304370625-7-10-2019-06-CC-MMAK-BDXNEK-20190710102403

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370625
Report Date: 07/10/2019
Date Signed: 07/10/2019 10:24:07 AM

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:	ROBINHOOD MONTESSORI		FACILITY NUMBER:	304370625
ADMINISTRATOR:	KLYMKO, RAMONA		FACILITY TYPE:	830
ADDRESS:	27500 MARGUERITE PARKWAY #6		TELEPHONE:	(949) 364-6342
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92692
CAPACITY:	12	CENSUS: 4	DATE:	07/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Director		TIME COMPLETED:	10:45 AM

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	Page 1 An unannounced annual inspection was conducted today by Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek who met with the licensee/director, Ramona Klymko, and her spouse/administrator, Friedhelm Klymko. Census was taken and there were a total of 4 infants and toddlers with 2 staff in one classroom. There were no napping children in the crib area observed. Staff stated one staff person stays in the crib area when infants are napping. A review of criminal record clearances indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility was reviewed to ensure compliance with license conditions and limitations, staffing and ratios, inaccessibility to poisons, medication, and hazardous items that can pose a danger to children. Equipment and furniture was inspected to ensure it's in good condition, free of sharp, loose or pointed parts. The bins had tight fitting covers. The napping area is separated from the activity are and has sufficient infant napping equipment. There is no walkers on the premises. The changing table is within the arm's reach of a sink. Bottles and dishes are labeled with the current date and children's names. The infants and toddlers were being supervised. There are no weapons, firearms or bodies of water in the facility. The playground was inspected for safety, good condition of equipment, including appropriate cushioning material around and under high climbing equipment. Staff's files were reviewed for education verification, CPR/First Aid, infant/toddler units, and immunization requirements for (MMR, Pertussis, and Flu vaccines). A sample of children's files were reviewed for completeness of medical assessment, and verification of sign in/out including time the child was signed in/out by authorized representative as well as verification of representatives full legal signature.(The facility has electronic sing in/out procedures). A manual procedure is available as needed. The facility has an individual feeding plan for each infant and each infant has an infant Needs and Services Plan. Continued on page 2

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 703-2810
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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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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: ROBINHOOD MONTESSORI	FACILITY NUMBER: 304370625
	VISIT DATE: 07/10/2019

NARRATIVE

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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 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 facility does not have any children with medication at this time.

The Notice of Site Visit was posted. Facility representative 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. The licensee was provided a copy of their appeal right (LIC 9058 1/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. First level appeal is to Regional Manager, address is above on the report. Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov
Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org

A copy of child care provider's guide to safe sleep pamphlet and a copy of Never Ever Shake a Baby pamphlet with the website www.dontshake.org were given to the facility representative on the last inspection.
An updated pamphlet regarding safe sleep regulations in childcare and a pamphlet for lead poisoning facts were given to the director today.

In the areas that were evaluated, the facility wan in compliance of the California Code of Regulations, Title 22, Division 12.
No deficiency was cited.
This report ends here.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 703-2810
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

LIC809 (FAS) - (06/04)

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