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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406649
Report Date: 12/04/2019
Date Signed: 12/04/2019 01:58:13 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:A LITTLE WORLD MONTESSORI SCHOOLFACILITY NUMBER:
073406649
ADMINISTRATOR:ELAINE SALDIVARFACILITY TYPE:
850
ADDRESS:324 37TH STTELEPHONE:
(510) 412-2244
CITY:RICHMONDSTATE: CAZIP CODE:
94805
CAPACITY:55CENSUS: 10DATE:
12/04/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Aikkaduwa De AlwisTIME COMPLETED:
02:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced random annual site inspection for this facility at 1105. LPA met with and toured the facility with program director, Hikkaduwa De Alwis. Also present at the time of LPA's inspection were two additional teaching staff and ten preschool age children in care. All staff present are qualified teachers or higher. The facility is within ratio and capacity. All adults present are background cleared and associated to this facility. Children are supervised by staff at all times.

All areas of the facility licensed for use by children were toured for a health and safety inspection. This program operates out of one large room which is divided into multiple sections. All areas were inspected including furnishings for age appropriateness and absence of broken/sharp pieces, floors and surfaces for absence of toxins and hazardous conditions, and equipment and play items for age appropriateness and good repair. There are three working toilets and one toilet in need of repair. All faucets are in working condition. There are working drinking fountains indoors and outdoors. There is one pet (rabbit) present.

This facility serves snacks. There is a snack menu posted. Children bring their own lunches from home. There are napping mats available for all children in care. Children's linens are stored separate for individual children's use and sent home for laundering at least weekly.

Per facility director the most recent fire department inspection was within the past six months. There is a centralized smoke detector/fire alarm system, working carbon monoxide detector and fully charged fire extinguisher present. First aid supplies were inspected. Per facility director there are no firearms present or stored on the premises.

Continued of Page 2***************************************************************************************
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019
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 3
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: A LITTLE WORLD MONTESSORI SCHOOL
FACILITY NUMBER: 073406649
VISIT DATE: 12/04/2019
NARRATIVE
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There are individual storage cubbies for children's belongings. Food preparation and storage areas were inspected and appear free of pests. 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 Centers Sections 101173 and 101226. The following information 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 outdoor playground is fully fenced. There is one piece of high climbing equipment/slide which is securely anchored and has cushioning under and around the equipment. There are no pools or other bodies of water accessible to children.

LPA reviewed the facility, personnel and children's records including children's admissions agreements, parents' rights forms, and emergency ID forms and staff teaching qualifications and background clearances. LPA observed that children C1 and C2 did not have admissions agreements present at the time of this inspection. One teacher qualification form was completed during this inspection. Director and one teaching staff have current CPR/First Aid certification. Hikkaduwa De Alwis is a qualified preschool director with 8 hours of preventative health and safety training.

Facility Staff are encouraged to visit www.ccld.ca.gov for licensing updates and forms. Contact: ChildCareAdvocatesprogram@dss.ca.gov to sign up for quarterly updates. Staff are also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

The attached Type B deficiency was cited during this inspection. Appeal rights was provided and a notice of site visit was provided and is to remain posted for 30 days. A copy of this report was issued and is to remain in the facility records for a period of three years.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: A LITTLE WORLD MONTESSORI SCHOOL
FACILITY NUMBER: 073406649
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/03/2020
Section Cited

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101239(e)(4) All toilets, handwashing and bathing facilities shall be maintained in safe and sanitary operating condition. Additional equipment, aids and/or conveniences shall be provided as needed in centers that serve children with physical disabilities. This facility was not in compliance with this requirement as
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evidenced by the presence of one of the toilets in the children's bathroom which was not properly working/flushing and per director had overflown posing a potential risk to the health and safety of children in care.
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Type B
01/03/2020
Section Cited

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101219(a) The licensee and the child's authorized representative shall jointly complete a current individual written admission agreement for the child. This documentation shall be maintained at the child care center and shall be available for review. This facility was not in compliance with this requirement as
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evidenced by LPA's observation that children C1 and C2 did not have admissions agreements present at the time of this inspection posing a potential risk to the health and safety of children in care.
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corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3