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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371430
Report Date: 08/26/2021
Date Signed: 08/26/2021 12:04:58 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:MONTESSORI OF LAGUNA NIGUELFACILITY NUMBER:
304371430
ADMINISTRATOR:PULIYANDA, ANNAFACILITY TYPE:
850
ADDRESS:31171 NIGUEL ROADTELEPHONE:
(949) 661-5437
CITY:LAGUNA NIGUELSTATE: CAZIP CODE:
92677
CAPACITY:60CENSUS: 15DATE:
08/26/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Administrator Ms.Puliyanda Ana TIME COMPLETED:
12:15 PM
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A case management inspection conducted on this day by Licensing Program Analyst ( LPA) Ketki Desai. The facility is requesting to add a toddler option component to the existing preschool license with no change in capacity.
The facility is currently licensed for 60 preschool children and seeking to add 24 toddlers ages 18 to 36 months old to the preschool license. Room# 2 will be used for the toddler option program.
Operating hours for the facility is Monday to Friday 7.00 am to 6.00 PM.

A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Room # 2, is assigned as a Toddler room, it was observed to have age appropriate toys and educational activities. Cots shall be used during napping time, linens are brought from home. Toddler room has its own entrance door from the hallway. There are three sinks inside the Toddler room.
Measurement was taken as follows:
Room # 2 (Toddlers) : 35.25 X 24.75= 872'44 sq ft divided by 35 = 24'93 ( 25 Toddlers)

Sinks: 7 X 15= 105
Toilets: 6 x 15 = 90 children.( there are 2 toilets designated for Toddler use, along with 1 potty chair)

The outdoor yard: The facility has 2 outdoor yards, there is one small yard just outside the toddler classroom and a big play yard currently used by the Preschool children.

Facility shall use both the yards for Toddlers. The big yard shall be used on a rotating schedule with the Preschool children.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: MONTESSORI OF LAGUNA NIGUEL
FACILITY NUMBER: 304371430
VISIT DATE: 08/26/2021
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Outdoor space measurements

Toddler yard outside the room: 54.08 X 11.25 = 608'40 divided by 75= 8'11 ( 8 children)
Preschool yard : 120.08 X 69.50 = 8345'56 divided by 75= 111'27 ( 111 children)

Fire clearance from Orange county Fire Authority has been received and approved for requested capacity.

Based on today’s measurements and the sink & toilet availability, center has sufficient activity space to support the requested capacity of 24 toddlers in Room # 2 and 36 preschool children in Room # 1 &3. Total capacity remains at 60 children.

Facility to submit a Waiver request for Toddlers to use the Preschool yard on a rotating schedule.

Exit interview conducted.

Appeal rights presented to the Director.

Notice of Site Visit was posted. Director 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.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
LIC809 (FAS) - (06/04)
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