304370689-1-15-2020-06-CC-MMAK-BKUR49-20200115114110

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370689
Report Date: 01/15/2020
Date Signed: 01/15/2020 11:41:14 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:	VILLAGE MONTESSORI CENTER		FACILITY NUMBER:	304370689
ADMINISTRATOR:	JOHNSON, JENNIFER		FACILITY TYPE:	830
ADDRESS:	22900 LOS ALISOS BLVD.		TELEPHONE:	(949) 837-8518
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	20	CENSUS: 3	DATE:	01/15/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Nicole Mead		TIME COMPLETED:	10:00 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	Pg 1 of 2 An unannounced Required- 1 year inspection was conducted today by Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek who met with staff in charge, Nicole Mead. The director, Jenny Johnson was not present during today's inspection. Census was taken. There were a total of 3 infants and toddlers with 2 staff in the infant/toddler room (two connected rooms). The two staff were supervising three infants and toddler in the activity area. No infant was napping in the crib area. More children, parents, and staff were arriving during LPA's inspection. 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. Today 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 are no walkers or similar equipment that are banned 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 in the awake area. 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 new 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 Continued on page 2

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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: VILLAGE MONTESSORI CENTER	FACILITY NUMBER: 304370689
	VISIT DATE: 01/15/2020

NARRATIVE

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representatives full legal signature. The facility has an individual feeding plan for each infant and each infant has an infant Needs and Services Plan.
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 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. The facility representative was informed that they can refer to our Department website at www.ccld.ca.gov for obtaining the quarterly updates.

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 date.

An updated pamphlet regarding safe sleep regulations in childcare and a pamphlet for lead poisoning facts were given to the director today.

The Mandated Reporter Training Certificates for staff were available on staffs' files.

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

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

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