197493388-5-18-2022-17-CC-DTHN-CEJQFK-20220518120805

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493388
Report Date: 05/18/2022
Date Signed: 05/18/2022 12:08:09 PM

Document Has Been Signed on 05/18/2022 12:08 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	CHILDREN'S HOUSE MONTESSORI		FACILITY NUMBER:	197493388
ADMINISTRATOR:	SUMALI GANEGODA		FACILITY TYPE:	850
ADDRESS:	30610 THOUSAND OAKS BLVD.		TELEPHONE:	(818) 532-7004
CITY:	AGOURA HILLS	STATE: CA	ZIP CODE:	91301
CAPACITY:	62	CENSUS:	DATE:	05/18/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Rola Kontar		TIME COMPLETED:	12:25 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 May 18, 2022 at 9:45 AM, Licensing Program Analysts (LPA) Dean Thompson conducted an unannounced Annual/Random inspection. LPA conducted the Covid-19 screening questions prior to entering the facility. LPA met with Head of School Rola Kontar and advised the purpose of the inspection. LPA was provided a tour of the facility inside and out. There were 48 children in care at the time of the inspection. LPA observed required licensing documents mounted on the wall inside the lobby. Last fire drill was conducted on 5/5/2022. Facility provides morning and afternoon snacks as well as lunch. Each of the classrooms have age-appropriate toys and furniture readily accessible for children in care. LPA observed enough restrooms available for children to use. LPA did not observe any hazards/toxin items accessible to children. During nap time children are provided cots if they choose to sleep. The outdoor playground is shaded and has an ample amount of space for children to play. LPA observed the playground has age-appropriate toys and structures available for children to use. Children bring water bottles from home and water is also available throughout the facility. A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. LPA observed staff files to be complete and current. CPR current with an expiration date of 8/2023. Staff mandated reporter certification are all current. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. Head of School Rola Kontar was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com Continued on LIC-809C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022

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 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CHILDREN'S HOUSE MONTESSORI	FACILITY NUMBER: 197493388
	VISIT DATE: 05/18/2022

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
26
27
28
29
30
31
32

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

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.

Head of School Rola Kontar 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.

No deficiencies were cited.

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 Head of School Rola Kontar

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2