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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423107
Report Date: 09/17/2021
Date Signed: 09/23/2021 11:24:01 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:HAPPY DAY MONTESSORI SCHOOLFACILITY NUMBER:
013423107
ADMINISTRATOR:FATHIMA FAHIDHA BADURUDEENFACILITY TYPE:
850
ADDRESS:1501 WASHINGTON AVENUETELEPHONE:
(510) 837-0491
CITY:ALBANYSTATE: CAZIP CODE:
94706
CAPACITY:12CENSUS: 17DATE:
09/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Fathima BadurudeenTIME COMPLETED:
05:49 PM
NARRATIVE
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Licensing Program Analyst (LPA) Caroline Colson, arrived at the facility at 10:04 AM and met with Fathima F. Badurudeen, Director, to conduct an annual required inspection. Fathima provided the guided tour. Ten children's records and three staff's records were reviewed by the LPA and the licensee on 9/17/21 at 11:34 AM. All children have complete files. S1 and S3 have complete files. LPA made the following observations:

Capacity/Staffing: The facility is a preschool program. There are two classrooms in the preschool program. There are 17 preschool children present with 3 teachers and Center Director.

Physical Plant: The facility is a two (2) story building with two (2) classrooms. There are three restrooms. There is adequate heating, lighting and ventilation. There are no cleaning solutions, chemicals or other hazards accessible to children.

Classrooms: Furniture and equipment age appropriate and in good repair. There are separate storage areas for children’s belongings. Children do take naps at facility. There are mats and bedding materials for the children. Bedding materials are washed every week by the parents. The facility provides a morning and afternoon snack. Children bring their own lunches. The menu is posted for review.

Restrooms: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use.

Play yard: A climbing structure, a slide and other play equipment are safe and in good condition. There is a shaded area. Playground is free of debris and other hazards. Children have their own water bottle to refill. There are no pools, hot tubs or other bodies of water present.
Please See LIC 809 C for additional information
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 5
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: HAPPY DAY MONTESSORI SCHOOL
FACILITY NUMBER: 013423107
VISIT DATE: 09/17/2021
NARRATIVE
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Emergency Preparedness/Safety: Smoke and Carbon Monoxide detectors were both tested and are working. The 3A40BC fire extinguishers was serviced in July, 2021 . First Aid Kit is available and complete. Emergency Disaster Plan is posted. The facility utilizes a cell phone.

Postings: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist.

Sign in Sheet/Class Roster: All parents use an electronic signature to sign in and sign out. The roster is available.

Training/Record Review:
All staff present on this date have criminal background clearances and are associated to the facility. Staff have current CPR/First Aid and Mandated Reporter certificates on file. Immunization records including influenza and or a statement declining vaccination.

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The 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 Centers 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 ADA, available at: http://www.ada.gov/childquanda.htm.



Please Additional LIC 809 C for further information
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: HAPPY DAY MONTESSORI SCHOOL
FACILITY NUMBER: 013423107
VISIT DATE: 09/17/2021
NARRATIVE
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A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Fathima F. Badurudeen.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: HAPPY DAY MONTESSORI SCHOOL
FACILITY NUMBER: 013423107
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above in one out of three which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/15/2021
Plan of Correction
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S2 will obtain a health screening report with a TB clearance. The health screening report is due by the POC Due Date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: HAPPY DAY MONTESSORI SCHOOL
FACILITY NUMBER: 013423107
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101179(a)


This requirement is not met as evidenced by: A license shall be issued for a specific capacity, which shall be the maximum number of children that can be cared for at any given time. The Department may issue a license for fewer children than requested.
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above in having 17 children when the maximum amount of children is 12 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/17/2021
Plan of Correction
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Licensee had five (5) children picked up during the inspection. The deficiency was cleared today.
Type B
Section Cited
CCR
101174(d)


This requirement is not met as evidenced by: Disaster drills shall be conducted at least every six months.
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above because the facility is not conducting disater at least every six months which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/15/2021
Plan of Correction
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Licensee will conduct a disaster drill by the POC Due Date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 5 of 5