191226680-1-7-2020-33-CC-ACAS-BKLPN9-20200107102733

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191226680
Report Date: 01/07/2020
Date Signed: 01/07/2020 10:27:38 AM

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:	HILLCREST MONTESSORI SCHOOL		FACILITY NUMBER:	191226680
ADMINISTRATOR:	PAIVA, FRANCESCA		FACILITY TYPE:	850
ADDRESS:	1041 NORTH ALTADENA DRIVE		TELEPHONE:	(626) 791-8020
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY:	45	CENSUS: 23	DATE:	01/07/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Francesca Paiva		TIME COMPLETED:	10:40 AM

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 Analysts (LPAs) Ariel Cazares and Jose Guzman conducted an unannounced annual/random inspection on this date. LPA met with Director Francesca Paiva and was guided on a tour of the facility. There were 23 children present and 3 staff. The facility’s hours of operation are Monday through Friday, 7am-6pm. LPAs inspected the indoor and outdoor spaces. Per Director, no alterations have been made and LPAs observed none. The facility consists of 3 classrooms. Furniture and equipment were inspected for age appropriateness. Children have their own hook to store their belongings. Napping equipment is available in form of mats. There is available drinking water in form of water pitchers or dispenser to refill children's personal water bottles. There is a first aid kit and emergency supplies located in the classroom #1. LPAs tested the carbon monoxide detector located in classroom #3 and found it to be operational. There are children's restrooms in between classroom #2 and #3, and near the lounge area. The restrooms were observed to be clean and in good condition, with sufficient supplies for children to use. Per director, the isolation area is located in the director's office and one stall in the children's restroom is designated for ill children only. The kitchenette in classroom #1 was inspected and observed to be clean. Medication can be stored in the kitchen and a lock box is used to maintain inaccessibility. Snacks are prepared in the kitchenette. Children bring their own lunches from home and are stored with their belongings. Two snacks are provided by the facility.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019

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

FACILITY NAME: HILLCREST MONTESSORI SCHOOL	FACILITY NUMBER: 191226680
	VISIT DATE: 01/07/2020

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LPA inspected the children’s outdoor space. The playground was inspected for safety, cushioning material, good repair and age appropriateness. LPA observed an awning near the storage shed as the shaded area and adequate fencing. Children bring out their water bottles for outdoor drinking water use. Water pitchers are brought out to refill as needed.

LPAs children and staff records. LPA found the records to be complete and in order. Sign in and out sheets were reviewed and found to be accurate. Currently there are no children in care with medication needs.

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

No deficiencies were observed or cited on this date.

Exit interview conducted with Director Francesca Paiva. A copy of this report and appeal rights were provided and explained.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020

LIC809 (FAS) - (06/04)

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