406213429-9-27-2019-17-CC-MKST-BGESH9-20190927135309

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406213429
Report Date: 09/27/2019
Date Signed: 09/27/2019 01:53:15 PM

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:	PARIZEK FCC AKA TEMPLETON MONTESSORI PRESCHOOL		FACILITY NUMBER:	406213429
ADMINISTRATOR:	PARIZEK, HEATHER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 801-3782
CITY:	TEMPLETON	STATE: CA	ZIP CODE:	93465
CAPACITY:	14	CENSUS: 1	DATE:	09/27/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:11 PM
MET WITH:	Heather Parizek		TIME COMPLETED:	01:55 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) Melissa Stewart conducted an unannounced annual/random inspection and met with licensee, Heather Parizek. The home was toured inside and out. All required forms are posted in a prominent location. Licensee's 12 year old and 5 year old children were present at time of inspection. Licensee reported that the preschool operates Tuesday-Thursday, 9am -3pm. There are 3 bedrooms and 2 bathrooms. One bedroom is used for preschool children's activities. LPA observed age appropriate toys, books and furnishings. Bathroom used by children was observed to be clean and free of toxins. The two additional bedrooms and bathroom are off limits and are made inaccessible by child proof door knob locks. The laundry room which leads into the garage is inaccessible to children. All hazardous items are stored inaccessible to children in care. Licensee stated there are no guns or ammunition in the home. Backyard is completely fenced. There are no bodies of water. There is a trampoline which is securely locked and is not used during day care hours. LPA observed age appropriate swing set with appropriate cushioning material. Fire extinguisher was serviced on 9/9/19. Carbon monoxide and smoke detectors were tested and operational. Licensee completes and documents emergency drills. The most recent drill was held on 8/1/19. Licensee is current with CPR and first aid which expires on 5/7/20. Licensee and assistant have met immunization requirement and have completed AB 1207 Mandated Reporter Training. Continued on 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2019

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: PARIZEK FCC AKA TEMPLETON MONTESSORI PRESCHOOL	FACILITY NUMBER: 406213429
	VISIT DATE: 09/27/2019

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Children's records were randomly reviewed and found complete. Licensee provides “Effects of Lead Exposure” brochure to all families.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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: www.ada.gov/childqanda.htm

LPA reviewed and provided Licensee with a copy of “Child Care Providers Guide to Safe Sleep.” Licensee was advised to review Quarterly Updates and Provider Information Notices (PINs) which can be accessed on-line at www.ccld.ca.gov.

In the areas evaluated, no deficiency cited.

LPA observed Licensee post the Notice of Site visit.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2019

LIC809 (FAS) - (06/04)

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