354415951-9-17-2021-07-CC-DVIA-C6XQBQ-20210917120155

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 354415951
Report Date: 09/17/2021
Date Signed: 09/17/2021 12:02:18 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	HOLLISTER MONTESSORI SCHOOL		FACILITY NUMBER:	354415951
ADMINISTRATOR:	DEBORAH LYNN PARGA		FACILITY TYPE:	850
ADDRESS:	2300 SOUTHSIDE ROAD		TELEPHONE:	(408) 408-2930
CITY:	HOLLISTER	STATE: CA	ZIP CODE:	95023
CAPACITY:	30	CENSUS: 16	DATE:	09/17/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Deborah Parga		TIME COMPLETED:	12:10 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), Deanna Villagrana, conducted an unannounced one year required visit to the Facility today. LPA met with Deborah Parga, director, and explained the nature of today's visit to her. The Facility is licensed in four different rooms at the Facility. The playground area of the Facility is located to left of the facility building. LPA toured the Facility both inside and outside for today's inspection. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law, Menus, and Activity Schedule. A review of staff records on 09/13/2021 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Deborah of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12 month period. LPA reviewed ten children's and five staff files during today's inspection. All staff and children's files were complete. All five staff have current CPR and First Aid certifications on file. Teacher's files reviewed contain the required transcripts/verification of experience. Deborah understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). All staff have immunization records on file and have a current Mandated Reporter Certification on file.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna Villagrana	TELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: HOLLISTER MONTESSORI SCHOOL	FACILITY NUMBER: 354415951
	VISIT DATE: 09/17/2021

NARRATIVE

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LPA observed that the teacher/child ratio was in compliance during today's visit. LPA observed 16 preschool children with two teacher's, one aid and director getting ready to go out to the playground. Deborah understands the conditions, limitations, and capacity specifications of the Facility license. Deborah understands that children shall be visually supervised at all times. LPA observed that rooms are clean and safe for all children and staff. Deborah states that the Facility staff rotate cleaning duties on a weekly basis at the Facility. Drinking water is readily available for the children in each room and in the outdoor playground area via personal water containers. The facility is able to refill if needed. LPA observed solid waste containers with tight-fitting lids in the Facility. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff toilet not utilized by the children which an isolated child can use if needed. Deborah states that there are no weapons or firearms on the premises.

Children bring their lunches from home. Food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children. Any medications at the Facility are stored in the director's office area. IMS is administered by the Facility. LPA observed two children require IMS and forms are complete.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. Several trees and the tarps provide shade for the day care children. LPA did not observe any bodies of water.

LPA conducted an exit interview with Deborah and reminded Deborah to keep up to date with COVID-19 changes on CCLD website.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FACILITY ENTRANCE, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna Villagrana	TELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021

LIC809 (FAS) - (06/04)

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