304370845-6-18-2019-06-CC-CNGN-BD9T2B-20190618142029

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370845
Report Date: 06/18/2019
Date Signed: 06/18/2019 02:20:39 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:	ACE MONTESSORI PRESCHOOL		FACILITY NUMBER:	304370845
ADMINISTRATOR:	PAL, DHARMENDRA		FACILITY TYPE:	850
ADDRESS:	24602 RAYMOND WAY SUITE #1		TELEPHONE:	(949) 735-2905
CITY:	LAKE FOREST	STATE: CA	ZIP CODE:	92630
CAPACITY:	90	CENSUS: 28	DATE:	06/18/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Director, Pal Dharmendra		TIME COMPLETED:	02:50 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	An unannounced Annual/Required inspection was conducted at the facility by Licensing Program Analyst (LPA) Nguyen. The facility file was reviewed prior to this visit. A review of the personnel report on file indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Operating hours are 6:30am to 6:30pm, Mon-Fri. Upon arrival, LPA met with Director, Pal Dharmendra. LPA observed 28 children with 3 staff. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. The facility was toured inside and outside, and the floor and yard plan were verified. The facility representative stated there is no bodies of water onsite. LPA confirmed with facility representative that firearms/weapons are not allowed or stored on premises. The facility appeared clean and orderly. The items which could pose a danger to children (disinfectants and cleaning solutions) were stored out of the reach of children. Poisons/Hazardous Items are locked in the kitchen area. All materials and surfaces accessible to children are toxic free. Medications are in a safe place inaccessible to children. The children’s bathrooms were observed to be in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Food is not prepared on site; lunch and snacks are provided by parents. Food prep areas appear clean and sanitary. On site kitchen is free from hazards. Solid waste receptacles have a tight-fitting cover and are in good repair. Children nap on cots/mats, and bedding is laundered weekly by parents. There is drinking water available to children both indoors and outdoors. A current menu is posted is a prominent location viewable by an authorized representative. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher that meet statutory requirements. Continued on Page 2

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy Nguyen	TELEPHONE: (714) 703-2834
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

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: ACE MONTESSORI PRESCHOOL	FACILITY NUMBER: 304370845
	VISIT DATE: 06/18/2019

NARRATIVE

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Spanish: https//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdf
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. A copy of the Department of Social Services Lead Information brochure was provided to the facility representative.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

Documents/Information to be updated and returned to the Licensing Office:

- Administrative Organization (LIC 309)

Exit interview was conducted with Director, Pal Dharmendra. Report reviewed and discussed. Notice of Site Visit was posted during the visit. 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. Appeal rights provided and explained. The director/licensee was provided a copy of their appeal rights (LIC 9058 12/16) and their signature on this form acknowledges receipt of these rights. Licensee was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov. This report is to be on file and accessible for public review at the facility for at least 3 years.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy Nguyen	TELEPHONE: (714) 703-2834
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

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: ACE MONTESSORI PRESCHOOL	FACILITY NUMBER: 304370845
	VISIT DATE: 06/18/2019

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The playground was completely fenced. The playground equipment appeared in safe condition, and play area is free from hazards. The facility has conducted an emergency drill within the past six months.

Sign in/out procedure was reviewed for compliance. A random sample of ten children’s sign/in out sheets for two dates was reviewed. The person who signs the child in and out uses their full legal signature and records the time of the day. The child is signed in and out for the person responsible for the child. A random sample of ten children's files were reviewed and found to be in substantial compliance.

Staff files for staff present during today’s inspection were reviewed for appropriate documentation of education credits. At least one staff member present possesses current CPR/First Aid certifications, which expires 12/20/2019. Proof of immunization's against influenza (or written decline), pertussis and measles for all employees/volunteers were reviewed for compliance with SB 792. Beginning March 31, 2018, Health and Safety Code 1596.8662 requires all directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years, per A.B. 1207. Proof of completion as required by AB 1207 was observed in staff files.

This facility provides Incidental Medical Services -IMS. LPA reviewed storage of medication, 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. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov 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
Continued on Page 3

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy Nguyen	TELEPHONE: (714) 703-2834
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

LIC809 (FAS) - (06/04)

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