304371545-3-8-2022-06-CC-KDEI-CCBTTF-20220308140039

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371545
Report Date: 03/08/2022
Date Signed: 03/08/2022 04:37:31 PM

Document Has Been Signed on 03/08/2022 04:37 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:	DANA MONTESSORI SCHOOL		FACILITY NUMBER:	304371545
ADMINISTRATOR:	GOVINDASWAMY, M.		FACILITY TYPE:	850
ADDRESS:	34052 ST.OF THE VIOLET LANTERN		TELEPHONE:	(949) 240-7271
CITY:	DANA POINT	STATE: CA	ZIP CODE:	92629
CAPACITY:	45	CENSUS: 20	DATE:	03/08/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Applicant Ms. Govindaswamy,Mohanpriya & Mr Anand		TIME COMPLETED:	02:15 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) Ms. Ketki Desai conducted an announced on site pre-licensing inspection at the childcare center. It is a Change of Ownership LPA met with Facility Applicant's Ms. Govindaswamy,Mohanpriya & Mr.Raghavendran, Anand who gave a tour of the Child Care Center. The applicant has requested to provide care and supervision for 45 Pre-school age children 2 to 6 years of age, Monday through Friday 7.30 am. to 6.00 PM. in the assigned three classrooms and two study areas. During the walk through LPA observed staff and children wearing face mask, social distancing and following CDC and Dept of Public Health Guidelines. A review of the Facility Personnel Report Summary on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility has a white metal door at the entrance, which is leads to one door on each side, the door on the left hand side, enters into the reception area in front of the Director's office. This door has a numeric lock installed and a top stopper latch installed. Children are received here and the parents sign them in manually and a Bright Wheel application is also used by the parents to sign in the children. . APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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 (Page-1)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

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: DANA MONTESSORI SCHOOL	FACILITY NUMBER: 304371545
	VISIT DATE: 03/08/2022

NARRATIVE

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Emergency First Aid kits are stored in the classrooms and in the in assigned cabinets.
Isolation area is the Director’s office and the sick child shall use the designated adult restroom, there an additional mat and linens for the sick child.

LPA discussed the posting requirements including, but limited to, the following:
· Facility License in public area (101160)
· Emergency Disaster Plan (LIC 610)
· Earthquake Preparedness Check List (LIC 9148)
· Parents’ Rights Poster (PUB 393)
· Personal Rights (LIC 613A)
· Menus / Activity Schedule
· Notice of Site Visit (LIC 9213) and Type A deficiencies / Plan of Corrections of Type A deficiencies
· Granted Waivers (available for review)
· Child Car Seat Law (PUB 269)
· COVID Posters

All the posters are posted on the side wall in the reception area.

Facility Administrator gave a tour of the new center. There are three designated classrooms and two study areas with open play yard for the enrolled children. Each of the designated space for enrolled children was measured on today's inspection.

The following were inspected in the indoor activity space:
· Classroom are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available through water pitchers and personal water bottles, which are refilled as needed.
· Sign in/Sign out procedure was reviewed and meets regulation requirements (Manual/Electronic sign in and out)
· There is a working smoke detector, carbon monoxide detector and fire extinguisher that meet statutory requirements. (Page-2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

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: DANA MONTESSORI SCHOOL	FACILITY NUMBER: 304371545
	VISIT DATE: 03/08/2022

NARRATIVE

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· Cubbies available for storage of individual child’s personal belongings and/or bedding
· Napping equipment: Mats are used and are stored in the closet area inside the classroom, this storage door has a safety latch installed.
· Facility shall provide AM/PM snacks daily, while every Friday lunch is provided by the facility. On a daily basis lunch is brought from home and stored in their individual cubbies.
The cubbies are arranged in a small study area, where children are accompanied by the teacher to pick up their personal items.
There is an emergency exit door in KG room # 1, this door opens to the main entrance area, where there is a white metal door of the facility. The exit door in this room has a child safety stopper latch installed. Per Fire department the door cannot be locked from inside, it has to be locked from outside only. But as a safety alert measure, applicant is also in process of installing an Alarm system to the door along with the safety latch stopper.

LPA measured the indoor rooms, designated for preschool children.
Total indoor activity space: 1172'65 divided by 35 = 33.50 (34 children)
Facility does not have sufficient indoor space to accommodate the requested capacity of 45 children.

Total sinks and Toilets
Sinks : 3 X 15= 45 and Toilets: 4 X15= 60 children.
Toilets and sinks are inside the classrooms. There is also a changing table inside the younger preschool room (Toddler room) Age appropriate sinks and toilets are observed. There is a small step stool if needed for the child to reach the sink. The cabinet under the sink has a child safety latch installed.

Facility has sufficient sinks and toilets to accommodate the requested capacity of 45 children.

The following were inspected in the outdoor activity space;
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water pitchers and personal water bottles
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structures, outdoor play houses, covered sandbox and a surrounding bike trail.
There is a locked wooden shed for storage. (Page-3)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

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: DANA MONTESSORI SCHOOL	FACILITY NUMBER: 304371545
	VISIT DATE: 03/08/2022

NARRATIVE

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· An adequate amount of cushioning material consisting sand is in place under the play structures
· Adequate shade is provided by shaded structure (Covered patio )and benches are placed underneath.
· There are is a second emergency exit door along with fence, facing the parking area. This gate has been covered with a green cloth. Applicant has installed a metal chain with a lock tied up with a wooden panel. The chain is tightly fitted across it. The key remains with the facility staff. This is also a Fire Emergency door and it needs to be opened immediately in case of emergency. Facility staff ensures that this door remains closed and locked at all times.

Outdoor measurements
Total outdoor activity space: 2524.30 divided by 75= 33.66 (34 children)

Based on the indoor and outdoor measurements, sink and toilet availability, facility has enough space to accommodate only 34 children in the designated three classrooms and two open study areas.

Fire clearance received from Orange County Fire Authority dated 2/15/22 have approved the requested capacity.

Facility Administrator is current on the required Immunization/ Pediatric CPR/ First training valid through 1/22/24 and have provided the completion certificate for the Preventive Health training (Nutrition and Lead component)

Applicant, Ms.Govindaswamy,Mohanpriya and Mr.Raghavendran Anand were was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

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: DANA MONTESSORI SCHOOL	FACILITY NUMBER: 304371545
	VISIT DATE: 03/08/2022

NARRATIVE

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Safe Sleep

LPA discussed the safe sleep regulations with applicant Ms.Govindaswamy, Mohanpriya and Mr. Anand discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Review of records to be maintained

LPA reviewed with Applicant Ms. Govindaswamy, Mohanpriya and Mr. R Anand the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Subscribe to CCLD important information

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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

The facility was following Title 22 requirements at the time of the inspection. Based on today’s measurements, and the sink and toilet availability, this center has enough activity space to support only 34 preschool age children (2-6 years old) in three classrooms and two study areas.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

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: DANA MONTESSORI SCHOOL	FACILITY NUMBER: 304371545
	VISIT DATE: 03/08/2022

NARRATIVE

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A license will be issued for the capacity of 34 preschool children age 2-6 years old, after a final review. The applicant will be notified if any additional information is required.

Exit interview conducted and report was reviewed with the Applicant Ms.Govindaswamy, Mohanpriya and

Mr. Raghavendran Anand.

Appeal rights were presented to the applicant.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

LIC809 (FAS) - (06/04)

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