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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426212766
Report Date: 07/16/2019
Date Signed: 07/16/2019 01:20:53 PM

COMPREHENSIVE INSPECTION
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:CHILDREN'S MONTESSORI SCHOOLFACILITY NUMBER:
426212766
ADMINISTRATOR:JAMES MURPHYFACILITY TYPE:
850
ADDRESS:3910 CONSTELLATION ROAD, #101TELEPHONE:
(805) 733-2290
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:30CENSUS: 9DATE:
07/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Yun Lee Murphy and James MurphyTIME COMPLETED:
01:30 PM
NARRATIVE
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A annual random visit was conducted by LPA S. Mendoza-Ceja and Christian Patterson met with Yun Lee Murphy was providing care to 9 children. The center was toured inside and outside. The classroom was observed to be clean and orderly. During the visit James Murphy arrived. The appropriate documents were posted for review. There is no carbon monoxide detector in the center. LPA was advised there was no medication administered at this time. The first aid kit was reviewed. The restrooms were observed to clean. The outside playground equipment was inspected and observed to be age appropriate. A 10% random review was conducted of children's records and the sign in/out sheets to ensure legal signature is used. Staff records were reviewed. Currently, no one is current with CPR and First Aid. LPA also reviewed the handout “A Child Care Provider’s Guide to Safe Sleep, Safe Sleep in Child Care, and Effects of Lead Poisoning”. LPA reviewed the requirement for care providers/employees, including volunteers to obtain immunization against Influenza, Pertussis, and Measles. LPA advised, each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year or sign a statement declining the influenza vaccination. Verification was not available for review. LPA also discussed the requirement to complete AB 1207 Child Mandated Reporter Training for staff.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
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: CHILDREN'S MONTESSORI SCHOOL
FACILITY NUMBER: 426212766
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/22/2019
Section Cited
CCR
101216(f)
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Personnel Requirements: At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or off site for center activities.
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Please submit verification to Licensing of enrollment in course by 07/22/2019.
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This requirement was not met as evidenced by the interview and review of records which revealed Licensee failed to have a staff with current CPR and First Aid on site, Yun Lee Murphy nor James Murphy are not current with CPR and First Aid which poses a a potential health and safety risk to children in care.
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Type B
07/29/2019
Section Cited
HSC
1596.7995(a)(1)
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1596.7995 (a)(1) Health and Safety - Employees or volunteers at day care center; immunization requirements; records; exemption: 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
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Please submit verification to Licensing for review by 07/29/2019.
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vaccination between August 1 and December 1 of each year.
-This requirement was not met as evidenced by the record review and interview which revealed verification of immunization was not available for staff which poses a potential health and safety risk to children 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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CHILDREN'S MONTESSORI SCHOOL
FACILITY NUMBER: 426212766
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/29/2019
Section Cited
HSC
1596.8662(b)(1)
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Health and Safety - Child Abuse Mandated Reporter Training: On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
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Please submit a plan of correction to Licensing and verificaiton of completion for review by 07/29/2019.
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This requirement was not met as evidenced by the record review and interview which revealed staff have not completed the training which poses a potential health and safety risk to children 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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
LIC809 (FAS) - (06/04)
Page: 5 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CHILDREN'S MONTESSORI SCHOOL
FACILITY NUMBER: 426212766
VISIT DATE: 07/16/2019
NARRATIVE
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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


The following Type B deficiencies are cited on the following pages according to CCR, Title 22, Division 12. Appeal Rights Provided.

The Notice of Site Visit was posted at the visit.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
LIC809 (FAS) - (06/04)
Page: 3 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CHILDREN'S MONTESSORI SCHOOL
FACILITY NUMBER: 426212766
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/17/2019
Section Cited
HSC
1596.954
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Carbon monoxide detectors required; inspection: Every licensed child day 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.
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Please submit verification to Licensing for review the carbon monoxide detector is installed in the center by 07/17/2019.
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This requirement was not met as evidenced by the interview and inspection of the center which revealed the Licensee failed to have a carbon monoxide detector in the center which poses a Health, Safety, or Personal Rights risk to children in care
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Type B
07/22/2019
Section Cited
CCR
101238.2(d)(1)(2)
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101238.2 (d)(1)(2) Outdoor Activity Space: The surface of the outdoor activity space shall be maintained: In a safe condition for the activities planned. Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.
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Please submit verification the cushion/bark has been corrected for review by 07/22/2019
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This requirement was not met as evidenced by the LPAs observations of the cushion material (bark) was observed to be clumped in various areas of the yard which poses a potential health, safety or personal rights risk to children 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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5