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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009834
Report Date: 10/27/2023
Date Signed: 10/27/2023 11:58:21 AM

Document Has Been Signed on 10/27/2023 11:58 AM - 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, 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: 10TOTAL ENROLLED CHILDREN: 9CENSUS: 5DATE:
10/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Anahi Salinas TIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced annual inspection. A COVID risk assessment was conducted upon entry. LPA met with Anahi Salinas, Director, who guided analyst on tour of the facility. This facility operates Monday-Friday from 7:00am- 6:00pm. This is an infant program that is licensed for 10 children. There is also a preschool program on site license # 198009833. Per Director, there is currently 9 children enrolled.

All areas identified on the Facility Sketch were inspected. The infant program consists of 1 classroom. LPA observed 3 teachers with 5 children in the classroom. Teacher-child ratio is met. All adults present have obtained a criminal record clearance or exemption on file. The following was observed during the tour of facility:

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Site Supervisor states that there is no poisons in the facility. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and hand washing facilities are safe, sanitary and are operating properly. All floors are clean and safe.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors. The facility was observed to be free of flies, other insects and rodents.


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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2023
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ANNEX MONTESSORI CHILDCARE CENTER
FACILITY NUMBER: 198009834
VISIT DATE: 10/27/2023
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Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard.

Infant changing tables have a padded surface no less than one inch thick and are covered with washable vinyl or plastic and have raised sides at least three inches high. Toys were observed to be clean and safe. Infant napping equipment and cribs were observed. Indoor activity space for this infant program is physically separate from the other components at this facility.

The facility is in compliance with the staff-infant ratios. A fully qualified teacher is directly supervising no more than 12 infants. Each aide is responsible for the direct care and supervision of a group of no more than four infants. Individual Feeding Plans are on file for each infant. Infant Needs and Services Plan are on file for each infant. Teachers present have proof of the required infant units on file and meet the qualification requirements.

LPA discussed the safe sleep regulations with Director Anahi Salinas and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA observed the LIC 9227 Individual Sleeping Plan on file.

All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. The name
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: 10/27/2023
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of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed. LPA observed that staff # 3 and # 4 are missing proof of required immunization TDAP, Staff # 4 is also missing MMR.

In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

LPA issued a copy of the LIC 859 Staff Records Review to the licensee during this inspection.

Children's roster was reviewed and is current. LPA observed that 3 out 5 children present were signed in. Disaster drill log was available, last drill was conducted on 10/10/23.



Per Director, parents provide all meals for infants enrolled.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of ------------------------------------------------------------ pg. 3 of 4 ---------------------------------------------------------------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: 10/27/2023
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the first test. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.


LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Facility representative was informed of the MyChildCarePlan.org website; a
consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process


At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Facility Representatives Anahi Salinas & Terna Sepulveda.---------------------------------------------------- pg. 4 of 4----------------------------------------------
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
LIC809 (FAS) - (06/04)
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