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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015474
Report Date: 08/28/2019
Date Signed: 08/28/2019 03:18:17 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:MONTROSE CHRISTIAN MONTESSORI SCHOOLFACILITY NUMBER:
198015474
ADMINISTRATOR:RIMA CHRISTINA DIBIEFACILITY TYPE:
850
ADDRESS:2545 HONOLULU AVENUETELEPHONE:
(818) 249-2319
CITY:MONTROSESTATE: CAZIP CODE:
91020
CAPACITY:105CENSUS: 52DATE:
08/28/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Jay Thompson TIME COMPLETED:
03:32 PM
NARRATIVE
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Licensing Program Analyst (LPA) Justin Dorsey conducted an unannounced Annual Random Inspection. LPA met with Jay Thompson, Director, who guided LPA on a tour of the facility. The facility also operates a kindergarten through 6th grade program on the property. Per Director the two programs don't share any common areas

The following staff were observed in each classroom during this visit: Class A: Staff #1, Staff #2 and Staff #3 with 26 children; Class B: Staff #4 with 6 children; Class C: Currently not in use; Class D: Staff #5 and Staff #6 with 20 children.

LPA inspected all areas identified on the Facility Sketch. Students have access to the classrooms, restrooms (located in each classroom), patio and the outdoor play area. Students of the program are signed in by their parents at their assigned classrooms. The 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 staff lunch room is used as an isolation room, the staff restroom has been designated 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.

The kitchens, which the students don't have access to are located in classrooms B and D. The facility provides A.M. and P.M. snack, lunch is provided by parents. Parents also have the option to order their children's lunch from Cibo, a restaurant that brings lunches to the school. Containers used to discard food have tight fitting lids at this time. Snack menus were posted in the kitchens and classrooms. Snacks were reviewed for availability, quantity and appropriateness to children in care. Poisons are locked in a cabinet. Cleaning compounds and sharp items are inaccessible.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019
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 4
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: MONTROSE CHRISTIAN MONTESSORI SCHOOL
FACILITY NUMBER: 198015474
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/11/2019
Section Cited

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101174 Disaster and Mass Casualty Plan (d)(2) Disaster drills shall be conducted at least every six months. The drills shall be documented. This documentation shall be kept in the child care center for at least one year. This is not met as evidenced by:
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Based on observation and interview the facility has not conducted an earthquake drill since 04/16/18, which poses a potential Health, Safety or Personal Rights risk to children in care.
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Type B
09/11/2019
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. This is not met as evidenced by:
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Based on observation and interview the facility does not have a immunization record on file for Staff #2, Staff #3 and Staff #6, 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: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 08/28/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/28/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: MONTROSE CHRISTIAN MONTESSORI SCHOOL
FACILITY NUMBER: 198015474
VISIT DATE: 08/28/2019
NARRATIVE
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Exit interview was conducted with Owner Sharon Lee and Director Jay Thompson, Notice of Site Visit and Appeal Rights were given.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: MONTROSE CHRISTIAN MONTESSORI SCHOOL
FACILITY NUMBER: 198015474
VISIT DATE: 08/28/2019
NARRATIVE
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The outdoor area includes a asphalt and sand area for children to play, shade is provided by shade sails. The play area is fully fenced. A review of records was conducted for staff and participants. LPA observed that staff have current First Aid and CPR (Expires 8/2020).

On 08/28/19 while reviewing staff files it was found that Staff #2, Staff #3 and Staff #6 do not have their immunization records on file. Per Director he will get a copy of the immunization records and email a copy to LPA Dorsey.

Ratios were observed to be in compliance. First Aid supplies are available. The preschool conducted a fire drill 04/09/19.

On 08/28/19 based on LPA interview and observation it was found the facility does not have documentation of an earthquake drill since 04/16/18. Per Owner Sharon Lee the facility has been conducting the earthquake drills but a log can not be found at the moment.

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


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.

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.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4