198010717-2-23-2023-33-CC-CRES-CPC2CQ-20230223161708

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010717
Report Date: 02/23/2023
Date Signed: 02/23/2023 04:17:50 PM

Document Has Been Signed on 02/23/2023 04:17 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	MONTESSORI ACADEMY OF WEST COVINA		FACILITY NUMBER:	198010717
ADMINISTRATOR:	ZAFIRA FIRDOSY		FACILITY TYPE:	830
ADDRESS:	1030 E. MERCED AVENUE		TELEPHONE:	(626) 917-0767
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91790
CAPACITY:	12	CENSUS: 7	DATE:	02/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:31 PM
MET WITH:	Aysegul Inceoglu,		TIME COMPLETED:	04:55 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	Licensing Program Analyst (LPA) Cynthia Reyes, conducted an unannounced annual site inspection, to ensure the health and safety standards as required by the regulations governing child care centers are met. LPA met with Aysegul Inceoglu, Director and a copy of the Entrance Checklist for Child Care Centers form (LIC 125) was provided. A risk assessment was conducted prior to entering the facility. Due to COVID- 19 precautionary measures were taken during the entire inspection. This facility is located on this Calvery chapel new beginnings church site. The facility operates Monday-Friday, 6:30 AM to 6 PM. LPA was guided on a tour of the facility by Aysegul Inceoglu, Director. Each class room has a Sign-In and Sign-Out sheet which is located outside the Main office and all were observed to have signatures and dates and counts of children were inspected. Each class room does physical checks which include temperature being taken of children by staff when the child enters the class rooms. Use of hand sanitizer will also be available. Facility was observed to be adhering to local public health guidelines. (According to CDC guidelines, children under the age of (2) are not required to wear masks.) Their is a room at the front of the school (Future office) that is used as an ill/isolation area for children and the staff rest room is located right across from this room for the ill child to use. LPA observed an ill child cot/mat available. Continue on page 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023

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: MONTESSORI ACADEMY OF WEST COVINA	FACILITY NUMBER: 198010717
	VISIT DATE: 02/23/2023

NARRATIVE

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The tour began in the only infant class room. Teacher child ratios were observed and discussed in accordance with Title 22 Regulations. Staff names and children census were recorded for this date. LPA discussed that children should be under supervision and observation, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were observed to be inaccessible to children. Aysegul Inceoglu, states there are no poisons, weapons or firearms on the premises.

Furniture, equipment and toys were observed and inspected to be clean, safe and age appropriate and in good repair. Telephone service, heating, lighting and ventilation were evaluated. Infant children have their own cubby to store their personal belongings. LPA observed napping equipment/bedding for infant children to be in good condition, appropriate storage and cleanliness. Linens are provided and washed weekly by the parents of the children in care.

Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Menus for the past 30 days are available upon request. The facility offers AM and PM snack and Lunch. Food is brought in from an outside vendor. Food preparation area is in the central kitchen of the church. The licensee takes measures to keep the facility free of flies, other insects and rodents. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair.

There is drinking water available indoors and outdoors by use of pitchers and disposable cups, as well as the child own labeled bottle/zippy cup.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023

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: MONTESSORI ACADEMY OF WEST COVINA	FACILITY NUMBER: 198010717
	VISIT DATE: 02/23/2023

NARRATIVE

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The outdoor playground was inspected and the play 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, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the outdoor play yard. LPA did not observe any bodies of water on the premises.

Age appropriate sinks, urinals and toilets were inspected for availability, good repair, water temperature, toilet paper, safety and sanitation.

Director 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.

Children’s Records were reviewed for completeness; Inspection of required forms were made and documented on the LIC 857. LPA reviewed staff records, which are documented on the LIC 859. Staff present have proof against TB, measles, pertussis, and influenza, as well as current Mandated reporter. LPA observed during staff file review, that there is at least one person trained in Pediatric CPR and Pediatric First Aid present during this inspection and at all times.

Medication: This facility provides Incidental Medical Services – IMS. 1 child medication policy was reviewed including storage of medication and equipment/supplies, and review of children’s, personnel, and administrative records. 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
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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023

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: MONTESSORI ACADEMY OF WEST COVINA	FACILITY NUMBER: 198010717
	VISIT DATE: 02/23/2023

NARRATIVE

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Children's roster was reviewed for completeness. Disaster drill log was available and last drill was conducted and document on 01/20/2023.

First Aid supplies were observed in each classroom and were observed to contain the required first-aid supplies. According to the Director, medication is only administered to a child when accompanied with a doctor's note and is stored in the office. No transportation is being conducted by the facility.

Update: Effects of Lead Exposure and the following Provider Information Notices (PINs) Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD. were discussed.

Carbon monoxide detectors and smoke detectors are present and are in operable condition in the facility. Smoke and Carbon Monoxide detectors should be checked, and batteries replaced as needed. LPA observed they are both located in each classroom, as well as the fire extinguisher type 2A-10BC and the valve on each indicated that they are all fully charged and each has a tag with a service date. of 02/02/2023. Fire extinguishers need to be serviced annually or as often as necessary.

Access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov. Reporting Unusual Incidents: MPROIncidentReports@dss.ca.gov. CCL Resources for Parents & Providers: https://ccld.childcarevideos.org/ Provider Information Notices (PINs): https://www.cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/child-care

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023

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: MONTESSORI ACADEMY OF WEST COVINA	FACILITY NUMBER: 198010717
	VISIT DATE: 02/23/2023

NARRATIVE

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SAFE SLEEP: LPA discussed the safe sleep regulations with Director, and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Boppy recall: https://www.cpsc.gov/Recalls/2021/The-Boppy-Company-Recalls-Over-3-Million-Original-Newborn-Loungers-Boppy-Preferred-Newborn-Loungers-and-Pottery-Barn-Kids-Boppy-Newborn-Loungers-After-8-Infant-Deaths-Suffocation-Risk

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.

There were no deficiencies cited during today’s Annual inspection.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Aysegul Inceoglu, Director

Page 5 of 5 End of Report

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023

LIC809 (FAS) - (06/04)

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