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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406208351
Report Date: 06/30/2023
Date Signed: 06/30/2023 12:47:29 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 06/30/2023 12:47 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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117



FACILITY NAME:CHILDREN'S ACADEMY MONTESSORI SCHOOL, THEFACILITY NUMBER:
406208351
ADMINISTRATOR:TAMERA DAVISFACILITY TYPE:
850
ADDRESS:711 ROLLING HILLS DRIVETELEPHONE:
(805) 239-9790
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:40CENSUS: 28DATE:
06/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Tamera DavisTIME COMPLETED:
01:00 PM
NARRATIVE
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On June 30th, 2023 at 9:00 AM, Licensing Program Analyst (LPA) Dixie Wright conducted a Comprehensive Annual/Required inspection. LPA met with Licensee/Director Tamera Davis and conducted a facility tour of both buildings, inside and outside.

The program had 28 total children present at time of inspection. There is a toddler class with eleven children and two staff, and a primary class for ages 3 to 5 years old, with 17 children and three staff. Staff to child ratio was within guidelines. The facility operates Mon-Fri 8:00 AM to 4:30 PM during the summer, and 7:30 AM to 5:30 PM when school is back in session.

The facility has a building for the toddlers and for pre-school, both separate. The facility has two outdoor play areas that are separated by a fence. LPA observed required postings on the wall near the kitchen/desk area, prominently in view. Facility has enough restrooms for children in care. Children bring their own lunch, the facility provides two snacks a day. The menu for snacks is posted on the kitchen cabinet and is up to date. There are cubbies in each classroom for the children's belongings. Children bring their own water cups, or the facility provides cups. All the cups observed had the children's names on them. The facility provides drinking water from Culligan water service. Age appropriate toys, books, supplies for activities, furniture and playground equipment were observed. There is ample shade and space for the children. LPA did not observe any hazards on the playground. Carbon monoxide detectors in both buildings were tested and functioning at 10:50 AM. Last disaster drill was done on 05/24/2023. The facility water has not been tested for lead contaminants. Licensee previously submitted a waiver request to not test the facility water for lead since the facility doesn't use the tap water for drinking or cooking. CCLD requested additional information and the information was not submitted. Licensee gave LPA the requested information for a waiver at the visit. Continued on 809-C...

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Dixie Marie WrightTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:
DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/30/2023
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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CHILDREN'S ACADEMY MONTESSORI SCHOOL, THE
FACILITY NUMBER: 406208351
VISIT DATE: 06/30/2023
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There is always a staff present that has a current CPR/First Aid card. Mandated Reporter Trainings are up to date. There are no children that have medications being dispensed at the facility If they do have children with medication, the medication is stored on top of the refrigerator in the kitchen, not accessible to children. Staff are aware of the children who need medication and have been trained on how to dispense the medication.

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.



Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). CCC did not complete testing prior to their deadline. LPA referred licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. Licensee is submitting a waiver request to not test for lead in water.
Cont. on 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Dixie Marie WrightTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CHILDREN'S ACADEMY MONTESSORI SCHOOL, THE
FACILITY NUMBER: 406208351
VISIT DATE: 06/30/2023
NARRATIVE
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LPA discussed the safe sleep regulations with licensee and 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 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.

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) 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

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee [or facility representative] (include name).

Appeal Rights given.

See attached 809-D for deficiency.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Dixie Marie WrightTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 06/30/2023 12:47 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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


FACILITY NAME: CHILDREN'S ACADEMY MONTESSORI SCHOOL, THE
FACILITY NUMBER: 406208351

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/15/2023
Section Cited
HSC
1597.16(a)(1

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(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020 but no later than January 1, 2023 and every five years
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Per Licensee, the Center does not use any tap water to cook with or drink, and has Culligan water service delivery. Licensee gave a waiver request with supporting documents to LPA at today's visit. LPA will submit the request to LPM for review, and if approved, will send the approval to
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 after the date of the initial test.This requirement is not met as evidenced by: Based on interview with Licensee the Child Care Center's water has not been tested for lead contamination levels which poses a potential health, safety or personal rights risk to children in care.
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Licensee. If waiver is not approved, Licensee will schedule for the water to be tested.

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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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Dixie Marie WrightTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:
DATE: 06/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/30/2023
LIC809 (FAS) - (06/04)
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