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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419680
Report Date: 02/24/2020
Date Signed: 02/24/2020 06:41:20 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PALOS VERDES MONTESSORI ACADEMYFACILITY NUMBER:
197419680
ADMINISTRATOR:OFELIA WATANABE & MS. HAQFACILITY TYPE:
830
ADDRESS:28451 INDIAN PEAK ROADTELEPHONE:
(310) 541-2405
CITY:RANCHO PAOLS VERDESSTATE: CAZIP CODE:
90274
CAPACITY:24CENSUS: 20DATE:
02/24/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Ofelia Watanabe, Infant DirectorTIME COMPLETED:
07:00 PM
NARRATIVE
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On February 24, 2020 at 3:00 PM, Licensing Program Analyst (LPA) Miriam Cohen met with Infant Director, Ofelia Watanabe, Palos Verdes Montessori Infant Center, 197419680 located at 28451 Indian Peak Road, Rancho Palos Verdes, CA 90274 for the purpose of conducting an Annual Random inspection. LPA Cohen toured and inspected all classrooms, interior and exterior, as identified in the facility sketch. LPA observed Sign In/Out sheet with missing record of time of day and signature of parents for the following dates: Week of February 17- 21, 2020 and February 24, 2020.
The Infant Center hours are from 6:30 AM to 6:30 PM, Monday through Friday. The facility is operating within capacity limitations. Upon arriving at the preschool, LPA observed 20 children being supervised by seven adults. LPA observed care provided in two classrooms:
Toddler Classroom with a ratio of three adults to 12 toddlers
Infant Classroom with a ratio of four teachers to eight infants
LPA inspected above classrooms and found them to be clean and free from any potential hazards. The floors of each classrooms were observed clean and safe. LPA observed the classrooms to have age appropriate material and equipment. Furniture in the classrooms is found to be in good repair and age appropriate. Disinfectants, cleaning solutions, and poisons are inaccessible to children. Storage areas for poisons are inaccessible to children in care. Medications are kept in a safe place in the director’s office. LPA observed all toilets and handwashing facilities in safe and sanitary operating condition. All kitchen, food-preparation and storage areas are kept clean, free of litter, rubbish, and free of rodents and other vermin. Food snacks were observed protected against contamination.
A menu was observed in a place visible by the child’s authorized representative. LPA observed First Aid Kit stored in the emergency backpack inside each classroom. Storage containers for solid waste, including moveable bins were observed with tight-fitting covers that are kept on, and in good repair. Uncontaminated drinking water was readily available both indoors and out. Inspection of the outdoor play area was conducted.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PALOS VERDES MONTESSORI ACADEMY
FACILITY NUMBER: 197419680
VISIT DATE: 02/24/2020
NARRATIVE
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Playground equipment were observed in safe to be in good condition, free of sharp, loose, or pointed objects. The surface of the outdoor activity space is maintained in a safe condition and free of hazards. LPA observed climbing structures, swings, slides, and other large play equipment securely anchored with adequate cushioning material underneath and around the perimeter that absorbs a fall. Materials and surfaces accessible to children appeared to be toxic free. The facility is free of flies, and other insects, and rodents. Playground is free from miscellaneous debris such as tree branches, trash, leaves, etc.
The above facility provides IMS. A review of medication policy, including administering, labeling, storage, and records was made. Children’s record was reviewed for Emergency Identification form including name of authorized representative who can assume responsibility for the child if the authorized representative cannot be reached when necessary. Children’s record was reviewed for medical assessment. Staff records were reviewed during inspection for completeness including but not limited to Criminal Record Clearances for adult and health screening including immunization records. LPA observed CPR/First Aid expires 06/2020. LPA advised the director that records for all children and staff must be maintained for three years after separation from the facility. A record of teachers and teacher’s assistants’ names was check against current facility roster. The name of the director or fully qualified teacher designated to act in the director’s absence was observed and posted (LIC 308 form).
The following requirements were discussed with the licensee:
Mandatory forms for the children and provider’s files; requirements for fire drills, earthquake drills, and documentation for both; role and responsibilities of being a mandated reporter. The licensee was advised on how to access forms and Regulations for Child Care Center online at www.ccld.ca.gov . Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco on the premises. 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
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PALOS VERDES MONTESSORI ACADEMY
FACILITY NUMBER: 197419680
VISIT DATE: 02/24/2020
NARRATIVE
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The ADA requires that childcare providers not discriminate against persons with disabilities on the basis of disability, that is, that they provide children and parents with disabilities with an equal opportunity to participate in the child care center's programs and services.
Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 (5 days) for the 1st offense and up to $3000.00 for the 2nd offense within a 12-month period. The licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and licensing within the time frame specified by the regulation. The "Notification of Parent's Rights" (PUB394) poster must be posted in an area accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.
The licensee was informed of The Child Care Advocate Program (CCAP) that is available from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541 Email Address: childcareadvocatesprogram@dss.ca.gov

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com


Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.
New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into childcare or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.
New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. Appeal may be submitted and mailed to the following address:
300 North Continental Boulevard, 290 A, MS 29-13
El Segundo, CA, 90245
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PALOS VERDES MONTESSORI ACADEMY
FACILITY NUMBER: 197419680
VISIT DATE: 02/24/2020
NARRATIVE
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The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If the above requirements is not met, a civil penalty in the amount of $100 per violation will be assessed. Upon receipt of the Type A Violation(s), licensee shall provide copies of the licensing report (LIC 809D/LIC9099D) to parents/guardians of children in care at the facility and obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file by the close of business the following day or these next day child returns to the facility. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file.
The facility was found to be NOT in compliance per Title 22 regulations,
There shall be one Type B deficiency cited today, 02/24/2020.
The following deficiency was observed during today’s inspection:
*101229.1(a)(1) Sign In and Sign Out
(a)In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain, and
implement a written procedure to sign the child in/out of the childcare center that shall, at a minimum, include the following:
(1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.
This requirement is not met as evidenced by observation and record review conducted during today’s
inspection. The director did not ensure that the required sign in/out procedure is carried out. This poses a potential risk to the health and safety of children in care.
LPA observed Sign In/Out sheet with missing record of time of day and signature of parents for the following dates: Week of February 17- 21, 2020 and February 24, 2020 (TYPE B).
POC: Director agrees to send evidence proof of correction to LPA, via email, by 02/28/2020, end of business day.
A copy of this report along with a Notice of Site Visit were issued and explained to the licensee.
An exit interview was discussed and conducted with preschool director, Ofelia Watanabe, including, but not limited to: Provider Rights, Appeal Procedures and Agency's Consultative Role.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PALOS VERDES MONTESSORI ACADEMY
FACILITY NUMBER: 197419680
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/24/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2020
Section Cited

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Sign In and Sign Out
(a)In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain, and
implement a written procedure to sign the child in/out of the childcare center that shall, at a minimum, include the following:
(1) The person who signs the child in/out
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shall use his/her full legal signature and shall record the time of day.
This requirement is not met as evidenced by observation and record review conducted during today’s
inspection. The director did not ensure that the required sign in/out procedure is carried out. This poses a
potential risk to the health and safety of children in care. LPA observed Sign In/Out sheet with missing record of time of day and signature of parents for the following dates: Week of February 17- 21, 2020 and February 24, 2020

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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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2020
LIC809 (FAS) - (06/04)
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