304371418-3-12-2020-06-CC-GCOY-BMMW32-20200312165514

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371418
Report Date: 03/12/2020
Date Signed: 03/12/2020 04:55:28 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:	LAGUNA NIGUEL MONTESSORI CENTER		FACILITY NUMBER:	304371418
ADMINISTRATOR:	MCLANE, DEBBIE		FACILITY TYPE:	850
ADDRESS:	28083 MOULTON PARKWAY # B		TELEPHONE:	(949) 643-1200
CITY:	LAGUNA NIGUEL	STATE: CA	ZIP CODE:	92677
CAPACITY:	174	CENSUS: 110	DATE:	03/12/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Debbie McLane		TIME COMPLETED:	05:20 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) Connolly conducted an onsite pre/licensing visit at this proposed change of ownership child care center. LPA met with Director Debbie McLane and toured the center. The applicant has requested to provide care and supervision for children two to five years of age, Monday through Friday, 7:00 AM to 6:00 PM. Office area is located in the front of the building and will serve as the isolation area for ill children temporarily until parents arrive. The staff bathroom will be used as the isolation bathroom and is conveniently located next to the isolation area. Medication is not kept on the premises. The First Aid Kit is complete and located in a cabinet in the kitchen. The finger print electronic scan, sign in/ sign out record, was reviewed and meets regulation requirements. Food preparation area is equipped with microwave oven, refrigerator and freezer. Center policy is lunches and AM snacks are provided by the parents. PM snacks are provided by the center. Evaluator reviewed Title 22 Sections 101227 and 101327 with director that the licensee is ultimately responsible to provide adequate, nourishing food. Menus were observed posted. 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 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 Continued on page two

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Gesine Connolly	TELEPHONE: (714) 293-9314
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

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: LAGUNA NIGUEL MONTESSORI CENTER	FACILITY NUMBER: 304371418
	VISIT DATE: 03/12/2020

NARRATIVE

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Classrooms are adequately equipped with age and size appropriate furniture and equipment. Drinking water in the indoor activity space will be supplied by water fountains. Additionally children will bring from home name labeled water bottles. In the reception area there is a section set aside to be used on an as needed purpose for additional indoor activities.

Total indoor activity area:
Bathrooms: Children bathrooms consist of:
Total children toilets and sinks
Thirteen toilets x 15 = 195 children
Fifteen sinks x 15 = 225 children

Total indoor activity area:
Room #1: 908 sq. feet
Room #2: 908 sq. feet
Room #3: 908 sq. feet
Room #4: 908 sq. feet
Room #5: 908 sq. feet
Room #6: 908 sq. feet
Room #7: 844 sq. feet
Total room space: 6292 sq. feet divided by 35 sq. feet = 179.7714

Playground is completely enclosed by a fence. Outdoor activity space is supplied with age and size appropriate equipment. An adequate amount of cushioning material, sand and artificial turf with foam underlay, is in place under the climbing/slide structures. Shade is provided by two trees, shade cover, umbrella and gazebo overhang. Drinking water is provided by a water fountain.

Total outdoor activity area:
12,732 divided by 75 sq. feet = 169.76
Center has submitted rotating schedule for per classroom use of the outdoor activity area.

Continued on page three

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Gesine Connolly	TELEPHONE: (714) 293-9314
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

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: LAGUNA NIGUEL MONTESSORI CENTER	FACILITY NUMBER: 304371418
	VISIT DATE: 03/12/2020

NARRATIVE

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There is a private elementary school, grades kindergarten to second, located on the premises. The preschool playground is shared with children who attend the private elementary school. The center has submitted a waiver request to share the outdoor play area. The waiver request includes the schedule to share the playground.

A license will be issued for capacity 174.

An exit interview was completed with the director. 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. If the facility receives a Type A violation, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00.

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 (LIC 9182). The facility representative was informed that Licensing Updates are available at www.ccld.ca.gov.
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 facility representative 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 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. Continued on page four

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Gesine Connolly	TELEPHONE: (714) 293-9314
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

LIC809 (FAS) - (06/04)

Page: 3 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: LAGUNA NIGUEL MONTESSORI CENTER	FACILITY NUMBER: 304371418
	VISIT DATE: 03/12/2020

NARRATIVE

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A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided as follows:
English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf
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

The facility representative 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: Gesine Connolly	TELEPHONE: (714) 293-9314
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

LIC809 (FAS) - (06/04)

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