070211836-12-17-2019-02-CC-SNEN-BJXUZF-20191217150128

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 070211836
Report Date: 12/17/2019
Date Signed: 12/17/2019 03:01:36 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	FOUNTAINHEAD MONTESSORI SCHOOL ORINDA CAMPUS		FACILITY NUMBER:	070211836
ADMINISTRATOR:	MARGARET SCHEVING		FACILITY TYPE:	850
ADDRESS:	30 SANTA MARIA WAY		TELEPHONE:	(925) 254-7110
CITY:	ORINDA	STATE: CA	ZIP CODE:	94563
CAPACITY:	129	CENSUS: 52	DATE:	12/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Julie Heitman and Ais Her		TIME COMPLETED:	03:30 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	An unannounced annual/random site inspection visit was conducted by LPA Susan Neeson. Met with Julie Heitman and Ais Her. Present today are 11 staff and 52 preschool age children. Visit began at 10:10. All staff are fingerprint clear and associated with the facility. Personnel list was discussed and will be edited in the future. Waiver for play area is posted. Each classroom has first aid supplies. A tour of the facility was conducted. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible during this visit. Furniture and equipment appear to be in good condition, free of sharp, loose or pointed parts. All toilets and sinks are operable and there is sufficient soap and paper products. Menus are posted. Snacks are served and parents send lunches. Each classroom has a charged fire extinguisher and smoke detector as well as a carbon monoxide detector. There are adequate toys and equipment for children in care. Ratios were met throughout the visit. The outside yard remains fenced. There is anchored and moveable play equipment and sufficient cushioning under the anchored play equipment to absorb falls. Most recent fire drill was done 12/13/19. A sample of staff records were reviewed. A sample of children's records were reviewed. Sign-in and out forms were reviewed. Children's medication was reviewed to ensure proper authorization, prescription and original packaging. Plan of operation for IMS has been received. The facility has no pets. Julie Heitman states that there are no guns or firearms on the premises. Licensee is reminded that ALL assistants, volunteers 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.ca.gov

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan Neeson	TELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2019

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: FOUNTAINHEAD MONTESSORI SCHOOL ORINDA CAMPUS	FACILITY NUMBER: 070211836
	VISIT DATE: 12/17/2019

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a 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.

The following documents were issued and discussed: blue immunization forms, Flu prevention information, Quarterly update from Department, AB 1207 information, Safe Sleep for infants, Fire/earthquake drill information, Safe and healthy diapering, Parents Rights and Licensee rights. .

Copy of roster is requested. Copy of LIC 500 is requested.

Julie Heitman is the new director. This is her first day. Documents for the director need to be submitted within 10 days. Updated LIC 610 is posted.

No deficiencies are observed.

An exit interview was given.

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan Neeson	TELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2019

LIC809 (FAS) - (06/04)

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