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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401712191
Report Date: 10/09/2024
Date Signed: 10/14/2024 04:10:51 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/14/2024 04:10 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CHILDREN'S HOUSE MONTESSORI SCHOOLFACILITY NUMBER:
401712191
ADMINISTRATOR/
DIRECTOR:		DUDLEY, KOREYFACILITY TYPE:
850
ADDRESS:3025 MONTEREY ROADTELEPHONE:
(805) 466-5068
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY: 79TOTAL ENROLLED CHILDREN: 67CENSUS: 35DATE:
10/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Angelica RuizTIME VISIT/
INSPECTION COMPLETED:
05:45 PM
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On 10/9/24, at 2:00 PM, Licensing Program Analysts (LPAs) Elvin Baddley and Matthew Sapien conducted an unannounced Annual Random Inspection the abovementioned Child Care Center (CCC). LPA met with Angelica Ruiz, Director of the CCC, and explained the purpose of the inspection. LPAs, in the company of Director, toured the interior and exterior of the CCC. The CCC contains three classrooms (toddler [18-36 months], primary [3-5 years old], and kindergarten [ages 5 and older]) and has operational hours from 8:00 AM until 5:00 PM, Monday through Friday. Importantly to note, the CCC has a private elementary school that is not licensed through CCLD. During the inspection, LPAs observed 35 children in care.

LPAs observed a kitchen near the entry area of the CCC with an operable refrigerator. LPAs also observed the kitchen area to be secured by mesh thru-ways. The kitchen area is inaccessible to children in care.

LPAs also observed snack menus and required notices and other relevant licensing documents and forms posted prominently to the entry's bulletin board. LPAs also reviewed the electronic children's sign in/sign out forms and found the arrival times of children, along with the departure times. The signatures of authorized representatives were also present.

The classrooms of the CCC were orderly. Each classroom has age-appropriate toys, books, and other furnishings for children in care. At 3:00 PM, LPAs observed a number of trash bins without a tight-fitting cover. The trash bin contained garbage. LPAs reminded Director to ensure all trash cans used for storage of waste have a tight-fitting lid. Additionally, at 3:05 PM, LPAs observed an unsecured drawer that contained needle-nose pliers and a staple-remover. LPAs reminded Licensee that these items should be secure and inaccessible to children in care.

The CCC provides morning snacks for children, while lunches are supplied by parents brought from home. (CONT. LIC 802-C, Page 2)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CHILDREN'S HOUSE MONTESSORI SCHOOL
FACILITY NUMBER: 401712191
VISIT DATE: 10/09/2024
NARRATIVE
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There is available and safe drinking water for children in the classroom via filtered water. Children also bring bottled water from their respective homes.

CCCs constructed before 1/1/20, to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5-years except after the date of the first test. For child care center licenses issued after 7/1/22, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPAs observed a carbon monoxide detector in the primary age classroom, which was tested at 2:41 PM, and was found to be operable. Medications and cleaning compounds are observed in locations (elevated cabinets and secured drawers) that are made accessible to staff, yet inaccessible to children in care. The CCC possesses a First Aid kit.

The CCC has a restroom attached to each classroom. The restrooms were observed to be clean and free of toxins.

The outdoor playground area is enclosed by wire fencing. The fence’s entry/exit gates are secured and furnishings in the area are age appropriate. The CCC has a playground areas that are age appropriate and have adequate cushioning material (wood chips) to absorb falls. Shade is provided by large trees throughout the outside area. No bodies of water were observed on site.

Staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information as well admission agreements, among other relevant licensing documents and forms. A sampling of staff records were reviewed and contained current pediatric CPR and First Aid certifications (EMSA approved), along with Mandated Reporter certifications. Facility record show the last fire drill on site occurred on 9/24/24. LPAs confirmed that there are no firearms or ammunition that are stored on site.

This facility does currently provide Incidental Medical Services – IMS. LPAs reviewed storage of medication supplies (i.e. Epipen in a secure lockbox). LPAs also reviewed children’s, personnel, and administrative records in relation to IMS services. For IMS information see PIN 22-02-CCP. (CONT. 809-C, Page 3)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CHILDREN'S HOUSE MONTESSORI SCHOOL
FACILITY NUMBER: 401712191
VISIT DATE: 10/09/2024
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The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication Commonly Asked Questions about Child Care Centers and the ADA are available at:https://www.ada.gov/resources/child-care-centers/.

Facility representative was reminded that all adults 18 and over, including employees and volunteers,
as specified in HSC section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address
provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Type B Deficiencies are being cited based on LPAs' observation and interviews pursuant to Title 22 of the CA Code of Regulations and Health and Safety Codes (see LIC809 D). Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

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, Angelica Ruiz.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/09/2024 05:44 PM - It Cannot Be Edited


Created By: Matthew Sapien On 10/09/2024 at 05:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CHILDREN'S HOUSE MONTESSORI SCHOOL
FACILITY NUMBER: 401712191

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/23/2024
Section Cited
CCR
101239(f)(1)

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(1) All containers used for storage of solid wastes, including movable bins, shall have a tightfitting cover that is kept on...This requirement is not met as evidenced by: based on observations/interviews,

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Administrator of Child Care Center to place tightfitting lids on all waste containers containing garbage. Administrator to provide proof of correction to CCLD (matthew.sapien@dss.ca.gov), via photographs, by the close of business (5:00 PM) on 10/23/24.
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the licensee did not comply with the section cited above in that LPAs observed three waste containers without tight-fitting lids, containing garbage, which poses a potential health, safety, or personal rights risk to persons in care.
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Type B
10/09/2024
Section Cited
CCR101238(g)

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(g) Disinfectants, cleaning solutions, poisons, and other items that could pose danger if readily available to children shall be stored where inaccesible to children in care...This requirement is not met as evidenced by: based on observations/interviews,
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Administrator of Child Care Center to place needle-nose pliers and a staple remover in a location inaccessible to children in care. Administrator to provide proof of correction to CCLD (matthew.sapien@dss.ca.gov), via photographs, by the close of business (5:00 PM) on 10/23/24.
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the licensee did not comply with the section cited above in that LPAs observed needle-nose pliers and a staple remover in an unsecured drawer, accessible to children in care, which poses a potential health, safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Matthew Sapien
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2024


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