013422411-2-21-2024-52-CC-LDBX-D2NTLZ-20240221135023

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422411
Report Date: 02/21/2024
Date Signed: 02/21/2024 01:50:31 PM

Document Has Been Signed on 02/21/2024 01:50 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	LEARN AND PLAY MONTESSORI PERALTA, INC.		FACILITY NUMBER:	013422411
ADMINISTRATOR:	GOMEZ, MAVI		FACILITY TYPE:	850
ADDRESS:	4511 PERALTA BLVD.		TELEPHONE:	(510) 870-2324
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY:	118	CENSUS: 0	DATE:	02/21/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Natasha Aguilar		TIME COMPLETED:	02:10 PM

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On February 21, 2024, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux conducted an announced Case Management Inspection at this facility which was initiated by the licensee. LPA Dacanay Breaux met with Director Natasha Aguilar and tour the facility for health and safety inside and out. This facility was on inactive status effective 01/26/2023 and would like to be placed back on active status. The facility plans to operate Monday through Friday 8:00 AM - 6:00 PM.

CLASSROOMS: The facility consists of (six) 6 classrooms with private playground space for the children in the rear of the building, this area is fully fenced. There is a play structure that is anchored and has bark to provide cushion. There is drinking water foundations outdoors, per director the facility will have families supply water bottles and staff will refill as needed. The staff will provide 100% supervision during outdoor play time. The isolation area is the director's office and the facility has an isolation bathroom for sick children.

BATHROOMS: Staff bathroom is separate from the children's bathroom. There is a diaper changing table that is in arms reach of the sinks.

KITCHEN: LPA inspected the kitchen area, there is a refrigerator that is clean and free from rodents during today's inspection. The school will supply only morning and afternoon snacks. LPA reminded the director keep post the menu weekly in a public accessible area. The kitchen area is off limits to children, there were no sharp knives observed in the kitchen today.

Required documents were posted in public places as required. This facility has a waiver for rotating the children in the play area, the waiver is posted as required. LPA discussed the importance of keeping hazardous items out of the reach of children. Facility director has current CPR and First Aid certificate, which was completed on 08/30/2022 and Mandated Reporter Training completed on 05/12/2022. The facility has carbon monoxide detectors in each classroom (tested and working), at least four (4) fully charged 3A40BC fire extinguishers and pull down fire alarm systems through out the facility. Fully stocked first aide kits are available in the classrooms.

Continue on 809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LEARN AND PLAY MONTESSORI PERALTA, INC.	FACILITY NUMBER: 013422411
	VISIT DATE: 02/21/2024

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At approximately 12:10 PM, LPA requesting staff files to review. All files are to be found completed and current staff have been associated to the facility. LPA reviewed and qualified staff. Per director the facility will use an electronic app called Line Leader for the purposes on signing in and out children. LPA reminded director to have a back up in case there is a power outage. LPA reminded director fire/disaster drills required every 6 months and to be document. Facility and personal roster to be maintained.

The facility is neat and clean with age appropriate furnishings and equipment in good repair. LPA observe napping mats for sleeping. There were no hazardous items/toxins observed to be accessible to children. There are age-appropriate toys that appear to be safe and in good condition. There are no bodies of water accessible to children in care, director confirmed there are no pools and/or bodies of water on the facility grounds.

California Law requires Child Care Centers 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 to the Oakland Regional Office.

The center administers medication. Per director the medication will be kept in the directors office in a locked cabinet. There are no medication to review during today's visit. Incidental Medical Services Plan is on file.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Center Sections 101173 and 101226. 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.

809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LEARN AND PLAY MONTESSORI PERALTA, INC.	FACILITY NUMBER: 013422411
	VISIT DATE: 02/21/2024

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For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list. Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL adults, employees, and frequent visitors must be fingerprint cleared prior to being in the presence of children in care, or an immediate civil penalty will be assessed from $100 to $500 per person, per person.

Effective 02/21/2024, this facility is placed on active status and LPA advised licensee she will receive a new license in the mail.

There are no deficiencies cited. This report shall remain on file for 3 years. Appeal Rights provided. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted with director Natasha Aguilar.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

LIC809 (FAS) - (06/04)

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