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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009834
Report Date: 09/13/2019
Date Signed: 09/13/2019 03:29:46 PM

COMPREHENSIVE INSPECTION
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:ANNEX MONTESSORI CHILDCARE CENTERFACILITY NUMBER:
198009834
ADMINISTRATOR:HAYDEE DIAZFACILITY TYPE:
830
ADDRESS:3400 AEROJETTELEPHONE:
(626) 569-2641
CITY:EL MONTESTATE: CAZIP CODE:
91731
CAPACITY:10CENSUS: 6DATE:
09/13/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
09:08 AM
MET WITH:Stephanie Garcia, DirectprTIME COMPLETED:
03:30 PM
NARRATIVE
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An unannounced Annual Inspection was conducted on this day by Licensing Program Analyst (LPA) Mireya Garcia in accordance with Community Care Licensing (CCL) Title 22 Division 12 Chapter 1, governing Infant Child Care Centers. Facility is currently licensed for a capacity of 10. Licensing staff met with Stephanie Garcia, Director. The program currently operates Monday thru Friday from 7 AM to 7 PM. Licensing staff was taken on a guided tour of the facility of both indoors and outdoors.

During the site inspection, there is a total census of 6 infants present and a total census of 3 teachers present. Furniture and equipment was inspected for age appropriateness. Telephone service, heating, lighting and ventilation were evaluated. Storage for infants’ belongings and napping equipment/cribs was inspected and meet all regulatory requirements. Availability of drinking water was reviewed. The children have their own sippy-cups with their names written on them. Age appropriate sink and toilet were inspected for availability, water temperature, area safety and sanitation. The sensor in the sink faucet located inside the infant restroom is currently not working properly. Per Director, she was not aware of the problem however, during this LPAs visit Director placed a service call to address this issue. Changing table has raised sides at least three inches high and is within an arm’s reach of a hand washing sink. Toys observed to be clean.

A first aid kit is kept in the cubbie area inside the classroom. Carbon monoxide detector and smoke detector are present in the facility and are in operable condition. Fire extinguishers were serviced in 07/03/2019. Storage cabinet in classrooms was locked and hazardous items including poisonous cleaning compounds were stored inaccessible to children.

Children bring their own bedding materials which are sent home at the end of each week to be laundered. Storage for children's belongings was reviewed. Food preparation areas were toured for safety, cleanliness and proper equipment. Meals are provided by parents. Bottles, dishes, and containers were labeled with infants’ names; dates were visible on all children's bottles and other refrigerated items. Page 1 of 4
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019
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 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANNEX MONTESSORI CHILDCARE CENTER
FACILITY NUMBER: 198009834
VISIT DATE: 09/13/2019
NARRATIVE
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The Director was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation. Director advised to visit www.shotsforschool.org for immunization information.

Director advised that indoor and outdoor supervision required at all times.



These forms may also be downloaded from our website: www.ccld.ca.gov

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.



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

Exit interview was conducted with Director, Stephanie Garcia. A copy of this report and appeal rights were provided and explained.

Page 4 of 4 End of report--------
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019
LIC809 (FAS) - (06/04)
Page: 5 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANNEX MONTESSORI CHILDCARE CENTER
FACILITY NUMBER: 198009834
VISIT DATE: 09/13/2019
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Outdoor equipment was inspected for safety, cushioning material and good repair. However, outdoor area needs to be cleaned. The sand area is not kept clean (LPA took picture) per Director it is currently not in use and a service call has been placed. Toys are not kept clean the storage box has dirt and spider webs (LPA took picture). Per Director she will work with staff to ensure the outdoor yard area is kept clean and orderly. Required shade is available however, there is bird droppings on the top of the surface. Drinking water and fencing were inspected. LPA Garcia advised Director Stephanie that the Infants need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. Infants use their own sippy-cups with their name written on the cups when outdoors. Play area was inspected for hazards and inaccessibility to bodies of water. No hazards or bodies of water observed.

Teacher-infant ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of infants are met and appropriate. Infant Needs and Assessments are done quarterly. Sign-in and out sheets and procedures were reviewed. Personal Rights of infants were observed by LPA. .

Staff and Infant Records were reviewed for completeness. Criminal Record Clearances were reviewed for adults. Inspection of required forms was made. Upon review of staff files LPA observed that Staff #2, and #3 do not have 3 semester/quarter units related to the care of infants as required, Per Director she was not aware of this requirement. LPA issued the Children’s Record Review (LIC 857) and the Review of Staff records (LIC 859) to the Director during this inspection.

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

Page 2 of 4

SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANNEX MONTESSORI CHILDCARE CENTER
FACILITY NUMBER: 198009834
VISIT DATE: 09/13/2019
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The following was discussed with the Director Stephanie:
Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited. No infant walkers, no Johnny Jumpers, no excersaucers or any other item that falls into that category are allowed in facility.

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

The Director was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. LPA also provided a complete packet of the Provider Information Network (PIN) 10-02-CCP dated February 20, 2019 regarding Safe Sleep Awareness Campaign during today’s inspection.

Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Director was advised how to access forms and Regulations online at www.ccld.ca.gov. Director was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. The Director was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

LPA advised Director that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.

LPA informed Director to log onto web site www.ccld.ca.gov to obtain forms and LIVE SCAN application. Records for all children and staff must be maintained for three (3) years after separation from the facility.

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SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANNEX MONTESSORI CHILDCARE CENTER
FACILITY NUMBER: 198009834
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/27/2019
Section Cited

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101238-Buildings and Grounds: (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
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This requirement is not met as evidenced by LPAs observation and interview with Director in the infant restroom the sensor for the faucet/sink is currently not working properly. In the outdoor Infant play area; needs to be clean and kept in orderly specifically in the sand area, toys/containers, children's furnishings, and in the shaded area (tarp). This poses a potential health and safety risk to children in care.
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In addition, Director added the following items that need to be addressed; outdoor yard and the shaded area needs to be clean. Per Director staff will clean the toys/containers. Director will submitt proof of corrections (poc) on or before POC due date of 09/27/2019 to LPA Garcia via email.
Type B
10/04/2019
Section Cited

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101416.2-Infant Care Teacher Qualifications and Duties: (c)To be a fully qualified infant care teacher, a teacher shall have the following:(1) Completion, with passing grades, of 12 postsecondary semester or equivalent quarter units in early childhood or child development education at an accredited or approved college or university.(A) At least three of the units required in (c)(1) above shall be related to the care of infants or shall contain instruction specific to infants.
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This requirement is not met as evidenced by LPAs records review LPA observed that Staff #2, and #3 do not have 3 semester/quarter units related to the care of infants as required, on file. This poses a potential health and safety risk to children in care.
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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: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5