outdoor play areas. Hazardous items are inaccessible to children. Furniture and equipment are in operable and safe condition. Playground equipment and surfaces are free of loose or sharp parts, and adequate cushioning was observed in areas underneath climbing equipment. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. No children in care require medications. LPA observed a functional carbon monoxide detector.
Lunch and snacks are provided by the facility and or families. LPA observed posted menus showing planned meals at least one week in advance. Noncontaminated Drinking water is readily available to children both indoors and outdoors.
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
The facility currently utilizes and electronic sign in and out sheet. LPA reviewed records for all present staff. At least one staff member present today has current Pediatric CPR and First Aid certification which expires 10/2023. All staff currently employed with the facility have: a criminal record clearance, a health screening report, immunization records, current AB1207 Mandated Reporter Training, and documentation of their educational background, training, and/or experience. Report Continued on the following page.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 09/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/11/2023
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: MARIA MONTESSORI CHARTER ACADEMY - PRESCHOOL
FACILITY NUMBER: 313615881
VISIT DATE: 09/11/2023
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Three children records were reviewed. Each child's file contained a completed emergency contact form, records, signed personal rights form.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

All individuals subject to criminal record review have obtained clearance. Licensing representative, Brent Boothby, was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensing representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No deficiencies were observed during today’s inspection.
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensing representative Brent Boothby.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023
LIC809 (FAS) - (06/04)
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