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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 344500189
Report Date: 04/13/2023
Date Signed: 04/13/2023 01:24:38 PM

Document Has Been Signed on 04/13/2023 01:24 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:ART OF MONTESSORIFACILITY NUMBER:
344500189
ADMINISTRATOR:MENDOZA, CHRISTINEFACILITY TYPE:
850
ADDRESS:8930 SIERRA STREETTELEPHONE:
(916) 686-5800
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 83TOTAL ENROLLED CHILDREN: 83CENSUS: 64DATE:
04/13/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Christine MendozaTIME COMPLETED:
03:00 PM
NARRATIVE
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On 04/13/2023, Licensing Program Analyst Katy Maestas (LPA) conducted an announced field visit to the Center. LPA arrived at the Center and was met by Director Christine Mendoza (D1). LPA disclosed the purpose of the inspection and was granted entrance into the Center. LPA toured the Center and observed 64 children under the supervision of 12 staff members. LPA determined, through accessing Guardian, that 3 of the adults staff members were not associated to the facility's license and 1 additional staff member was not background cleared nor associated to the license.

As a result, 1 deficiency was cited on a subsequent 809-D page. D1 understands that all parents or authorized representatives of currently enrolled children must sign the LIC 9224 form and be available to the Department for review. D1 understands that parents or authorized representatives of children enrolling for up to one year must sign the LIC 9224 form and be available to the Department for review.

An exit interview was conducted, and the report was reviewed with D1. Licensee Appeal Rights were provided. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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
Document Has Been Signed on 04/13/2023 01:24 PM - It Cannot Be Edited


Created By: Nola Maestas On 04/13/2023 at 01:07 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: ART OF MONTESSORI
FACILITY NUMBER: 344500189

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/14/2023
Section Cited
CCR
87355(e)(1)

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87355 Criminal Record Clearance (e) All
individuals subject to criminal record
review...shall prior to working...in a licensed facility: (1) obtain a California clearance...as required by the Department.
This requirement was not met as evidenced by:
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D1 will submit Transfer Requests for 3 staff members and send 1 staff member to be Livescanned by 04/14/2023. D1 will email LPA proof by closing on 04/14/2023. D1 will not have staff members on site until Guardian deems the individuals as cleared and associated.
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Based on LPA's observation and record review, 3 adult staff members were not associated to the license and 1 adult staff member was not background cleared nor associatedf to the license which poses an immediate health, safety and or personal rights risk to chidlren in care.
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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:Jeanne Smith
LICENSING EVALUATOR NAME:Nola Maestas
LICENSING EVALUATOR SIGNATURE:
DATE: 04/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2023


LIC809 (FAS) - (06/04)
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