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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750013
Report Date: 10/28/2019
Date Signed: 10/28/2019 03:04:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:MONTESSORI OF NORTH PARKFACILITY NUMBER:
197750013
ADMINISTRATOR:JOHNSON, ERINFACILITY TYPE:
830
ADDRESS:28180 MCBEAN PARKWAYTELEPHONE:
8189743582
CITY:VALENCIASTATE: CAZIP CODE:
91355
CAPACITY:52CENSUS: 24DATE:
10/28/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Director, Rushani Thomas-WiseTIME COMPLETED:
01:38 PM
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Licensing Program Analyst (LPA) Maddox met with Director, Rushani Thomas-Wise today for the purpose of conducting an unannounced Annual/Random inspection. Present today in the Infant room (#1) 12 Infants and 4 staff and Infant Room(#2) 15 infants with 4 staff. LPA observed diaper changing tables within arms reach of sink and Needs and Service plans are kept in each classroom. Director led LPA on a tour of the Infant Center and the outside play area.
**LPA observed age appropriate furniture, equipment, toys and materials. The classrooms were observed to be clean and safe and free of any Health or safety hazards. Telephone service was verified as well as adequate heating, lighting, and ventilation. Children's belongings are kept in cubbies along the walls as you enter classrooms. Drinking water is available inside the classroom in the form of a water cooler and Sippy cups.

**There are bathrooms within each classroom that are not used at this time. The staff rest-room is located next door to the office in the main entrance area. appropriate.

**There is a separate nap room with cribs, each crib is labeled with each Infants name, LPA observed 3 infants in this room with 1 staff person. Infants bedding and linens are stored individually so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: MONTESSORI OF NORTH PARK
FACILITY NUMBER: 197750013
VISIT DATE: 10/28/2019
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**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes wood chips under climbing structures for cushioning material and there is sufficient and adequate shade available. Outside Drinking water is available. There are no bodies of water observed on the premises. The playground is enclosed by a fence to protect children and to keep them in the outdoor activity area.

**Food preparation area/Kitchen was inspected for safety, cleanliness, proper equipment & protection against contamination and storage. Parents supply lunches for infants, LPA observed all bottles and Sippy cups labeled with each Infants name, bottles are sent home at the end of the day with parents. Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children



**The Parent Board (located in the main entrance area) contained all documents that are required to be posted according to Title 22 Regulations. A sampling of Children's and Staff records were reviewed as part of this inspection. Staff are certified in Pediatric CPR and First Aid (exp 2/2020).

**Sign in and out sheets were inspected and contain full legal signatures. LPA observed a fully stocked first aid kit; fully charged fire extinguishers; carbon monoxide detectors throughout the center. Fire Drill/Earthquake log is posted (last drill conducted 10/16/2019).

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. 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 - Center provides Incidental Medical Services, plan has been submitted.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: MONTESSORI OF NORTH PARK
FACILITY NUMBER: 197750013
VISIT DATE: 10/28/2019
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Director was reminded of the following:

§1596.8662 On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child 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.

**§1596.7995 (a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.


**Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state licensed facility to another using form LIC 9182



**New upcoming safe sleep laws will be mailed

There were no violations noted as a result of this inspection, Center is operating in accordance to Title 22 Regulations. Copy of 811 (Confidential Names List) was provided during this inspection. Exit interview conducted and a copy of this report was left at the facility. A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
LIC809 (FAS) - (06/04)
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