198020331-11-5-2021-33-CC-JGUN-C8GPWT-20211105114118

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020331
Report Date: 11/05/2021
Date Signed: 11/05/2021 11:41:24 AM

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:	CREEKSIDE MONTESSORI PRESCHOOL		FACILITY NUMBER:	198020331
ADMINISTRATOR:	CAMILLE CORPODIAN		FACILITY TYPE:	850
ADDRESS:	18790 AMAR ROAD		TELEPHONE:	(626) 581-7353
CITY:	WALNUT	STATE: CA	ZIP CODE:	91789
CAPACITY:	105	CENSUS: 44	DATE:	11/05/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:52 AM
MET WITH:	Director, Camille Corpodian		TIME COMPLETED:	11:45 AM

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 (LPA) Jose Guzman conducted an unannounced required inspection. A risk assessment was conducted prior to entering the facility. LPA met with Director, Camille Corpodian, who guided the LPA on a tour of the facility. This is a preschool age program licensed for 105 children which operates Monday – Friday from 7:30 AM – 6:00 PM. Upon arrival, the following staff was present during this inspection: Room 1: staff #1, #2 with 9 children; Room 2: staff #3 with 11 children, Room 3; staff #4 with 7 children, Room 4; staff #5, #6 with 12 children, and Room 5; staff #7 with 5 children. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded. All children were observed to be under supervision, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. 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. At this time, the office is used as an isolation area. There are chairs in the office a cot is also provided to the children. Parents are contacted immediately when children are determined to be ill. 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 lunch, AM, and PM snack. Page 1 of 2

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose Guzman	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

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 2

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: CREEKSIDE MONTESSORI PRESCHOOL	FACILITY NUMBER: 198020331
	VISIT DATE: 11/05/2021

NARRATIVE

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Food prep and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination. There is drinking water available in all indoor classrooms and drinking containers with cups are taken outdoors. Solid waste storage vessels, 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 inaccessible. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

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. Areas around and/or under climbing equipment, cushioning material to absorb a fall. The director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this inspection.

Staff Records were reviewed to ensure that appropriate documentation of education credits is on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. Proof of immunization against influenza, pertussis and measles for staff was readily available during today's inspection. Staff did have a current Mandated Reporter Training as required.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed 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

A notice of site visit was given and must remain posted for 30 days.
At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.
Exit interview was conducted with Director, Camille Corpodian.
Page 2 of 2

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose Guzman	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2