304370502-2-12-2020-06-CC-KDEI-BLR36Y-20200212165908

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370502
Report Date: 02/12/2020
Date Signed: 02/12/2020 04:59:19 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:	MY FIRST MONTESSORI		FACILITY NUMBER:	304370502
ADMINISTRATOR:	WENDY MARTIN		FACILITY TYPE:	830
ADDRESS:	19118 BROOKHURST STREET		TELEPHONE:	(714) 962-2620
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92646
CAPACITY:	23	CENSUS: 13	DATE:	02/12/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Administrator Wendy Martin		TIME COMPLETED:	05:15 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	Licensing Program Analyst (LPA) Ketki Desai conducted an unannounced one year required inspection in accordance with Community Care Licensing (CCL) Title 22 Division 12 Chapter 1, governing Infant Child Care Centers. Licensing staff met with designated facility Director Wendy Martin. This is an infant program licensed for 23 infants ages 0 – 2 years. The facility operates Monday – Friday from 6:30 AM – 6:30 PM. The infant parents will have to pass through Preschool Center to drop off their child. LPA also observed sign in sheets for infant center located near the front door of the facility( electronic Sign in - out) Per Title 22, The licensee shall require the child's authorized representative to remain in the center until the daily inspection for illness is completed and the child is accepted for care. LPA observed 18 infants with 5 staff member present providing care and supervision to infants in the designated Pink room . Staff name were recorded. All infants were observed by LPA to be under visual supervision of a teacher at all times. The Licensee is within the conditions, limitations, and capacity specified on the license. At this time, the office is used as an isolation area. When infant is determined to be ill a portable infant play pen is available in the office. Parents are contacted immediately. Furniture and equipment was inspected for age appropriateness, free of sharp, loose, or pointed parts. Storage for infants’ belongings and napping equipment/cribs was inspected and meet all regulatory requirements. Availability of drinking water was reviewed. The children have their own sippy-cups with their names written on them. Changing table has raised sides at least three inches high and is within an arm’s reach of a hand washing sink. Toys observed to be clean. Indoor classroom was inspected to ensure that the floors have a surface that is safe and clean.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MY FIRST MONTESSORI	FACILITY NUMBER: 304370502
	VISIT DATE: 02/12/2020

NARRATIVE

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A first aid kit is kept in each classroom. Carbon monoxide detectors and smoke detectors are present in the facility. Fire extinguishers are serviced monthly by the Maintenance department of the AQMD complex. Storage cabinet in classrooms was locked and hazardous items including poisonous cleaning compounds were stored inaccessible to children.

Infants bedding materials provided by parents are changed daily or as needed If needed Center does provide an additional linen. Storage for children's belongings was reviewed. Food preparation areas were toured for safety, cleanliness and proper equipment. Meals are provided by parents only. Bottles, dishes, and containers were labeled with infants’ names were visible on all children's bottles and other refrigerated items.

Outdoor equipment was inspected for safety, cushioning material, good repair and appropriateness. Required shade, drinking water and fencing were inspected. The playground is completely fenced and fencing is in good repair. The playground equipment appeared in safe condition, and the play area is free from hazards. There is sufficient cushioning (soft foam) underneath climbing structures and/or play equipment to absorb falls. Sign in/out procedure was reviewed for compliance. Staff have proof of current pediatric CPR/First Aid certification, which expires 03/2021. LPA Desai advised Facility Director that the infants need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. Infants use their own sippy-cups with their name written on the cups when outdoors. Play area was inspected for hazards and inaccessibility to bodies of water. No hazards observed.

Teacher-infant ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of infants are met and appropriate. Infant Needs and Assessments are done quarterly or updated as needed. Sign-in and out sheets and procedures were reviewed. Personal Rights of infants were observed by LPA. Staff and Infant Records were reviewed for completeness. Inspection of required forms made. Director stated there is a always a staff in the crib room when there is napping infant(s). During the walk through three infants were in the crib room with one staff member seated besides them.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

LIC809 (FAS) - (06/04)

Page: 2 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MY FIRST MONTESSORI	FACILITY NUMBER: 304370502
	VISIT DATE: 02/12/2020

NARRATIVE

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Staff and Children’s Records were reviewed. Criminal Record Clearances were reviewed for Associations and Transfers. All Staff present in the facility are current on First aid/ CPR card valid through March 2019, staff are current on required Immunization and have completed the Mandated Reporting training.

Incidental Medical Services (IMS) policy was discussed. 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 and 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 at: http://www.ada.gov/childqanda.htm

The following was discussed with the Director:
Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited. No infant walkers, no Johnny Jumpers, no excersaucers or any other item that falls into that category are allowed in facility. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Changes should 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.

A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the facility representative.

English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Spanish: https//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdf

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MY FIRST MONTESSORI	FACILITY NUMBER: 304370502
	VISIT DATE: 02/12/2020

NARRATIVE

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AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx

NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

· Always place infants on their backs for sleeping

· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used as long as they do not have items attached to them
· Infants should not be swaddled or have any items covering them while sleeping
· The temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold

Provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org

The facility representative 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 facility representative was also informed that the LIC 508 must be submitted with all Criminal Background Clearance Transfer Request (LIC9182). The facility representative was informed that Licensing Updates are available at www.ccld.ca.gov

No deficiency cited on today's inspection per Title 22. Facility meets the regulatory requirements.

Exit interview was conducted. Appeal rights provided to the facility. The director was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

LIC809 (FAS) - (06/04)

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