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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600679
Report Date: 02/07/2020
Date Signed: 02/07/2020 03:22:39 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: 5DATE:
02/07/2020
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Shirani Perera-OwnerTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA), Andrea Taylor conducted an on site inspection for the purpose of an Annual Required. LPA Taylor and owner, Shirani Perera toured the facility inside and outside and the floor and yard plan (LIC 999) were verified. Census was taken. The overall census observed was two preschool staff and three preschool children, one school-age staff and two school-age children in the preschool classroom. During the inspection it was determined the facility is not operating within its licensed capacity and within compliance of staffing ratios. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Upon LPA Taylor's arrival LPA observed five children in the preschool classroom with three staff members present in the room. LPA was informed by owner two of the five children have already turned six years old. LPA confirmed the children's ages with a review of the children's files. The owner has been cited on 1/10/20, 12/9/19, 9/24/19 and 12/14/16 for commingling school age children in the same classroom as the preschool children. Licensee had a non-compliance conference in the Orange Regional Child Care Office on 10/1/19 where the subject of commingling was discussed at length with the owner. LPA Taylor has explained the regulation 101161(a) - Limitations on Capacity & Ambulatory Status: A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
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
VISIT DATE: 02/07/2020
NARRATIVE
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During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed not to be stored out of the reach of children. LPA Taylor observed a cylinder style container with a lid containing "Tide" detergent in the unlocked cabinet under the sink. The children have access to this cabinet and the "Tide" in the container. Poisons/Hazardous Items are not kept on the premises. Food is brought from home; snacks are provided. Food prep areas were clean and sanitary. Food is properly stored. Menus were posted where they could be reviewed by parents. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. There is drinking water available to children indoors by sports bottle with the child’s name on it. The children's bathrooms are clean and sanitary. Children nap on cots/mats, and bedding is stored individually and is taken home weekly to be washed by parents. The facility has conducted an emergency drill within the past six months. The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility

Staff files were reviewed for staff present during the facility inspection this date. Two out of two staff files were reviewed. Health screening and immunization as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1596.7995 (c) states, a person shall not be employed or volunteer at a child care center if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles were not available for review. The licensee does have proof of immunization against influenza on file for both employees.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
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: 02/07/2020
NARRATIVE
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Page 3

Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training, and to renew the training every two years. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires 11/20.

The director was informed that the Criminal Record Statement (LIC 508) has been updated, and the facility must now use the new form with revised date 7/15. The director was also informed that the LIC 508 must be submitted with all Criminal Background Clearance.

Children's records were reviewed, and there was a separate, complete and current record for each child. All five of children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their full legal signature and records the time of the day.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
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
VISIT DATE: 02/07/2020
NARRATIVE
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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

The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The fence on the north side of the playground has a gate which was open during today's inspection. This gate being open allows the children to have access to the yard of grass and fruit trees which is fenced and still on school property. The surface of the outdoor activity space was well maintained and free of hazards. The cushioning material (sand) around the climbing equipment, swings, slides and other similar equipment appeared to be enough to absorbs falls. Drinking water in the outdoor activity space is provided by drinking fountain. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility. The facility grounds were safe, sanitary and in good repair.

LPA Taylor requested an updated Plan of Operations including a parent handbook and an employee's handbook. The owner stated she does not have a plan of operation or handbooks for parents or employees.

SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
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
VISIT DATE: 02/07/2020
NARRATIVE
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Based on LPAs observation of two children age 6 in the preschool classroom, a container with "Tide" detergent accessible to children and no plan of operation the following violations were observed are being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 3, Section 101161(a) Limitations on Capacity and Ambulatory Status, 101238 (g) Building and Grounds and 101173 Plan of Operation are being cited on the attached LIC 809D.

Safe sleep information, E-Learning Modules information was provided to owner on 1/10/20.

An exit interview was completed with owner. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties 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. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/07/2020
Section Cited

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101161(a) Limitations on Capacity and Ambulatory Status: The licensee shall not exceed the conditions, limitations and capacity specified in the license. The above requirement is not met by observing two school children with three preschool age children in the same classroom
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This is an immediate risk to Health and Safety to children in care. This is a repeated citation issued 1/10/20, 12/9/19, 9/24/19 and 12/14/16.
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Type A
02/07/2020
Section Cited

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(101238(g) Building and grounds: Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.
The above requirement is not met by evidence of observing a container with
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"Tide" detergent under the sink, which was unlocked and accessible to children. This is a potential risk to Health and Safety to children in care.
This is a repeat violation.
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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: Andrea TaylorTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2020
LIC809 (FAS) - (06/04)
Page: 6 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: 02/07/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2020
Section Cited

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101173(a)(b)(c)(d) Plan of Operation Each licensee shall have and keep on file a current written, definitive plan of operation. A copy of the plan shall be submitted to the Department with the license application.
This requirement was not met as evidenced by owner admitting to not have a plan of operation.
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This is a potential risk to the health and safety of 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: Andrea TaylorTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2020
LIC809 (FAS) - (06/04)
Page: 7 of 7