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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600679
Report Date: 09/19/2019
Date Signed: 09/19/2019 12:18:18 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MONTESSORI HOUSE OF CHILDRENFACILITY NUMBER:
300600679
ADMINISTRATOR:SHIRANI PERERAFACILITY TYPE:
850
ADDRESS:1239 SOUTH MAGNOLIATELEPHONE:
(714) 761-3109
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:26CENSUS: 7DATE:
09/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Director Shirani Perera TIME COMPLETED:
12:45 PM
NARRATIVE
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An unannounced ,Annual / Random inspection was conducted on this date by Licensing Program Analyst (LPA's) Ketki Desai and Jordan Nelson . Upon arrival, LPA was greeted by Facility Director Sharani Perara who stated that the school opens at 9.00 am but she guided the LPA to the facility which is located behind the residence of the Director. The front facility gate was opened and LPS were guided to the Preschool classroom, at the time of arrival there were no children or staff present. This is a preschool program with one classroom and Elementary classroom. A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearances.
Census: Preschool age: 7 ( 2 school age children )

The Center's days and hours of operation are Mon.-Fri. 8.30 A.M. to 4.30 PM. (Monday - Friday)

Posting requirements: All posting requirements were observed on the Parent Boards. The license, the Personal Rights, Child Passenger Safety Law, and Notification of Parents Rights, Emergency disaster plan are posted on the Parent Board. ( waiver for commingling children for special activities not posted)

Physical Plant: Facility designee guided LPA on a tour of the facility, pre-school and elementary classroom and the pre-school playground Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating and air-conditioning, lighting and ventilation were evaluated. Storage for children's belongings and toilets were inspected.( Cluttered) Ill children will remain with the Director's inthe classroom. Availability of drinking water was reviewed - children bring in their own water bottles and is refilled as needed.
Elementary classroom was observed with animal cages ( Rabbit/ Chicken/ Birds/ Cat) inside, air was foul.
There is a carbon monoxide detector/ Fire extinguisher and Smoke detector mounted on the wall.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019
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 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI HOUSE OF CHILDREN
FACILITY NUMBER: 300600679
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/03/2019
Section Cited

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Outdoor Activity Space. All playground equipment shall be cushioned with material that will absorb a fall. This requirement is not met by evidence of missing cushioning material under the play structures. Dried grass and weed observed. This is an immediate risk to H&S to children.
Type A
09/26/2019
Section Cited

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Building / Grounds: The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
The above requirement is not met by evidence of observing Paint cans
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Sharp tools/ wire mesh/ huge wooden planks in the childrens play yard, with no barrier placed barriacading the area. This is an immediate risk to Health and Safety for the children in care.
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Type A
09/26/2019
Section Cited

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Building and Grounds: Disinfectants, other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met by observing Cat food stored in the children's cubbies. This is an immediate risk to H&S to children in care
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: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2019
LIC809 (FAS) - (06/04)
Page: 4 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI HOUSE OF CHILDREN
FACILITY NUMBER: 300600679
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2019
Section Cited

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Personal Rights:To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This is not met by evidence of observing clutter/ cages with animals- Rabbit/ Roaster/ cats cages in the classroom utilized by
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children and cat food stored in children's cubbies . Sharp working tools placed in the children's play yard. Sleeping mats stored in area with spider webs around it. This is an immediate risk of Health and Safety to children in care.
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Type A
09/25/2019
Section Cited

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Alterations to Existing Buildings: Prior to construction or alterations, the licensee shall notify the Department of the proposed change(s). This requirement is not met by evidence of construction being done on childrens yard. Buidling a chicken coup on premises and CCL was not informed
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This is an immediate risk to Health and Safety 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: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2019
LIC809 (FAS) - (06/04)
Page: 5 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MONTESSORI HOUSE OF CHILDREN
FACILITY NUMBER: 300600679
VISIT DATE: 09/19/2019
NARRATIVE
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Outdoor Yard: Observed wood planks/ Paints cans/ wire mesh and sharp tools in the yard, while the playground was observed to have dried grass, weed with sharp edges/ spider webs . NO Cushioning material under the swings / slides and small play structure. Swings were observed without the seats only rusted chains were present. The play yard is dry .
There are no Bodies of water on the premises.
There are several pets roaming in the facility both inside and outside.

Food Service: Children bring in their own food for the day

Napping: Children do nap in the facility. Mats are stored in the storage area and linens are brought in from home. Mats are stored in a storage room.

Health related Services: There is one First Aid Kit in each classroom. A review of medication policy, including administering, labeling, storage, and records was made

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


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 athttp://www.ada.gov/childqanda.htm www.ada.gov/childqanda.html.

Transportation: This facility does not provide transportation services.



An Emergency Disaster Drill log is kept. The last fire drill was ran July 2019 Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met appropriately.
Sign in and out sheets and procedures were reviewed with Director as was the policy of checking children for illnesses.
Facility Roster: Not maintained.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019
LIC809 (FAS) - (06/04)
Page: 2 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MONTESSORI HOUSE OF CHILDREN
FACILITY NUMBER: 300600679
VISIT DATE: 09/19/2019
NARRATIVE
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Personal Rights of children were discussed and observed by LPA.
Per Director, there are currently no firearms or weapons on the premises.

File review: There are 8 pre-schoolers currently enrolled. A random sampling of six pre-schoolers' files and five staff files were reviewed for completeness, including, but not limited to Criminal Record Clearances for adults, qualifications and verification of CPR/First Aid for the openers and closers.

Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov.

In the areas that were evaluated, the facility was not in compliance and violation(s), in accordance with California Code of Regulations, is being cited on the attached LIC 809D.

Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00
If the facility receives a Type A violations, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days, and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days.

Facility Director was remained to ensure there is no commingling of children except for special activities( Waiver in place)

Upon receipt, Director Sharani Perara posted the Notice of Site Visit. The Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100 civil penalty. An exit interview has been conducted with, and a copy of this report has been signed by and provided to Director. Appeal Rights provided and explained to the Director.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019
LIC809 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI HOUSE OF CHILDREN
FACILITY NUMBER: 300600679
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/23/2019
Section Cited

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Facility Roster: Current roster of children provided care in facility required. 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
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This requirement is not met by evidence of facility not maintaining the required facility roster.
This poses a potential risk to Health and Safety 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: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2019
LIC809 (FAS) - (06/04)
Page: 7 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI HOUSE OF CHILDREN
FACILITY NUMBER: 300600679
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/18/2019
Section Cited

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Mandated Reporting: Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion
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This requirement is not met by record review of Licensee and Assistant are missing the above required training. This poses a potential risk to Health ans Safety to children in care.
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Type B
09/26/2019
Section Cited

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Waivers and Exceptions for Program Flexibility:The licensee shall maintain and make available for review, at the child care center, a copy of the written approval or denial.
The above requirement is not met by evidence of missing the Waiver for
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commingling children during special activities. Not posted next to the License.
This is potential risk to Health and Safety 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: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2019
LIC809 (FAS) - (06/04)
Page: 6 of 7