010203130-6-17-2019-52-CC-LDYN-BD92DX-20190617171905

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010203130
Report Date: 06/17/2019
Date Signed: 06/17/2019 05:19:11 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	MONTESSORI CHILDREN'S HOUSE OF HAYWARD		FACILITY NUMBER:	010203130
ADMINISTRATOR:	KAVITA HAKIM		FACILITY TYPE:	850
ADDRESS:	26236 ADRIAN AVENUE		TELEPHONE:	(510) 782-4427
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94545
CAPACITY:	59	CENSUS: 20	DATE:	06/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:17 PM
MET WITH:	Kavita Hakim		TIME COMPLETED:	05:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 6/17/19 at 2:17pm, Licensing Program Analyst (LPA) Loretta Dyson arrived at the center for an unannounced random inspection. LPA met with Kavita Hakim, the director. There were 4 additional staff members and 20 preschool age children also present. The center's hours of operation are Monday thru Friday 7:30am-5:30pm. At 2:20pm, LPA began a tour of the center, to conduct a health and safety inspection. The center consists of 3 classrooms, 3 bathrooms, and the playground. The classrooms have sufficient heating, ventilation and lighting for the safety and comfort of children in care and staff. LPA observed that the classroom floors and surfaces are safe, clean, in good condition, and toxic free. The furniture, toys and activities are age appropriate and in good condition, and there is an ample supply for the number of children enrolled. The toilets and sinks are in safe and sanitary operating condition. There are working combination smoke/carbon monoxide detectors, smoke alarm systems with sprinklers, fully charged 3A40BC fire extinguishers, telephones, and first aid supplies in each classroom. The wall heaters in all of the classrooms are blocked by a barrier, to prevent access by children. There is a sufficient supply of sleeping mats for the number of children in care. The children have water bottles accessible to them inside of the classroom, and there is a working water fountain on the playground. The food preparation area is clean, and LPA did not observe any food stored with cleaning supplies. The playground is fully fenced and has areas that provide shade. LPA observed that the surface of the playground is safe and free from hazards. The play structure is anchored to the ground and has sufficient cushioning underneath to absorb a fall. The sandbox is clean and free from foreign material. All required forms are posted and visible for public review. The center is in compliance with the sign in/out procedure. The center conducts and documents fire/earthquake drills at least once every 6 months and the log indicates the last drills were completed on 4/8/19. At 2:38pm, LPA requested and reviewed the files of 6 children enrolled at the center, and 5 staff members. All staff have proof of completion of the required mandated reporter training, and the required immunizations. continued on 809C

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MONTESSORI CHILDREN'S HOUSE OF HAYWARD	FACILITY NUMBER: 010203130
	VISIT DATE: 06/17/2019

NARRATIVE

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All staff that are present have a criminal record clearance, and are associated to the facility. At least one opening/closing staff member has current CPR/first certificates. The center roster was reviewed, and a copy was obtained. The facility is in ratio, and in compliance with the capacity of the license, today.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS has been 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.
LPA inspected the medication that is stored in the classroom, and confirmed that is inaccessible to children. LPA provided the director with a copy of the Title 22 regulation for storage of medication in a child care center.

Licensee is reminded that ALL Staff must be fingerprint cleared and associated to this facility prior to being in the presence of children in care, or an immediate civil penalty can be assessed from $100 to $3000 per person, per incident. LPA reviewed the individuals associated to the license, and the director confirmed that everyone who is required to have a criminal record clearance is associated.

The licensee was reminded of the reporting requirements for unusual incidents/injuries and suspected child abuse. Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

There are no deficiencies being cited today. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted with the director.

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

LIC809 (FAS) - (06/04)

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