073405687-8-6-2021-02-CC-MMAR-C5MQJR-20210806121311

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073405687
Report Date: 08/06/2021
Date Signed: 08/06/2021 12:13:21 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:	ALICE'S MONTESSORI - ASTRID		FACILITY NUMBER:	073405687
ADMINISTRATOR:	PEREZ, TERESA		FACILITY TYPE:	850
ADDRESS:	105 ASTRID DRIVE		TELEPHONE:	(925) 947-0603
CITY:	PLEASANT HILL	STATE: CA	ZIP CODE:	94523
CAPACITY:	40	CENSUS: 31	DATE:	08/06/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Teresa Perez		TIME COMPLETED:	12:00 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	On 8/6/21 at 10:30 AM Licensing Program Analysts (LPAs) Monica Mathur and Michelle Sutton conducted an unannounced Annual inspection at Alice's Montessori - Astrid. . LPA met with Director Teresa Perez and explained the purpose of today's inspection. LPAs were granted the inspection authority to enter the facility. Facility's operating days and hours are Monday to Friday 8 am to 5 pm during COVID. Normal operation hours are 7 am to 6 pm. At 10:40 AM the physical plant was inspected. LPAs toured the premises with the Director. Indoor space: Facility operates in Large room with combined ages 2 - 6 year olds. Present in the facility were 31 children, 5 staff and Director. Facility was observed to be in compliance with teacher to children ratio requirement during LPAs' inspection. The classroom, restrooms, food storage areas and spaces accessible to children were inspected. Disinfectants, cleaning solutions, poisons and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Storage areas for poisons were locked and medications were kept in a safe place inaccessible to children. Cabinets, drawers, and rooms used for storage were locked. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. Foods and beverages were stored safely. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. Director stated that facility does not possess nor store any weapons on the premises. LPA observed a fully charged Fire extinguisher that meets State Fire Marshall requirements, Smoke and Carbon Monoxide Detectors, fire pull stations, and sprinkler system. All toilets, hand washing areas were observed to be in safe and sanitary operating condition. All materials and surfaces accessible to children appeared to be toxic free. Menus were observed to be posted at least 1 week in advance in a place visible by the child’s authorized representative, dated and kept on file for 30 days and made available upon request. There are 1 fish, 1 frog tank and bunny cage in the classroom. Fish tank is at child's level with a lid that is not locked. Director is reminded to have visual supervision when children are playing around fish tank. continued

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ALICE'S MONTESSORI - ASTRID	FACILITY NUMBER: 073405687
	VISIT DATE: 08/06/2021

NARRATIVE

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Outdoor Space: At 11:00 AM Outdoor playground was inspected and observed to be fenced and safe. The play equipment was maintained in good condition and free of hazards. Surface of the outdoor activity space was in safe condition and free of hazards. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were no bodies of water observed outside. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

File Review: At 11:05 AM Children sign in and out procedures and logs were reviewed. All children were signed in by their authorized representative with full legal signatures. A sample of 10 Children's files and 6 Staff files was taken for review.
Child files contained Information and Emergency Forms and Medical Assessments – Physician’s Report LIC701, Child’s Preadmission Health History - Parent Report LIC702 and immunization record.
Staff files contained their Personnel Record LIC501 with Health Screening, immunizations for Measles, Pertussis and Influenza or opt out statement and current Mandated Reporter Training. There was at least one staff present with current certification in Pediatric CPR and First Aid at the facility during inspection. Children's Roster and Personnel Report was reviewed, and a copy obtained.

Director was reminded about ensuring that each child is accorded their personal rights. LPA informed Director that the Department shall notify the licensee to immediately terminate the employment of or to remove/bar any person with specified convictions or for other reasons. The licensee shall comply with the notice. LPA reminded Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $3000.00 per person.

LPA reminded Director about violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

continued

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	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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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: ALICE'S MONTESSORI - ASTRID	FACILITY NUMBER: 073405687
	VISIT DATE: 08/06/2021

NARRATIVE

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Website for Quarterly Updates:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates
OR EMAIL TO:
childcareadvocatesprogram@dss.ca.gov
Director stated Center is registered to receive CCLD updates.

For information on Guardian Background Check, visit website:
www.guardian.dss.ca.gov

At 12:00 pm In the areas that were evaluated, no regulatory violations were observed. Exit Interview was conducted with Director, where this report was reviewed and discussed. Report was signed by the Director confirming receipt of documents. Appeal rights were provided.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	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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