304370773-7-20-2023-06-CC-PRIS-CTWRW4-20230720132231

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370773
Report Date: 07/20/2023
Date Signed: 07/20/2023 01:25:42 PM

Document Has Been Signed on 07/20/2023 01:25 PM - It Cannot Be Edited

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:	ANAHEIM MONTESSORI ACADEMY		FACILITY NUMBER:	304370773
ADMINISTRATOR:	BIBILE NIRANJALA, ERIN		FACILITY TYPE:	850
ADDRESS:	744 NORTH EAST STREET		TELEPHONE:	(714) 776-5075
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92805
CAPACITY:	64	CENSUS: 3	DATE:	07/20/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Dulce Cirpriano, Teacher & Niranjala "Angela" Bibile, Director		TIME COMPLETED:	01:45 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) P Rivas conducted an unannounced annual inspection. LPA was met by Teacher Dulce Cipriano who called Director, Niranjala "Angela" Bibile . LPA spoke with Ms. Bibile who stated that she should arrive by 9:00am. LPA set up computer and waited in area between kitchen and play area. Census was taken and LPA viewed three children in care. Ms. Bible arrived at 9:08am and continued to assist LPA with inspection. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 6:30 a.m.to 6:00p.m., Monday through Friday. 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. During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Food is brought from home. Food prep areas were clean and sanitary. 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 water bottles and outside water fountains.. The children's bathrooms are clean and sanitary. The facility has conducted an emergency drill within the past six months 05/2023. The facility has has working carbon monoxide and smoke detectors and fire extinguisher fire that meet the State Fire Marshall Requirements. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

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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Document Has Been Signed on 07/20/2023 01:25 PM - It Cannot Be Edited

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: ANAHEIM MONTESSORI ACADEMY	FACILITY NUMBER: 304370773
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 3 out of 3 records reviewed] which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2023
	Plan of Correction
1 2 3 4	Licensee will send copy of mandated reporter certificates for 3 staff by plan of correction date. Certificates can be emailed to LPA at patricia.rivas@dss.ca.gov

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/20/2023 01:25 PM - It Cannot Be Edited

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: ANAHEIM MONTESSORI ACADEMY	FACILITY NUMBER: 304370773
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101215.1(d)

The child care center director, or the substitute director as specified in (f) below, shall be on the premises during the hours the center is in operation. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review and interview with Director the licensee did not comply with the section cited above Director Bibile is listed as Director both at this facility and at lic 198004486, Montessori Academy in Glendale which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/21/2023
	Plan of Correction
1 2 3 4	Licensee will provide designation of new director , include copy of individuals file, Designation of Responsibility (LIC 308), Personnel Record (LIC 501),Health Screening (LIC 503),Employee Rights (LIC 9052), Statement Acknowledging Requirement to Report Child ,Proof of Education - Official Transcripts,Proof of Experience,Proof of Step II Orientation, Criminal Record Clearance (DOJ, FBI, Child Abuse), Proof of Current Pediatric First Aid and CPR, Proof of Health and Safety Training, including one-hour nutrition training. Proof of Immunizations,Measles (MMR Vaccine),ertussis/Whooping Cough (Tdap Vaccine),Influenza (statement to, decline),Proof of Tuberculous (TB) Clearance,Proof of Mandated Reporter Training,

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

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: ANAHEIM MONTESSORI ACADEMY	FACILITY NUMBER: 304370773
	VISIT DATE: 07/20/2023

NARRATIVE

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3 Staff files were reviewed for staff currently working. Health screening and immunization as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family day care center if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles . 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. Two files did not have a mandated reporter training certificate in file and one had an expired certificate in file. A B citation will be issued under H & S 1596.8662(b)(1).

At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications.

Children's records were reviewed, and there was a separate, complete and current record for each child. In the areas reviewed, 4 children’s files were found to be in full compliance. Sign in/out 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.

This facility does not provide Incidental Medical Services (IMS) LPA advised if Licensee determines need to provide Incidental Medical Services to adhere to; . PIN 22-02-CCP: Best Practices Related to the Provision of Incidental Medical Services in Child Care Centers and Family Child Care Homes 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

cont page 3

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

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: ANAHEIM MONTESSORI ACADEMY	FACILITY NUMBER: 304370773
	VISIT DATE: 07/20/2023

NARRATIVE

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The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height.. The cushioning is sand and is around the climbing equipment, such as swings, slides and other similar equipment appeared to be enough to absorbs falls. Drinking water in the outdoor activity space is provided by water fountains. 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. A technical violation is issued under 101238.2(d)(2)The area that is to be used for exit in an emergency is a side fenced area that has dry gasses, branches, tree trunks, piles of dry leaves broken toys which can pose a fire hazard.
Director reports to having had Lead Testing done but could not locate results of Lead Testing. LPA is providing a technical violation under Written Directives 100700(c)(1). Licensee to submit copy of Lead Testing results to LPA by 08/21/23.

During review of records LPA found that Director Niranjala "Angela" Bibile, Director is also the Director for license #198004486, Montessori Academy in Glendale. A citation is issued under 101215.1(d). Licensee will provide designation plus file of new Director by 08/21/23.

The Director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov Site Supervisor may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov

LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The Site Supervisor was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness Also provided was
cont. page 4.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

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: ANAHEIM MONTESSORI ACADEMY	FACILITY NUMBER: 304370773
	VISIT DATE: 07/20/2023

NARRATIVE

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information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative.

In the areas that were evaluated, the following deficiencies are cited under the California Code of Regulations, Title 22, Division 12 ,101215.1(d) and H & S Code H & S 1596.8662(b)(1) at the time of the visit.

An Inspection and exit interview was completed with Director Niranjala "Angela" Bibile. 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, Niranjala "Angela" Bibile 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.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

LIC809 (FAS) - (06/04)

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