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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343616551
Report Date: 02/02/2022
Date Signed: 02/02/2022 02:45:55 PM

Document Has Been Signed on 02/02/2022 02:45 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:COUNTRYHILL MONTESSORIFACILITY NUMBER:
343616551
ADMINISTRATOR:WALKER, REONNAFACILITY TYPE:
850
ADDRESS:7048 SUNRISE BLVD.TELEPHONE:
(916) 728-2929
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 102TOTAL ENROLLED CHILDREN: 102CENSUS: 51DATE:
02/02/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Hamid HosseiniTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analysts Amanda Blesi and Katrina Owens arrived at the facility to close a complaint at 1:30pm on 2/2/22. During the walk through inspection, some violations were observed that are unrelated to the complaint allegations. LPA Blesi observed the Sprouts classroom out of ratio when there were 29 napping preschool children supervised by one staff. In addition, two staff were observed working in the facility without a fingerprint clearance.

Violations are on the subsequent page of this report. See LIC 908-D.
Civil Penalties are assessed for repeat violations.

Exit interview with Hamid Hosseini
Appeal rights provided.

LPA Amanda Blesi informed licensee Hamid Hosseini that this report dated 02.02.22 document(s) two Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA Amanda Blesi informed the licensee to provide a copy of this licensing report dated 2.02.22 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2022
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 02/02/2022 02:45 PM - It Cannot Be Edited


Created By: Amanda Blesi On 02/02/2022 at 02:13 PM
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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: COUNTRYHILL MONTESSORI
FACILITY NUMBER: 343616551

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/03/2022
Section Cited
CCR
101170(e)(1)

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CRIMINAL RECORD CLEARANCE: All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:(1)Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not met as evidenced by:
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Owner Hamid was advised that employees cannot be present in the facility unless a criminal record clearance has been received by the Department. He states the employees had started the fingerprint process but have not yet received a clearance. To correct the deficiency, owner shall submit a clearance for the two eployees.
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Two staff were observed working in the facility today supervising children and used in ratio. (see LIC811 for name). The two staff did not have a criminal record clearance. This an immediate risk to the health and safety of children in care. Civil Penalties are assessed in the amount of $500.
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Type A
02/03/2022
Section Cited
CCR101230(c)

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Activities: A teacher-child ratio of one teacher supervising 24 napping children is permitted provided that the remaining teachers necessary to meet the overall ratio specified in Section 101216.3(a) are immediately available at the center. This requirement was not met as evidenced by:
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LPA will make a return visit to verify correction has been made.
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LPA Blesi observed one staff supervising 29 napping preschool children putting the room over ratio.
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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:Keven Peters
LICENSING EVALUATOR NAME:Amanda Blesi
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2022


LIC809 (FAS) - (06/04)
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