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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073402302
Report Date: 07/19/2019
Date Signed: 07/19/2019 12:20:26 PM

COMPREHENSIVE INSPECTION
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:ANGELS MONTESSORI PRESCHOOL - CONCORDFACILITY NUMBER:
073402302
ADMINISTRATOR:KARAMPOUR, ANGELFACILITY TYPE:
850
ADDRESS:1566 BAILEY ROADTELEPHONE:
(925) 686-5621
CITY:CONCORDSTATE: CAZIP CODE:
94520
CAPACITY:49CENSUS: 25DATE:
07/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:KARAMPOUR, MARYAM, ASSISTANT DIRECTOR, TIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Redmond, arrived at the facility on 07/19/2019 at 10:15 AM to conduct a health and safety inspection. The purpose of the inspection is to ensure the facility is in compliance with Title 22, CCR and Health and Safety Code Statutes for Child Care Centers. During the inspection, LPA met with KARAMPOUR, MARYAM, ASSISTANT DIRECTOR. During the physical inspection and review of the facility records, LPA made the following observations:

Capacity/Staffing: The facility has a capacity of forty-nine (49) children. On this date there are twenty-four (24) children in care and four (4) teachers. The facility is in compliance with capacity limitations, child ratios and staffing levels.

Postings: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist. If You See Something, Say Something. A menu is posted for meals.

Sign in Sheet/Class Roster: Parents use a daily sign in sheet to sign in their children. The Roster is current.
Classroom: Furniture and equipment age appropriate and in good repair. There is separate storage for children’s belongings. The are mats for sleeping.

Restroom: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use. There are no cleaning solutions or other toxins accessible to children.

Play yard: School aged children share the elementary school play yard. Preschoolers have a separate and enclosed yard. Climbing structures, swings, slides appear safe and in good condition. There is a shaded

CONTINUED ON LIC 809C.
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen RedmondTELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
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: ANGELS MONTESSORI PRESCHOOL - CONCORD
FACILITY NUMBER: 073402302
VISIT DATE: 07/19/2019
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area. Playground is free of debris and other hazards. Drinking water readily available.

Kitchen: Kitchen is sometimes used by children during cooking instruction. LPA observed that locks were installed, however did not work on multiple cabinets and drawers. Advisory given.

There are is one wading pool used for the children which, appears of height where children may enter and exit without assistance. The facility recently purchased a new wading pool, with higher walls, however, has decided not to use it. LPA reminded Director of the importance of ensuring proper supervision during pool usage.

Emergency Preparedness/Safety: Smoke detector and carbon monoxide detectors are attached throughout the facility and tested by a professional company. LPA reviewed inspection report, which, was dated, 04/24/19. There is a fire extinguishers which was also professionally tested on 07/11/19. First aid supplies available. Emergency Disaster Plan is dated, 08/07/17 and is current, per Director. Fire and earthquake drills were conducted on 07/01/19 and meets six (6) month requirement. The facility utilizes a land line telephone. The facility does provided *Incidental Medical Services (IMS), however, there are no children currently receiving the services. The IMS plan is included in the Admission Agreement.

Training/Record Review:
LPA reviewed three (3) staff records and observed that each staff has a criminal background clearance and is associated to the facility. Staff have current CPR/First Aid and Mandated Reporter training on file. Immunization records including influenza and or a statement declining shot.

Overall, the facility is clean and has adequate heating, lighting and ventilation.
NO DEFICIENCIES CITED ON THIS DATE.

A Facility Evaluation Report was issued A copy of this report shall be maintained for 3 years and available for public review upon request. A Notice of Site visit was issued and shall remain posted for 30 days. Failure to keep this notice posted for the 30 consecutive days will result in an immediate $100 civil penalty.

Please visit CCLD website at www.ccld.ca.gov for training videos, forms and other resources.
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen RedmondTELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
LIC809 (FAS) - (06/04)
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