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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420951
Report Date: 07/08/2019
Date Signed: 07/08/2019 11:45:50 AM

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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:GLOBAL MONTESSORI INTERNATIONAL SCHOOLFACILITY NUMBER:
013420951
ADMINISTRATOR:TENG, VIVIFACILITY TYPE:
850
ADDRESS:2830 - 9TH STTELEPHONE:
(510) 845-6969
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY:90CENSUS: 34DATE:
07/08/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Vivi TengTIME COMPLETED:
12:00 PM
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An unannounced Annual/Random inspection visit was conducted by LPA Susan Neeson. Visit began at 8 AM. LPA met with Licensee and Director, Vivi Teng. All staff are fingerprint clear and associated with the facility. All teaching staff have current CPR and First Aid. The fire clearance is current. A health and safety inspection was conducted inside and outside. There are 34 preschoolers are present today. During the summer program only two of the classrooms are being used.

The preschool operates in 3 classrooms. All classrooms are equipped with developmentally appropriate materials and equipment. There are 9 sinks, 7 toilets, and 2 urinals available for children. The isolation bathroom is located in the library/music room and the isolation area is located in the director's office. There is a separate restroom for staff. There is a kitchen on site with a stove, a microwave, a small refrigerator and a sink. All food items and cleansers are stored properly. Food is not provided. The parents send lunch and snacks. The play yard is fully fenced. First Aid supplies are available in the center. Drinking water is provided to children by pitchers and disposable cups in the classrooms and in the play yard. The center has 2 parakeets, two finches, one canary, 1 fish, one bell dragon reptile and one gecko. Bathrooms all have toilet paper, soap and paper towels to meet children's needs. LIC 500 is current as is the LIC 9040. Sign-in and out was discussed.

The following informational items were issued: Licensee Rights, AB 1207 information, fire/earthquake pamphlet, Safe Sleep for infants concepts, safe and healthy diapering, car seat pamphlet, blue immunization form and Departmental Quarterly updates fro Winter and Spring 2019.
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: GLOBAL MONTESSORI INTERNATIONAL SCHOOL
FACILITY NUMBER: 013420951
VISIT DATE: 07/08/2019
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Licensee is reminded that ALL assistants, volunteers, frequent visitors or adults 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. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov and for day care updates visit www.myccl.gov

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 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 deficiencies are observed. An exit interview was given.

SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019
LIC809 (FAS) - (06/04)
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