343616551-12-12-2022-03-CC-KGUA-CM2SQA-20221212130425

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343616551
Report Date: 12/12/2022
Date Signed: 12/12/2022 01:04:33 PM

Document Has Been Signed on 12/12/2022 01:04 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 MONTESSORI		FACILITY NUMBER:	343616551
ADMINISTRATOR:	WALKER, REONNA		FACILITY TYPE:	850
ADDRESS:	7048 SUNRISE BLVD.		TELEPHONE:	(916) 728-2929
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY: 102	TOTAL ENROLLED CHILDREN: 102	CENSUS: 39	DATE:	12/12/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	April Vasquez		TIME COMPLETED:	01:20 PM

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At 9:50 a.m. on Monday, December 12th, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Licensee, Hamid Hosseini, for the purpose of an unannounced, required - 1 year inspection. LPA observed a census of 34 preschool children supervised by 6 staff, and 5 toddler children supervised by 2 staff. Facility hours of operation are 7:00 a.m. - 6:00 p.m., Monday thru Friday.

All individuals subject to criminal background review have obtained criminal record clearance. Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. LPA observed cleaning disinfectants accessible in lower cabinets in the Sprouts and Redwood classrooms corrections were made during inspection. Licensee stated there are no poisons on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. Bins for solid waste in the have tight fitting lids. The floors appeared clean throughout the facility. The facility provides morning and afternoon snack. The food preparation space is free of litter and all food was protected against contamination. Drinking water was readily available to children both indoors and outdoors via drinking fountains and labeled bottles. LPA reviewed sign in and sign out binders and reminded Licensee that full legal signatures of authorized representatives are required. There are no firearms nor bodies of water on the premises. Licensee stated that carbon monoxide detectors are hard wired into the alarm system. Playground equipment and surfaces are free of loose or sharp parts. LPA observed wood chip cushioning beneath the

Report continues on 809-C.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

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 12/12/2022 01:04 PM - It Cannot Be Edited

Created By: Karyn Guerra On 12/12/2022 at 12:30 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: 12/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(g)

Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above as cleaning products were found accessible to children in lower cabinets of two classrooms, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/13/2022
	Plan of Correction
1 2 3 4	Office Manager discussed storage of cleaning products with staff. Cleaning items were moved to higher cabinets inaccessible to children. POC cleared during inspection.

Type B

Section Cited

CCR

101212(b)

Reporting Requirements

(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as new director has been in the position for over 30 days qualifications have not yet been received, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/12/2023
	Plan of Correction
1 2 3 4	Licensee will provide Director packet with qualifications to LPA by POC due date.

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:

Seychelle De Luca

LICENSING EVALUATOR NAME:

Karyn Guerra

LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: COUNTRYHILL MONTESSORI	FACILITY NUMBER: 343616551
	VISIT DATE: 12/12/2022

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play structure. Outdoor shade is provided by trees, a large canopy, and awnings.

Staff files were reviewed. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience and AB 1207 Mandated Reporter training certificates in most staff files.

Children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment and notifications of children’s and parent’s rights, health history, physician's report and immunization records. LPA observed signed form LIC224 Acknowledgement of receipt of licensing reports. Technical assistance was conducted regarding documentation of 15 minute checks of napping infants.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s personnel and administrative records. Licensee was reminded to replace any expired medications. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.

The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA discussed annual fees. A staff interview was conducted with the Licensee, Hamid Hosseini. Licensee stated that lead testing of drinking water was conducted recently and results are pending.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Title 22 deficiencies are cited on the subsequent pages of this report. Appeal rights were provided. Exit interview conducted and report was reviewed with Licensee, Hamid Hosseini. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

LIC809 (FAS) - (06/04)

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