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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624782
Report Date: 04/20/2023
Date Signed: 04/20/2023 01:45:46 PM

Document Has Been Signed on 04/20/2023 01:45 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:CITRUS HEIGHTS MONTESSORIFACILITY NUMBER:
343624782
ADMINISTRATOR:RENDLEMAN, JASMINEFACILITY TYPE:
850
ADDRESS:8085 OAK AVENUETELEPHONE:
(916) 910-9145
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 19DATE:
04/20/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jasmine RendlemanTIME COMPLETED:
01:45 PM
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Application Specialist (AS) Mai Lor and Licensing Program Analyst (LPA) Karyn Guerra met with Director Jasmine Rendleman for the purpose of an announced pre-licensing change of ownership inspection. This is a change of ownership from My Preschool (#343623868). Applicant Kavitha Vankayala was not present during this inspection. Applicant is requesting a preschool license to serve 68 preschool children from age two to entry into kindergarten and 12 toddler children aged 18-36 months in the Toddler Option Program. Total requesting capacity is 80 preschool children. Census included 14 preschool children and 2 staff, and 5 toddler option children and one staff. The program will operate Monday through Friday from 7:30 AM to 5:30 PM. The fire clearance was granted on 03/15/2023.

Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Effects of Lead Exposure, car seat poster, menus, and daily schedule. Entrance Checklist was provided to the applicant.

INDOOR ACTIVITY SPACE:
The preschool has four classrooms and a gym room. The Toddler Option children will be in classroom #2. The preschool children will be in classroom #1, #3 and #4. There is a kitchen to support food preparation. AS and LPA observed the kitchen area to be a foot traffic pass through for parents to drop off and pick up children. Applicant was reminded to ensure that any kitchen items that need to be inaccessible should be made inaccessible to children. Applicant stated parents will provide blankets and the facility be providing linens. Applicant stated parents will be responsible for washing the children’s blankets while the facility will be responsible for washing the sheets. AS and LPA observed sufficient age-appropriate equipment, toys, tables, chairs, mats and individual cubbies. However, bedding storage were not individually stored and are in contact with other beddings.

(Report continues on subsequent LIC 809)
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE: DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/20/2023
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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: CITRUS HEIGHTS MONTESSORI
FACILITY NUMBER: 343624782
VISIT DATE: 04/20/2023
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There is a first aid kit in the kitchen. Director stated medications is stored in the kitchen and inaccessible to children in care. Director stated there are no firearms or weapon on the premises. Director stated drinking water for outdoor and indoor will be provided via purified water in individualized water bottles. AS and LPA observed a carbon monoxide detector in the facility; however, upon testing it, it was not functional. AS and LPA observed an electronic sign in and sign out system. Applicant stated the facility will provide morning and afternoon snacks, while parents are responsible for lunch.

The indoor space was previously measured on 07/19/2021 and has not changed. Therefore, AS did not measure the indoor space. The total indoor space contains a total of 2,811.206 square feet, which will accommodate the applicant’s request of 68 preschool children and 12 toddler option children. There are six toilets, one urinal and 9 sinks available to children. However, one of the toilets is non-operational. There is a separate private restroom for the staff. Children who become ill during the day will be isolated in office and will use the staff restroom room, if necessary.

Multiple butane cans were observed in the staff break room and were not locked. Aersol cans were observed through out the facility. The applicant was advised to ensure that these items are to either tp be inaccessible and/or locked.

OUTDOOR ACTIVITY SPACE:
There is an outdoor play area for preschool, one outdoor area for toddler option children, and a garden/botany area which will be utilized by both the preschool and toddler option children. The play space in the back of the center is surrounded by wooden fence that is at least four feet tall. The garden/botany is enclosed by iron wrought rod that is at least four feet tall. AS and LPA did not observe sufficient amount of equipment and toys. There are shaded areas supplied by overhangs and trees. There is a play structure in the preschool play yard with no safety label. Applicant and director was reminded to follow manufacturer guidelines. AS and LPA observed substrate under high climbing areas to be low and advised applicant to purchase additional bark to fill in the areas under high climbing areas. AS and LPA observed portable play structures in the toddler option play yard. There is a shed located in the back of the preschool play yard.


(Report continues on subsequent LIC 809)
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: CITRUS HEIGHTS MONTESSORI
FACILITY NUMBER: 343624782
VISIT DATE: 04/20/2023
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The outdoor space was previously measured on 07/19/2021 and has not changed; therefore, AS did not measure the outdoor activity space. The preschool yard contains a total of 7,489.05 square feet. The toddler option yard contains a total of 1,277.23 square feet. Thus, the total outdoor preschool and toddler option outdoor activity space contains a total of 8,766.28 square feet, which will accommodate 68 preschool children and 12 toddler option preschool children. Applicant stated the preschool and the toddler option children will share the garden/botany play area, thus the measurement of the garden/botany area was not included in the total outdoor activity space for the preschool and toddler option children. Applicant and Director acknowledge staff must ensure children always use age-appropriate equipment.

AS and LPA observed pesticide not locked; broken fence pickets, protruding nails, and dry rot box frame at the back of the preschool yard; and door knob to classroom #3 not properly functional.

AS reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

AS discussed the following: 100% supervision is required at all times; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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)/ (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.



Applicant 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.

(Report continues on subsequent LIC 809)
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: CITRUS HEIGHTS MONTESSORI
FACILITY NUMBER: 343624782
VISIT DATE: 04/20/2023
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Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

AS provided and discussed Health and Safety Code 1596.955 regarding the toddler option with Applicant.

The following items are required before a license will be issued:



1. Pending Licensing Program Manager Seychelle De Luca’s final review
2. Health screening for the applicant and the director
3. Fix/replace fence pickets
4. Locked pesticide, combustibles and any other poisons
5. Remove/replace dry rot wood and protruding nails
6. Fix non-operational toilet in classroom #1
7. Kitchen items to be inaccessible in the kitchen
8. Functional carbon monoxide detector
(Report continues on subsequent LIC 809)
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: CITRUS HEIGHTS MONTESSORI
FACILITY NUMBER: 343624782
VISIT DATE: 04/20/2023
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9. Proper storage of bedding
10. Gym room - classroom walls to be patched/painted
11. Garden/Botany - patch/fix hole in the fence border and patch/fix hole on the pink dinosaur
12. Fill areas under high climbing areas with substrate
13. Ensure that the tether post is secured and stable
14. Purchase additional outdoor equipment

Exit interview conducted and report was reviewed with the Site Director, Jasmine Rendleman.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5