401711284-2-9-2023-17-CC-EBAY-CNVTRW-20230209135812

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401711284
Report Date: 02/09/2023
Date Signed: 02/09/2023 01:58:53 PM

Document Has Been Signed on 02/09/2023 01:58 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	MONTESSORI CHILDREN'S SCHOOL		FACILITY NUMBER:	401711284
ADMINISTRATOR:	MARY KERN		FACILITY TYPE:	850
ADDRESS:	4200 SOUTH HIGUERA		TELEPHONE:	(805) 544-6691
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	45	CENSUS: 30	DATE:	02/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Mary Kern		TIME COMPLETED:	02:00 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	On 2/9/23, at 11:30 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required Inspection of the abovementioned Child Care Center (CCC). LPA met with Mary Kern, Director of the CCC and explained the purpose of the inspection. LPA, in the company of Director, toured the interior and exterior of the CCC. The CCC operates from 8:00 AM to 5:30 PM, Monday - Friday. The preschool uses two classrooms (Trailblazers- ages 2.5 years old to 4 years old) and Stargazer-3 year old to 6 years old) for child care services. LPA observed 30 children on site at the time of the inspection, along with six teacher providing supervision. The CCC's classrooms are clean and well organized. Each classroom has age appropriate toys and furnishings available for children in care. Sharps and cleaning supplies are observed in elevated locations in each classroom. LPA notes medication in the CCC is stored in the kitchen area in a lock box which is exclude from children. The CCC's restrooms are in safe and sanitary operating condition. The CCC has an operable refrigerator which contained food and beverages. LPA notes children in care bring lunches and snacks from their homes. Director informed LPA lunches and snacks brought from homes contained foods from the major food groups and are free of junk foods. LPA observed a posted menus in the in a common area along with licensing required notices and documents. The CCC provided filtered water to children and the CCC's water sources have been tested for lead containments. LPA observed Sign In/Out form near the Director's office. The forms contained the children's arrival/departure times as well as the signature of the children's authorized representatives. LPA observed an operable carbon monoxide detector in the CCC which was tested at 1:31 PM. The CCC’s outdoor playground area contains varied footing and is enclosed by chain linked and wooden fencing. The fence’s entry/exit gates are secured. LPA observed age appropriate toys and play equipment in the play area. The toys and play equipment are in suitable condition and free of sharp, loose or pointed (CONT. 809-C, Page 2)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: MONTESSORI CHILDREN'S SCHOOL	FACILITY NUMBER: 401711284
	VISIT DATE: 02/09/2023

NARRATIVE

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objects. LPA observed the play structures in the outdoor area to have adequate cushioning materials in the form of wood chips, to absorb falls. The outdoor area has shade provided by tree and building overhangs. LPA observed a shed in the outdoor area which contains CCC supplies. The shed is secure. No bodies of water were observed on site. Waste receptacles with tight fitting covers were observed throughout the center.

A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information, as well as current immunization records. Staff records were reviewed and contain current pediatric CPR/First Aid (EMSA) as well as teaching qualifications. Director informed LPA no firearms or ammunition are stored on site.

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

Facility representative was reminded that all adults 18 and over, 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.

A Notice of Site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility Representative Mary Kern.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

LIC809 (FAS) - (06/04)

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