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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020764
Report Date: 06/16/2021
Date Signed: 06/16/2021 02:47:05 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:MONTESSORI OF WALNUTFACILITY NUMBER:
198020764
ADMINISTRATOR:BISHAN SENEVIRATNEFACILITY TYPE:
830
ADDRESS:20121 E. ALISU CTTELEPHONE:
(909) 598-9267
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY:18CENSUS: 0DATE:
06/16/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Bishan Seneviratne & Laura WingerTIME COMPLETED:
02:46 PM
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Licensing Program Analyst (LPA) Cynthia Reyes, conducted an announced pre-licensing site Inspection to inspect and measure the requested Infant component for capacity determination. LPA met with Bishan Seneviratne, Administrator & Laura Winger, Director. Due to COVID- 19 precautionary measures were taken during the entire inspection and all individuals present during this inspection wore appropriate personal protective equipment. The licensee is requesting a capacity of 18 Infants (0-2). The facility has a preschool license 198013942 and is requesting a decrease to use one of the previous licensed class room 6 now for the Infants. Days & Hours for the proposed infant center will be Monday- Friday 7 AM-6:00 PM.

At 11 AM, LPA began the tour of the facility with the Director Laura, beginning at the front entrance to the facility. Director states parents will enter and exit the main lobby of the facility, however during Covid parents will sign the child in/out (Clean pins will be available and a container for used pins), outside of the lobby door where temperatures and use of hand sanitizer will be conducted. Parents will not enter the class rooms at this time unless they request to enter, which at that time all precautionary measures will be taken for that individual entering. Facility staff will walk the child inside the class room and bring the child out at pick up time. LPA observed a parent board in the front lobby visible for all to see with all licensing documents and Covid-19 posting are all located at the parent sign in/out table. 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.)

The Directors office will be used as an ill/isolation area and has a cot for a child to rest if needed. Ill children will use the bathroom located in the Directors office. The isolation area will be used by both components (Infant and Preschool), however the facility has an extra area that can be used if a child from both components are sick at the same time. The staff lounge can be used and a rest room is right outside the lounge if needed.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
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 OF WALNUT
FACILITY NUMBER: 198020764
VISIT DATE: 06/16/2021
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11:30 AM, The tour continued through the hallway on the right leading to class room 6, the Infant class room. This room was previously licensed under the requested decrease in capacity of the Preschool. LPA was guided to the outdoor play area though the infant class room back door. The infants have their own self contained out door play yard that they will access though their own class room. Preschool children will not transition to their own play yard through the infant yard at any time. Water bottles and zippy cups with labels with be used for each infant while outdoors. LPA observed age appropriate outdoor toys and play equipment to be clean safe and in good repair, as well as adequate shade is available. All areas around play equipment and slides are cushioned with material to absorb a fall. Measurements were taken of the outdoor play yard and the total outside capacity allows for 53 Infants and will be approved for the requested 18 Infants. LPA advised the Director that the children need to be within the direct care and supervision, including visual observation and supervision of the teacher(s) at all times.

12 PM Licensing staff was guided through the proposed infant classroom and LPA observed a separate 2 ft. high shelving surrounding the napping area with 5 cribs and 8 cots. The room also has a refrigerator available in the classroom for storing infant formula, bottles, and infant food. A microwave is also available in this room. There is a changing table with cushioning with 3" sides within arm’s length reach of a sink that is attached to the wall and a Diaper Genie to dispose of solid waste. A potty training chair and and high chairs are also available in this room. Play equipment, furniture and materials for infants were inspected to be in good repair as well as for cleanliness, safety and age appropriate. There is a fully equipped first aid kit available in the classroom. Individual storage space was observed to be available for each Infant. A designated area was observed for each child's needs and services plan. Parents will bring enough linen for the week and take home every day to be cleaned. Facility has extra linen and food available if needed. Parent will bring all infant food at this time.

Items discussed during this Inspection:
Current Children’s Roster LIC 9040: Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This children roster must be updated and available to the licensing agency upon request.
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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
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 OF WALNUT
FACILITY NUMBER: 198020764
VISIT DATE: 06/16/2021
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Criminal background clearance: LPA advised Director that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.
Reporting Requirements Section 101212: Changes at the facility must be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location. The Director was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation.

Infant Needs and Services Plan: The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. Infant Care: LPA advised the applicant to sleep infants where they can be directly supervised at all time. LPA advised against sleeping infants in a separate room. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided. LPA discussed and provided a copy of PIN 20-24-CCP.

Incidental Medical Services (IMS): This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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.



1:30 PM LPA also consulted with applicant regarding COVID-19 health and safety guidelines on this date. Applicant was provided forms to post via email. Licensing staff observed COVID- 19 postings posted in different areas of the day care for parents, as well as for children at eye level in their class rooms and in the bathrooms on this date. During this inspection LPA also discussed PIN 20-06 CCP, Social and Physical Distancing Guidance and Healthy Practices for Child Care Facilities in Response to The Global Corona virus (COVID-19) Pandemic Written in Collaboration with The California Department of Education. LPA reviewed with the applicant the Child Care Covid-19 Self-Assessment guide the applicant filled out and gave the department on 04/01/2021 at this inspection as it was conducted.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
LIC809 (FAS) - (06/04)
Page: 3 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: MONTESSORI OF WALNUT
FACILITY NUMBER: 198020764
VISIT DATE: 06/16/2021
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LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Based on the LPA observation, the following corrections need to be corrected before a license can be granted.


1) 4 foot partition installed for the napping area. 2) Lead training certificate.

Based on LPA measurements taken on this date, the capacity will be approved for the requested 18 Infants.
A fire clearance was approved on 05/04/2021 and on file for a capacity of 18 Infant.

2: 45 PM, Exit interview was conducted in person with Bishan Seneviratne & Laura Winger. A copy of this report and Appeal Rights were given and discussed, signed and printed on this date. Consultation regarding the licensing state laws and regulations, were conducted through out this inspection.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4