198011974-12-12-2019-54-CC-RNAO-BJT2PQ-20191212163442

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011974
Report Date: 12/12/2019
Date Signed: 12/12/2019 04:34:55 PM

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	MONTESSORI ON ELM PRESCHOOL + KINDERGARTEN		FACILITY NUMBER:	198011974
ADMINISTRATOR:	WIJEYEWICKREMA, CASSANDRA		FACILITY TYPE:	830
ADDRESS:	930 ELM AVENUE		TELEPHONE:	(562) 570-8080
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90813
CAPACITY:	24	CENSUS: 12	DATE:	12/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Ayumi Rathnayaka		TIME COMPLETED:	04:52 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 Analysts (LPAs) Raul Navarro and Katrina Chicote conducted an unannounced random inspection. LPAs met with designated facility Director, Ayumi Rathnayaka, who guided LPAs on a tour of the facility. This is an infant program licensed for 24 infants. The facility operates Monday – Friday from 6:00 AM – 6:00 PM. The infant program is physically separate from the other components at this facility both indoors and outdoors. All areas identified on the facility sketch were inspected. The following staff were present during this inspection: Room 1: Staff #1, with 4 infants; Room 2: Staff #2 with 4 infants; and Room 3: Staff #3 with 4 infants. Teacher-infant ratios were observed to be in accordance with Title 22 regulations. The facility is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times. Classrooms were observed to ensure that infants are never left unattended and under the direct visual supervision of a staff person at all times. Furniture and equipment was inspected for age appropriateness, good repair, free of sharp, loose, or pointed parts. LPAs observed that infant changing tables have a padded surface no less than one-inch-thick and are covered with washable vinyl or plastic. The infant changing tables have raised sides that are at least 3 inches high. Toys were observed to be safe, and do not have sharp points, edges, splinters and are not made of small parts that can pose a choking hazard. LPAs observed sufficient napping equipment that meets the requirements of Title 22 regulations. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Storage for medication was inspected to ensure that medications are in a safe place inaccessible to children. All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. Report continues- Page 1 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI ON ELM PRESCHOOL + KINDERGARTEN	FACILITY NUMBER: 198011974
	VISIT DATE: 12/12/2019

NARRATIVE

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At this time, the office is used as an isolation area. There are chairs in the office. Parents are contacted immediately when children are determined to be ill.

Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility provides AM snack and PM snack. Parents bring food from home. LPAs observed bottles/food containers to be labeled with the child's name. Food containers are given back to the parent on a daily basis. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and LPA inspected that any contaminated food is discarded immediately. There is uncontaminated drinking water available in all indoor classrooms and drinking containers / jugs are taken outdoors.

All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to infants. Storage areas for poisons are locked. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The licensee takes measures to keep the facility free of flies, other insects and rodents.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. The Director states that there are no bodies of water on the premises and LPAs did not observe any bodies of water during this visit. Per Director there are no weapons or firearms on the premises. Areas around and/or under climbing equipment, swings and slides have cushioning material to absorb a fall; climbing apparatuses are single level only.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Staff Records were reviewed to ensure that a health screening report is on file. Infant Teachers files were reviewed to ensure that teachers present are qualified. The Director and staff have proof of immunization and the mandated reporter training on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. LPAs provided Director with the LIC 859 during today's visit.

Report Continues- Page 2 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI ON ELM PRESCHOOL + KINDERGARTEN	FACILITY NUMBER: 198011974
	VISIT DATE: 12/12/2019

NARRATIVE

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Children’s Records were reviewed to ensure that Identification and Emergency form and a Needs and Services Plan are on file. LPAs issued the Children’s Record Review (LIC 857) to the Program 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

LPAs advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. Tools Resources-Quarterly Updates-Child Care Program

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with Assistant Director Ayumi Rathnayaka. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

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

Report ends- Page 3 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3