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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845807
Report Date: 06/30/2020
Date Signed: 07/01/2020 04:14:09 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:SUNSHINE MONTESSORI SCHOOL - SCHOOL AGEFACILITY NUMBER:
364845807
ADMINISTRATOR:ANUREE DE SILVAFACILITY TYPE:
840
ADDRESS:14611 PIPELINE AVE.TELEPHONE:
(909) 597-1800
CITY:CHINO HILLSSTATE: CAZIP CODE:
91710
CAPACITY:40CENSUS: 10DATE:
06/30/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Dhina Palevino and Ann DeSilvaTIME COMPLETED:
01:45 PM
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Due to COVID-19 pandemic, on June 30, 2020 at 10:30 a.m., Licensing Program Analysts (LPAs) Blanca Ruiz-Silva and Kim Leung conducted a Tele-inspection with Ms. Dhina Palevino and Ann (Hithaishi) DeSilva via Google Duo. Ms. Palevino guided LPAs on a virtual tour of the facility inside and outside. Due to Change of Ownership application, Component II-Face to Face interview was also addressed during inspection. New fire clearance approved 03/04/20.

There are 2 classrooms including Room#6 and Room#7. Per the measurements on record for the current license, it was determined that there is sufficient indoor activity space and outdoor activity space to accommodate the requested capacity of 40 children.

Limiting factor for school-age capacity is 40 when using Room#6 and the modular for indoor activities. School-age capacity is limited to 18 children when private elementary school is in session in Room#6.

The following was observed:
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Drinking water in the indoor activity space is supplied by used of pitchers of water and disposable cups indoor and outdoor as well as water faucet -COVID 19 Best practice review with applicant
· Playground is enclosed by an appropriate fence
· Outdoor activity area is supplied with age and size appropriate equipment
· There are no accessible bodies of water present on the premises. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· An adequate amount of cushioning material (wood chips) is in place under play equipment
· Adequate shade is provided by trees and building overhang
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2020
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: SUNSHINE MONTESSORI SCHOOL - SCHOOL AGE
FACILITY NUMBER: 364845807
VISIT DATE: 06/30/2020
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· Drinking water is provided in the outdoor play area by water faucet -COVID 19 Best practice review with applicant
· Kitchen is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies
· The office area is located at the entrance of the facility and will serve as the isolation area for ill children temporarily until parents arrive
· Staff bathroom will also be used as the isolation bathroom and is conveniently located to the isolation area
· Medication is stored in kitchen and will be secured in a locked box an inaccessible to children.
· Storage area for toxins and poisons is locked and inaccessible to children.
· The applicant states that they will be providing Incidental Medical Services. LPA informed applicant that prior to providing any incidental medical services a written plan must be submitted to the licensing office.
· Medication administration forms were reviewed
· First Aid kit is complete
· Sign in/Sign out record in substantial compliance as per COVID 19 Teleinspection.
· Component II Orientation was completed during this inspection
· A review of staff records on 06/30/20 indicates that the Licensee or designated individual who is required to have caregiver background checks have received criminal record and child abuse index clearances or exemptions, all other staff have required documentation in their personnel files.
The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov or Associations_Disassociations858@dss.ca.gov
· The "Notification of Parent's Rights" (PUB393 dated [8/02]) poster was provided to the applicant and they were advised that it must be posted in an area of the facility accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.
· The applicant was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov,
· The applicant was advised that, once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2020
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: SUNSHINE MONTESSORI SCHOOL - SCHOOL AGE
FACILITY NUMBER: 364845807
VISIT DATE: 06/30/2020
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 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
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

The following was also reviewed and discussed:
vAB 2621 – Public Information effective January 1, 2015 – The Department shall post licensing reports for Child Care Facilities on it’s internet Web site. This information is to be updated at least monthly on the website and will span the preceding five-year period.
vAB 2236 – Civil Penalties, effective July 1, 2015 – Enacts new civil penalties in cases where the Department determines that a violation of licensing standards resulted in the death or serious injury, or constitutes physical abuse of a child in care. The bill establishes an appeal procedure specific to these civil penalties. The bill also expands the scope of the Child Health and Safety Fund in order to assist parents in securing alternative child care when a Child Care Center license has been suspended or revoked. These civil penalty amounts are scaled in relation to the total capacity of all of the licensee’s facilities and not just the specific facility cited or limited to that facility type.
vAB 2386 – Carbon Monoxide Detector Regulations, effective January 1, 2015 – In accordance with California Health and Safety Code Section 1975.543 - Every child care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2020
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: SUNSHINE MONTESSORI SCHOOL - SCHOOL AGE
FACILITY NUMBER: 364845807
VISIT DATE: 06/30/2020
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v- SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 - it eliminates the exemption from existing specified immunization requirements based upon personal beliefs, and only allows an exemption from future immunization requirements deemed appropriate by the State Department of Public Health or a medical professional for medical reasons.
v- AB290 – Child Nutrition, effective January 1, 2016 - In accordance with California Health and Safety Code Section 1596.866 - each child care center shall have at least one person employed who was completed one hour of childhood nutrition training as part of the preventive health practices course or courses.
v- SB792 – Immunization requirements for staff, volunteers, effective September 1, 2016 – In accordance with California Health and Safety Code Section 1596.7995(a)(1) - Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. If employees/volunteers are receiving the influenza vaccination they must do so between August 1 and December 1 of each year.
v- AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For an Immediate Risk violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Immediate Risk violations the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
vNOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
vEffective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
vAccess to forms & Regulations for a Child Care Center are online at www.ccld.ca.gov.
vPlease subscribe at www.childcareadvocatesprogram to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov
vThe Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2020
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: SUNSHINE MONTESSORI SCHOOL - SCHOOL AGE
FACILITY NUMBER: 364845807
VISIT DATE: 06/30/2020
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An exit interview was conducted and during the interview, Dhina Palevino and Ann DeSilva confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

The following items need to be completed/corrected prior to a license being issued:

1. Waiver to allow share use of playground with children enrolled in the private elementary school on an alternate schedule. Applicant stated that a written request along with schedules for outdoor activities would be submitted.
2. Waiver to allow shared use of Room#6 for indoor activities private elementary school on alternate schedule.
3. Waiver for share used of bathroom with Preschool children.
4. Revise plan of operation to include Incidental Medical Services (IMS)
5. Extend the fence between the preschool playground and the school-age playground to completely separating the two playgrounds to prevent commingling.
6. Install a gate to prevent access by children to the swimming pool next door.
7. Install a functioning carbon monoxide detector a the modular.

Once all corrections have been made, with proof sent to licensing, and the fire clearance has been obtained, the application will be submitted for approval with a maximum capacity of 40. As agreed upon by the applicant, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied. An exit interview was conducted via Google Duo, LPAs provided the applicant with a copy of this report via email. Applicant agreed to acknowledge receipt of the email. An electronic “read receipt” was also attached. The electronic read receipt of the emailed report acknowledges receipt of this report. A copy of this report was emailed to applicant on 07/01/20 for the inspection conducted on 06/30/2020.

This report must be made available at the facility for 3 years for public review upon request.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2020
LIC809 (FAS) - (06/04)
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