191201813-2-13-2023-33-CC-AEIN-CNZRNU-20230213121054

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191201813
Report Date: 02/13/2023
Date Signed: 02/13/2023 12:11:07 PM

Document Has Been Signed on 02/13/2023 12:11 PM - 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	GLENDALE MONTESSORI SCHOOL		FACILITY NUMBER:	191201813
ADMINISTRATOR:	ANDREA VENTURA		FACILITY TYPE:	850
ADDRESS:	413 WEST DORAN		TELEPHONE:	(818) 240-9415
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91203
CAPACITY:	73	CENSUS: 32	DATE:	02/13/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Andrea Ventura, Director		TIME COMPLETED:	12:45 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	Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced required- 1 year inspection on 02/13/2023 at 8:30 AM. LPA met with Andrea Ventura, Director. LPA provided Andrea Ventura with a copy of the Entrance Checklist for Child Care Centers form (LIC 125). Director guided LPA on a tour of the facility. A COVID 19 risk assessment was conducted prior to entering the facility. This is a preschool program operates Monday – Friday from 8:00 AM – 4:30 PM. There is an elementary program on the premises from first to sixth grade. The preschool program consists of three classroom, ROOM A, B ,C, and Music Room. Room A is located next to the elementary classroom and separated by shelves. All areas identified on the Facility Sketch were inspected. Upon arrival, the following staff were present during this inspection; Preschool Room A: 18 preschoolers with 3 staff inside the classroom. Room B: 14 preschoolers with 2 staff, RM C: No children. The facility was observed to be within the license capacity and limitations. All children were observed to be under visual supervision of a teacher at all times. The following was observed during the tour of the facility: PHYSICAL PLANT LPA observed the facility to be clean, safe, sanitary and in good repair. Per director, cleaning crew clean the facility daily after hours. Furniture and equipment was inspected for age appropriateness and good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All materials accessible to children were observed to be toxic-free. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Per director, children do not take nap in this school. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in the classroom. LPA observed children water bottles in the classrooms. Per director, teachers refill water bottles by filleted water faucets in each classroom. REPORT CONTINUES ON NEXT PAGE 1 OF 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GLENDALE MONTESSORI SCHOOL	FACILITY NUMBER: 191201813
	VISIT DATE: 02/13/2023

NARRATIVE

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Disinfectants, cleaning solutions, medication, and other items that are dangerous to children, were inaccessible to children. Per director, there are no poisons stored at the facility. Director tested the carbon monoxide detectors in the Music room. It sounded off the alarms and heard by LPA to be functional. LPA observed carbon monoxide detectors in each building. LPA observed required posting information were posted in the hallway of Room A.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. Kitchen area is in the Music room. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal.

Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. There are two outdoor playgrounds on the premises, Sand playground and wood chip playground. The surface of the outdoor activity space is not maintained in a safe condition and is not free of hazards. LPA observed paint of both play structures are chipped. LPA observed tree branches on the wood chip play structure were really low in the height of a child. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with sand and wood chips cushioning material that absorbs a fall; climbing apparatuses are single level only. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. Per director, since Covid teachers take children water bottles outside during outdoor play time. LPA advised that no children shall be left without the supervision of a teacher at any time.

The Director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this inspection. Director states there are no weapons or firearms on the premises.

FACILITY RECORDS

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.

REPORT CONTINUES ON NEXT PAGE 2 OF 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GLENDALE MONTESSORI SCHOOL	FACILITY NUMBER: 191201813
	VISIT DATE: 02/13/2023

NARRATIVE

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Children’s Records were reviewed for completeness; Inspection of required forms was made and documented on the LIC 857.

There is at least one person trained in CPR and Pediatric First Aid present during this inspection. LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. LPA reviewed four staff files and all four reviewed staff files did not have proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present had proof against TB, measles, pertussis, and influenza. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions. LPA reviewed four staff files and staff#3 did not have Health Screening form LIC 503 on file.

Children's roster was reviewed and is current. Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. LPA observed sign in/out sheet was placed outside by the entrance door. During this inspection 32 children were present, and only 29 children were singed in. Disaster drill log was available, last drill was conducted on 02/09/2023.

Menus are not posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are not available upon request. Snacks were reviewed for availability, quantity and appropriateness to children in care. Preschoolers are provided PM snack and optional AM snack, and bring AM snack and lunch from home.

First Aid supplies were observed in the each classroom and in the office area. According to director, medication is only administered to a child when accompanied with a doctor's note and is stored in the kitchen area adjacent to the office area. The facility was observed to be equipped with an isolation area for any child who becomes ill and it is located in the staff office. The ill child will use the staff restroom located in the Music room during isolation which is disinfected immediately after use per Site Supervisor.

REPORT CONTINUES ON NEXT PAGE 3 OF 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GLENDALE MONTESSORI SCHOOL	FACILITY NUMBER: 191201813
	VISIT DATE: 02/13/2023

NARRATIVE

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Medication: Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing. Per director, facility has not completed required water lead testing.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

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.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the director, Andrea Ventura at 12:45 PM.

END OF REPORT PAGE 4 OF 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/13/2023 12:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GLENDALE MONTESSORI SCHOOL	FACILITY NUMBER: 191201813
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(d)(1)

Outdoor Activity Space

(d) The surface of the outdoor activity space shall be maintained: (1) In a safe condition for the activities planned. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on today's inspection, the licensee did not comply with the section cited above LPA observed paint of two play structures are chipped and tree branches on the wood chip playground were really low in the height of a child which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/13/2023
	Plan of Correction
1 2 3 4	Per director, both play structures and sand boxes edges will be painted and wood chip play ground tree will be trimmed by plan of correction due date, 03/13/2023.

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on director stated they have not completed water lead testing yet, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/13/2023
	Plan of Correction
1 2 3 4	Per director, they will complete required water lead testing by plan of correction due date.

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: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/13/2023 12:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GLENDALE MONTESSORI SCHOOL	FACILITY NUMBER: 191201813
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on four staff file review, the licensee did not comply with the section cited above in 4 out of 4 staff did not have required mandated reporter training certificate on file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/13/2023
	Plan of Correction
1 2 3 4	Per director, all staff will complete required mandated reporter training by plan of correction due date 03/13/23.

Type B

Section Cited

CCR

101216(g)(2)

Personnel Requirements

(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on staff files review, the licensee did not comply with the section cited above 1 staff out of 4 did not have required Health Screening LIC 503 on file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/13/2023
	Plan of Correction
1 2 3 4	Per director, staff#3 will have the required health screening form by plan of correction due date 03/13/23.

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: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023

LIC809 (FAS) - (06/04)

Page: 6 of 7

Document Has Been Signed on 02/13/2023 12:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GLENDALE MONTESSORI SCHOOL	FACILITY NUMBER: 191201813
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101229.1(b)

Sign In and Sign Out

(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on facility sign in/out sheet review for 02/13/23 the licensee did not comply with the section cited above in 3 out of 32 present children were not signed in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/13/2023
	Plan of Correction
1 2 3 4	Per director a reminder will be sent out to those parents who forgot to sign in their children for 02/13/23.

Type B

Section Cited

CCR

101227(a)(6)

Food Service

(6) Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on facility file review the licensee did not comply with the section cited above and did not have snack menus available and posted which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/13/2023
	Plan of Correction
1 2 3 4	Per director, AM and PM snack menu will be created and will posted on parent board.

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: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023

LIC809 (FAS) - (06/04)

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