013422410-8-6-2021-52-CC-JWIN-C5MS2X-20210806133015

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422410
Report Date: 08/06/2021
Date Signed: 08/06/2021 01:30:24 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:	LEARN AND PLAY MONTESSORI IRVINGTON, INC.		FACILITY NUMBER:	013422410
ADMINISTRATOR:	REYES, SHIRLEY		FACILITY TYPE:	850
ADDRESS:	40803 FREMONT BLVD.		TELEPHONE:	(510) 573-0071
CITY:	FREMONT	STATE: CA	ZIP CODE:	94538
CAPACITY:	214	CENSUS: 120	DATE:	08/06/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Ana Lopez		TIME COMPLETED:	12:45 PM

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On 08/06/2021 Licensing Program Analyst (LPA) Jabari Wilson conducted a 1 year required UNANNOUNCED ANNUAL INSPECTION. LPA met with Administrator Ana Lopez and the facility was toured to conduct a Health and Safety Inspection. Also present at the time of this inspection was HR Director Corrine Cory, Area Supervisor Rania Al-Nazer, 18 staff members, and 120 children. The facility is within ratio and capacity compliance today. This program operates out of 8 classrooms. All classrooms were inspected for age appropriate furnishings, equipment, and adequate storage for children’s belongings. LPA observed the cleanliness of floors and surfaces, the presence of working carbon monoxide detector, smoke detectors/fire alarms and a fully charged 2A10BC fire extinguisher that is accessible. The bathrooms have age appropriate faucets and toilets in working condition. The outdoor play area is large and fully fenced. There is rubber padding and tanbark under/around the climbing equipment. The play structures appear to be fully intact with no visual defects or concerns. There are no pools, hot tubs or other accessible bodies of water. Cleaning supplies/toxins are stored inaccessible to children. All required postings are present. The facility only serves snacks and the menu is posted and updated monthly. LPA reviewed storage of food, medication and medical equipment/supplies and is inaccessible to the children. Per Administrator, there are no firearms present on the premises.

A copy of the facility personnel roster and children’s roster was obtained. LPA reviewed the file of 10 children enrolled in the program and 18 staff members files, who are fingerprint cleared, completion of Mandated Reporter training as well as proof of immunizations. Each child's file reviewed is complete and contains a medical assessment. The opener Bertha Lopez-Gonzalez has a current CPR/First Aid certificate that expires 11/07/2022 respectfully, and proof of education and/or experience was also present. The center also conducts and documents fire and earthquake drills once every 6 months and the logs show that the last drill was conducted on 06/09/2021.

SEE LIC809 C FOR CONTINUANCE

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Jabari Wilson	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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: LEARN AND PLAY MONTESSORI IRVINGTON, INC.	FACILITY NUMBER: 013422410
	VISIT DATE: 08/06/2021

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LPA also discussed with the Administrator that ALL assistants, volunteers, frequent visitors, over the age of 18, must be fingerprint cleared and associated prior to being in the presence of children in care. An immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

Administrator was reminded of the responsibility as a mandated reporter and the trainings must be done once every two years. LPA also encouraged the Administrator to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded.

Individual Medical Services (IMS) policy was discussed. The Administrator is reminded that 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 website at: http://www.ada.gov/childanda.htm.

For licensing updates, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Effective August 1, 2003 California Law requires Child Care 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.

There are no deficiencies 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. Exit interview conducted with Administrator Ana Lopez..

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Jabari Wilson	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

LIC809 (FAS) - (06/04)

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