013419440-8-3-2021-52-CC-EWOS-C5JS4K-20210803133251

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013419440
Report Date: 08/03/2021
Date Signed: 08/03/2021 01:32:59 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:	EIFFEL TOWER MONTESSORI PRESCHOOL & K		FACILITY NUMBER:	013419440
ADMINISTRATOR:	JEFFERIES, VERONIQUE		FACILITY TYPE:	850
ADDRESS:	493 BLANCHE STREET		TELEPHONE:	(510) 475-1762
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94544
CAPACITY:	53	CENSUS: 26	DATE:	08/03/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Veronique Jefferies		TIME COMPLETED:	02:00 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 August 3, 2021, at 11:35 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced Annual Required Inspection and met with Director, Veronique Jefferies. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Director. There were twenty six (26) preschool age children and six (6) additional staff members present during this inspection. The facility was toured for a health and safety inspection. Hours of operation are 7:00 AM to 6:00 PM, Monday-Friday. CLASSROOMS: There's one large classroom divided into four classrooms by partitions and a separate classroom and bathroom on the outside yard. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting at the center. There is proper individual storage space for each child. The isolation area for sick children is in the room next to the director's office. Drinking water is available inside and outside of the center. There's three (3) fully charged 2A10BC fire extinguisher, a functioning carbon monoxide detector, and smoke detector, and pull down fire alarm. All solid waste storage containers have tight fitting covers on, and appear to be in good repair. BATHROOMS AND TOILETING AREAS: There are separate bathrooms for staff and children. There are four (4) toilets and four (4) faucets which are in safe and sanitary operating condition. The children are able to reach the sinks and toilets. Supplies are available to the children. FOOD SERVICE AREAS: The kitchen is clean, adequately equipped, and LPA did not observe any food stored with cleaning supplies. There are no menus and the children bring their lunches to the facility. Snacks are available upon request. LPA observed an area where the refrigerator is located, that is clean and free of evidence of rodents. See 809-C.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021

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: EIFFEL TOWER MONTESSORI PRESCHOOL & K	FACILITY NUMBER: 013419440
	VISIT DATE: 08/03/2021

NARRATIVE

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OUTDOOR PLAY AREAS: The playground area is fenced and all equipment and surfaces are safe and free from hazards. There are no bodies of water, or free standing water accessible to children. There are age appropriate toys and materials for the children. There’s a shaded rest area for children and a lock shed for equipment that is inaccessible to children in care.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Three (3) Children's files and three (3) staff files were reviewed around 1:00 PM. All files have required health screening, employee rights, and criminal records statements. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed and certificates were reviewed. Director's CPR and First Aid certificate is current and expires on 08/21/2022. The center is in compliance with the sign in and out procedure.

Disaster drills are being conducted at least once every 6 months and the log indicates the last one conducted was on 04/13/21. Per director, there are no firearms stored on the premises. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: IMS is being provided. LPA inspected the medication of one child, which is stored in a safe place that is inaccessible to children in care. Each of the medications has an unaltered label with the child’s name and date of issuance. The center is equipped with fully stocked first aid kits that are available in the classrooms.

California Law requires Family Child Cares/Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

See 809-C.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021

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: EIFFEL TOWER MONTESSORI PRESCHOOL & K	FACILITY NUMBER: 013419440
	VISIT DATE: 08/03/2021

NARRATIVE

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Director is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Director was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

Incidental Medical Services (IMS) policy was discussed. This facility provides IMS to children in care. Facility is following IMS plan on file. When any changes to the IMS plan is made, an updated Plan for Providing 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.”

No deficiency cited during today’s visit. A Notice of Site visit was posted at time of inspection and must remain posted for 30 days. Exit interview conducted with the Director. A copy of the report was provided

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021

LIC809 (FAS) - (06/04)

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