274414337-10-22-2019-07-CC-JMAS-BH7RH8-20191022130155

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274414337
Report Date: 10/22/2019
Date Signed: 10/22/2019 01:01:58 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	AUBURN'S HOUSE MONTESSORI SCHOOL		FACILITY NUMBER:	274414337
ADMINISTRATOR:	AUBURN VELASQUEZ		FACILITY TYPE:	850
ADDRESS:	1242 SIDDALL COURT		TELEPHONE:	(831) 236-0220
CITY:	SEASIDE	STATE: CA	ZIP CODE:	93955
CAPACITY:	34	CENSUS: 14	DATE:	10/22/2019
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	10:55 AM
MET WITH:	Joseph Velasquez		TIME COMPLETED:	01:15 PM

NARRATIVE

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Licensing Program Analyst (LPA) Joe Macias conducted a Case Management Inspection. The purpose of today’s visit is to ensure the facility is in compliance with Title 22 California Code of Regulations. LPA met with the Licensee Joseph Velasquez, and explained the nature of today's visit. LPA toured the Facility both inside and outside during todays inspection.

LPA Macias was present to observe staff supervision policy in practice. Supervision of children was discussed; the Licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time. Supervision shall include visual observation. On going monthly staff supervision training's are scheduled for all facility staff.

LPA reviewed children's files and observed the required LIC 9224 form present in all children's files. The center was been placed on required visits, as well as increased monitoring, and has shown to be in compliance.

The center is planning on conducting construction to a portion of the facility. LPA explained that the Department (CCL) shall be notified upon the start and completion of the construction. LPA explained that it is the Licensee's responsibility to notify the department on any structural changes to the center. If permitting is required, the center is to obtain such permits prior to construction. Upon completion of construction the Licensee shall submit an updated facility sketch (LIC 999).

No deficiencies issued during today's inspection, exit interview conducted, and report issued to the center.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

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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