197494554-10-14-2021-30-CC-DMIA-C7SSKV-20211014135722

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494554
Report Date: 10/14/2021
Date Signed: 10/14/2021 01:57:42 PM

Document Has Been Signed on 10/14/2021 01:57 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	BURBANK MONTESSORI ACADEMY		FACILITY NUMBER:	197494554
ADMINISTRATOR:	KITHMINI CURRY		FACILITY TYPE:	850
ADDRESS:	217 N HOLLYWOOD WAY		TELEPHONE:	(818) 848-8226
CITY:	BURBANK	STATE: CA	ZIP CODE:	91505
CAPACITY: 45	TOTAL ENROLLED CHILDREN: 45	CENSUS: 52	DATE:	10/14/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Kithmini Curry, Licensee/Director		TIME COMPLETED:	12:40 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 10/14/2021 at 9:00 a.m. Licensing Program Analyst (LPA) Denise Miranda and Licensing Program Manager (LPM) Claudia Escobedo met with Licensee/Director Kithmini Curry. The purpose of the visit was an announced pre-licensing inspection at the facility to ensure that health, safety and personal rights as requires by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. 52 children were present during this inspection. This is an application for 60 children, ages 2 years through entry into first grade. The child care center will operate Monday – Friday 08:00 a.m. – 6:00 p.m. The fire clearance was approved on 09/16/2021 for a capacity of 60. LPA and LPM toured and measured the on-limits areas and classrooms located at the facility. The facility has a total of 5 classrooms. Children will have access to 05 sinks and 05 toilets. The Classroom measurements are: · Room #1 = 568.34 square feet · Room #2 = 348.60 square feet · Room #3 =759.04 square feet · Room #4 = 315.00 square feet · Room #5 =242.32 square feet Total indoor space = 2,233.28 Square feet = A capacity of 63 children. Total Outdoor Play measurements are: Total: 8,284 square feet Indoor/Children’s Area: All outdoor and indoor passageways, stairways, inclines, ramps, open porches and other areas of potential hazard were observed to be free of obstruction. The child care center was observed be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. Floors of all rooms have a surface that is safe and clean. A comfortable temperature for children shall be

Peter Flores
Denise Miranda
	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: BURBANK MONTESSORI ACADEMY	FACILITY NUMBER: 197494554
	VISIT DATE: 10/14/2021

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maintained at all times. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. Tables and chairs were observed to meet the needs of the children. All play equipment and materials used by children were observed to be age-appropriate. The licensee shall ensure that each child has an individual permanent or portable storage space for his/her clothing, personal belongings and/or bedding. All materials and surfaces accessible to children, including toys, shall be free of toxic substances.
Drinking water from a noncontaminated fixtures or containers shall be readily available both indoors and in the outdoor activity area. The licensee shall take measures to keep the center free of flies, other insects, and rodents. All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting covers that are kept on; shall be in good repair; and shall be leakproof and rodent-proof. Fireplaces and open-faced heaters shall be made inaccessible to children to ensure children's safety. All window screens shall be in good repair and free of insects, dirt and debris.
Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. Storage areas for poisons shall be locked. The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children: LPA observed a current edition of a first-aid manual, sterile first-aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometer, and antiseptic solution.
A center shall be equipped to isolate and care for any child who becomes ill during the day. The isolation area shall be located to afford easy supervision of children by center staff. The isolation area shall be equipped with a mat, cot, couch or bed for each ill child. The isolation area shall not be located in the kitchen area or the general-use toilet area. The Isolation room will be determined by Director.
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility. All child care centers shall have working telephone service on the premises.
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 child care center that shall, at a minimum, include the following: The licensee shall be responsible for ensuring that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.

SUPERVISOR'S NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: BURBANK MONTESSORI ACADEMY	FACILITY NUMBER: 197494554
	VISIT DATE: 10/14/2021

NARRATIVE

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Smoking is prohibited on the premises of a child care center as specified in Health and Safety Code Section 1596.795(b).
A baby walker shall not be allowed on the premises of a child care center in accordance with Health and Safety Code Sections 1596.846(b) and (c).
There shall be at least 35 square feet of indoor activity space per child based on the total licensed capacity.
Based on the total licensed capacity, one toilet and one handwashing fixture shall be maintained for every 15 children, or fraction thereof.
Napping:
Cots used for napping shall be maintained in a safe condition. Constructed of foam at least 3/4 inch thick.
Covered with vinyl or similar material that can be wiped. Marked or colored so that the sleeping side can be distinguished from the floor side. Wiped with a detergent/disinfectant weekly or when soiled or wet.
Maintained in a safe condition with no exposed foam.
Each cot or mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child.
The licensee shall provide a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.
Restrooms:
All toilets, handwashing and bathing facilities shall be maintained in safe and sanitary operating condition. Additional equipment, aids and/or conveniences shall be provided as needed in centers that serve children with physical disabilities.
Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by children to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).
Notwithstanding (e) and (e)(1) above, handwashing fixtures shall not be required to deliver hot water.
There shall be one toilet and one handwashing fixture, separate from and in addition to the

SUPERVISOR'S NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: BURBANK MONTESSORI ACADEMY	FACILITY NUMBER: 197494554
	VISIT DATE: 10/14/2021

NARRATIVE

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number of toilets and handwashing fixtures required in (h) above, designated for use by children who are ill, for use by staff, and for emergency use. This toilet and handwashing fixture shall be conveniently located in relation to the isolation area.
Common towels or washcloths are prohibited. Urinals may be used to meet the requirements of this section provided they are low enough for children to reach them, or broad-based platforms or anchored steps are provided to enable children to reach them.
There shall be at least two toilets for each urinal counted.
Outdoor:
Provide a shaded rest area for the children. Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls.
Sandboxes shall be inspected daily and kept free of hazardous foreign materials.
The playground shall be enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence shall be at least four feet high.
Any construction or equipment that could pose a hazard in the outdoor activity area shall be made inaccessible to children in care. This shall include, but not be limited to, incinerators, air- conditioning equipment, water heaters, and fuse boxes.
All licensees shall ensure the inaccessibility of pools, including swimming pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds or similar bodies of water, through a pool cover or by surrounding the pool with a fence. There were no bodies of water at the facility.
There shall be at least 75 square feet per child of outdoor activity space based on the total licensed capacity.
Health Related Services:
Medications shall be kept in a safe place inaccessible to children. A refrigerator shall be used to store any medication that requires refrigeration.
The licensee shall develop and implement a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.
Food Service: Per Director, parents provide snacks and meals. All food shall be safe and of the quality and in the

SUPERVISOR'S NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: BURBANK MONTESSORI ACADEMY	FACILITY NUMBER: 197494554
	VISIT DATE: 10/14/2021

NARRATIVE

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quantity necessary to meet the needs of the children. Each meal shall include, at a minimum, the amount of food components as specified by Title 7, Code of Federal Regulations, Part 226.20, (Revised January 1, 1990) Requirements for Meals, for the age group served. All food shall be selected, stored, prepared and served in a safe and healthful manner.
All foods or beverages capable of supporting the rapid and progressive growth of microorganisms that can cause food infections or food intoxications shall be stored in covered containers at 45 degrees F (7.2 degrees C) or less.
Pesticides and other similar toxic substances shall not be stored in food storerooms, kitchen areas, food-preparation areas, or areas where kitchen equipment or utensils are stored.
Soaps, detergents, cleaning compounds or similar substances shall be stored in areas separate from food supplies.
All kitchen, food-preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin.
The food-preparation area shall not be used for: Children's play activities, unless such activities are part of a supervised food-education program. Full-day programs shall offer a midmorning and a midafternoon snack.
Full-day programs shall ensure that each child has a lunch. Half-day programs shall offer a midmorning or midafternoon snack.
Postings:
The license shall be posted in a prominent, publicly accessible location in the center.
The center shall post a copy of the LIC 613A (9/96) in a prominent, publicly accessible area in the center.
The licensee shall post the PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster in a prominent, publicly accessible area in the child care center at all times.
If Facility provide snacks and or meals, the 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

SUPERVISOR'S NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: BURBANK MONTESSORI ACADEMY	FACILITY NUMBER: 197494554
	VISIT DATE: 10/14/2021

NARRATIVE

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and the Department upon request.
The licensee shall post signs at the entrance to the child care center that provide the telephone number of the local health department and information on child passenger restraint systems pursuant to Health and Safety Code section 1596.95(g) and Vehicle Code sections 27360 and 27360.5 FORM: LIC 610
Each licensee shall have a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available. Contingency plans for action during fires, floods and earthquakes including, but not limited to, the following: FORM: LIC 9148
The following was discussed:
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.html.
Employee/Volunteer Files shall also be maintained and shall contain the following
Health Screening Report - Facility Personnel (LIC 503) and TB Clearance.
Proof of Immunizations
TB Clearance and "Good Health" statement from volunteers.
Personnel Record (LIC 501) or application/resume.
Evaluation of Director Qualifications (LIC 9096).
Evaluation of Teacher Qualifications (LIC 9095).
For each aide under age 18, verification of high school graduation or current participation in an occupational program conducted by an accredited high school or college.
Criminal Record Statement (LIC 508) for staff subject to fingerprint requirements.
Fingerprint clearances - Proof of clearance (Criminal Record, FBI and Child Abuse).
Appropriate driver's license for person(s) transporting children.

SUPERVISOR'S NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: BURBANK MONTESSORI ACADEMY	FACILITY NUMBER: 197494554
	VISIT DATE: 10/14/2021

NARRATIVE

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Mandated Reporter: Beginning on January 1, 2018, AB 1207, 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 (SB) 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.
Senate Bill (SB) 277 New Immunization Requirement: Beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.
The following corrections are needed before a capacity increase will be considered:
· LiC200A Application, submit with revisions. Director provided a copy of LIC200A with new capacity (63 children).
· Alarm door for the main door located at the classroom#5
· Install locks for the doors to the kitchen that has access to the classroom #5 and #4.
· Trash can need lids, indoors and outdoors
· Outlet safety covers need to install.
· The isolation shall be determined.
· Outdoor equipment label certification is needed

Licensee, Kithmini Curry states that facility will no longer operate under a private school affidavit.

An exit interview was conducted with the above items discussed and a copy of this report was provided to the Applicant. Final license determination will be made upon review by the Licensing Program Manager and correction of the above issues. Applicant to correct items by 10/24/2021.

SUPERVISOR'S NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

LIC809 (FAS) - (06/04)

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