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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013375
Report Date: 10/03/2019
Date Signed: 10/03/2019 01:51:08 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:LA CRESCENTA MONTESSORIFACILITY NUMBER:
198013375
ADMINISTRATOR:AMARASINGHE, GIRLIEFACILITY TYPE:
850
ADDRESS:3811 FOOTHILL BOULEVARDTELEPHONE:
(818) 249-5437
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY:45CENSUS: 22DATE:
10/03/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:TIME COMPLETED:
02:05 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Justin Dorsey and Bardo Baluyot conducted an unannounced Annual Random Inspection. LPA met with Jinali Hettiarachchi, Teacher, who allowed LPAs to tour the facility. At 12:45pm Director Girlie Amarasinghe arrived to the facility. Licensee also has an Infant Center (#198009548) and Kindergarten which operates on the same grounds.

On 10/03/19 upon entering the facility LPAs observed Staff #3 with 13 children on the playground. Per Staff #3 5 of the children were transition students and were going to the kindergarten. LPA observed the teacher to be back in ratio once returning to the classroom.

LPA inspected all areas identified on the Facility Sketch. The following staff were observed in each classroom during this visit: Toddlers Classroom: Staff #1 and Staff #2 with 8 children; PK 1: Staff #3 with 8 children and PK 2: Was used for napping during the inspection.

LPA inspected all areas identified on the Facility Sketch. Students have access to the classrooms, restrooms, Pre-School outdoor play area and toddler outdoor play area. Students of the program are signed in by parents at their assigned classrooms. LPAs observed sign in sheets in each classroom. This facility does not provide transportation. Furniture and equipment are safe and in good repair. There is telephone service, heating, lighting and ventilation available at the facility. The facility has a room near the Directors office which is used for Isolation, per Director the staff restroom in the toddlers classroom has beendesignated for the use of ill children.

Drinking water is available indoors and outdoors. Restrooms used were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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: LA CRESCENTA MONTESSORI
FACILITY NUMBER: 198013375
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/24/2019
Section Cited

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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. This requirement is not met as evidenced by:
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Based on observation Staff #2 and Staff #3 were missing required immunizations, which poses a potential Health, Safety or Personal Rights risk to children in care.
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Type B
10/24/2019
Section Cited

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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. This requirement is not met as evidenced by:
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Based on observation Staff #2 has nat taken the mandated reporter training, which poses a potential Health, Safety or Personal Rights 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: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2019
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: LA CRESCENTA MONTESSORI
FACILITY NUMBER: 198013375
VISIT DATE: 10/03/2019
NARRATIVE
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 LPA advised how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. Also, discussed new requirements for providers, including mandate reporting training for staff which can be found at: http:/www.mandatedreporterca.com/training /training.htm. This is a new regulatory requirement beginning January 2018. According to staff, training has been completed through Community Care Licensing. Please review all elements outlined in AB 1207- Mandated Reporting Training.

Upon receipt of this report, the licensee shall post ANY licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children in care and new parents for up to one year. A copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports was provided to the Licensee.

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

Exit interview was conducted with Director Girlie Amarasinghe, The Notice of Site Visit and Appeal Rights were given.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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: LA CRESCENTA MONTESSORI
FACILITY NUMBER: 198013375
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/24/2019
Section Cited

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101216.3 Teacher - Child Ratio (a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance...This requirement is not met as evidenced by:
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Based on observation there were 13 children on the playground with Teacher #3, which poses an immediate Health, Safety or Personal Rights 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: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2019
LIC809 (FAS) - (06/04)
Page: 2 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: LA CRESCENTA MONTESSORI
FACILITY NUMBER: 198013375
VISIT DATE: 10/03/2019
NARRATIVE
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The kitchen is located in the toddlers classroom, Per Staff toddlers use the kitchen to eat. LPAs observed tables for children in the kitchen.

On 10/03/19 LPA Dorsey observed a can of paint on the floor in the kitchen, Per Staff the classroom was just painted and the paint got left in the kitchen. LPA observed Staff #1 remove the bucket of paint from the classroom.

The facility provides AM and PM snack, lunch is provided by the parents. Containers used to discard food have tight fitting lid at this time. Snack menus were posted outside of the preschool and toddlers classroom. Snacks were reviewed for availability, quantity and appropriateness to children in care. Cleaning compounds and sharp items are inaccessible.

This facility has a toddler and pre school playground, both playgrounds are fully fenced. 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. Per Director the trees on the playground provide shade at all times. A review of records was conducted for staff and participants. LPA observed that staff have current First Aid and CPR (Expires 08/2021). First Aid supplies are available. Disaster drills are documented and all posting requirements have been met.



On 10/03/19 while reviewing staff files LPAs found that Staff #2 did not have an immunization record and Staff #3 was missing the MMR vaccination. LPAs also observed that Staff #2 was missing the mandated reporting training.

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

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5