198020806-9-14-2021-33-CC-CGRN-C6URDB-20210914125539

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020806
Report Date: 09/14/2021
Date Signed: 09/14/2021 12:55:46 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:	OAK KNOLL MONTESSORI SCHOOL		FACILITY NUMBER:	198020806
ADMINISTRATOR:	KIRA DONNELLY		FACILITY TYPE:	850
ADDRESS:	904 E CLAREMONT ST		TELEPHONE:	(626) 345-9929
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY:	14	CENSUS: 0	DATE:	09/14/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Kira Donnelly		TIME COMPLETED:	01:05 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	An announced pre-licensing site inspection was conducted today by Licensing Program Analyst (LPA) Crystal Green to inspect and measure facility for capacity determination. Applicant is seeking to provide care for a Preschool Program with a Toddler Option Program. Due to COVID- 19 precautionary measures were taken, individuals present during inspection wore appropriate personal protective equipment. Facility was observed to be adhering to local public health guidelines. Licensing staff met with Kira Donnelly, Head of School, Ellen Webb, Site Director, and Korina Navarro, Administrator, who guided analyst on a tour of the facility. This proposed Preschool Program with Toddler Option Program will operate from Monday through Friday from 7:45 AM until 4:00 PM. As a COVID- 19 precautionary measures, Director states that the facility plans to have children drop off and pick up conducted at the main gate. Temperature check will be conducted and recorded on all individuals that enter the facility. Facility has additional masks available for adults and children. At 10:25 AM, Licensing staff was guided through a tour of the proposed preschool and toddler classrooms. This facility will have (1) toddler classroom and (1) preschool classroom. LPA observed the toddler classroom to be physically separate from the preschool classroom. LPA also observed that each has its own entrance to prevent crossing over between programs. Individual storage space was observed available for each child inside the classrooms. Toys were observed to be clean and safe. Furniture and equipment were inspected for age appropriateness and good repair. There are smoke detectors and fire extinguishers located throughout the facility. LPA observed the facility to have 2 toilet and 2 sinks available to children. All toilets and sinks are in safe and sanitary operating conditions. The designated isolation area will be located in the patio area of the facility. Parents will be called immediately if children become sick. Ill children will use the staff restroom. Report Continues Page 1 of 2.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

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: OAK KNOLL MONTESSORI SCHOOL	FACILITY NUMBER: 198020806
	VISIT DATE: 09/14/2021

NARRATIVE

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At 10:30 AM, Licensing staff was guided through the proposed outdoor activity space for toddlers and preschoolers. The toddler program shall be conducted in areas physically separate from those used by older or younger children. Per Site Director, facility will install fencing to separate the preschool outdoor play area from the toddler outdoor play area. All areas around or under high climbing equipment, and slides should have cushion material to absorb a fall. Per Site Director, the facility will install cushioning material in both toddler and preschool yards. There is shade provided via tree located on the property. There is a kitchen on site were staff will prepare and provide AM/PM snacks and parents will provided lunch for the children in care.

No transportation is being conducted by the facility. 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

During this inspection, licensing staff obtained measurements from both indoors and outdoors. Based on measurements obtained today, capacity for the proposed preschool program with a toddler option program will be fourteen (14) children, allowing for (2) preschoolers and (12) toddlers.

A fire clearance was received and approved by Pasadena Fire Department. The following correction need to be made prior to submitting application for final approval. Correction will be due by 09/31/2021.

• Applicant will submit proof of the fencing installed to make the preschool outdoor space physically separate from toddler outdoor space.
• Applicant will submit proof of the cushioning material for the outdoor surface for both toddler and preschool yard.

An exit interview at 12:50 PM with Director.

Report ends Page 2 of 2.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2