073407476-7-20-2022-02-CC-MMAR-CGHQ63-20220720115252

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073407476
Report Date: 07/20/2022
Date Signed: 07/20/2022 11:52:57 AM

Document Has Been Signed on 07/20/2022 11:52 AM - It Cannot Be Edited

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:	BLACKHAWK MONTESSORI		FACILITY NUMBER:	073407476
ADMINISTRATOR:	BARI, NAVEEDA & PATEL, N.		FACILITY TYPE:	850
ADDRESS:	3380 BLACKHAWK PLAZA CIR,ST112		TELEPHONE:	(925) 575-7212
CITY:	DANVILLE	STATE: CA	ZIP CODE:	94506
CAPACITY:	144	CENSUS: 72	DATE:	07/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Naureen Patel		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 7/20/22 at 9:15 AM Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Annual Inspection at Blackhawk Montessori. LPA met with Director, Naureen Patel and explained the purpose of today's inspection. Facility's operating days/hours are Monday to Friday from 7 am - 6 pm in 8 Rooms. At present during summer months due to lower enrollment only 5 rooms are being used. There is an active waiver on file for outdoor play ground usage for no more than 84 present at one time. The physical plant was inspected. LPA toured the premises with the Director. Room 1: 2 staff, 14 children Room 2: 2 staff, 18 children Room 3: 2 staff, 16 children (playing outside) Room 4: 1 staff, 8 children (playing outside) Room 5: 2 staff, 14 children Rooms 6, 7, 8 are not being used and closed for summer. Facility was observed to be in compliance with teacher to children ratio requirement during inspection. Indoor space, classrooms, restrooms, pantry, storage room, and office area were inspected. Children were engaged in various activities under the visual supervision of the teachers. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. 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. LPA observed a working Fire extinguisher, Smoke and Carbon Monoxide Detectors. Log shows that the last Fire Drill was conducted in June 2022. Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles. Facility’s License, Waiver, Parents’ Rights Poster, Personal Rights, Activity Schedules, and Menus were observed to be posted.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022

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: BLACKHAWK MONTESSORI	FACILITY NUMBER: 073407476
	VISIT DATE: 07/20/2022

NARRATIVE

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Outdoor Space playground was inspected and observed to be fenced and safe. The play equipment was maintained in good condition and free of hazards. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. Shade is provided and there were no bodies of water observed. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

File Review: Children sign in and out procedures and logs were reviewed. Facility uses an electronic app called Playground. A sampling of Children and Staff files was taken for review. All files contained required documents. There was at least one Teacher with current certification in Pediatric CPR/First Aid present at the facility during inspection. Children's Roster was reviewed, and a copy obtained.

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 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

Director 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

In the areas that were evaluated, no regulatory violations were observed.
At 11:45 am Exit interview conducted and report was reviewed with the Director, Naureen Patel. A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022

LIC809 (FAS) - (06/04)

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