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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426212766
Report Date: 01/16/2020
Date Signed: 01/16/2020 05:46:58 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: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: 14DATE:
01/16/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:James MurphyTIME COMPLETED:
06:00 PM
NARRATIVE
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A case management inspection was conducted by (LPA) S. Mendoza-Ceja who met with Licensee James Murphy. The purpose of inspection was to discuss the incident that occurred on December 11, 2019 which was reported by the licensee via mail and was received on December 20, 2019.

On December 11, 2019 child #1 wandered from the premises of the licensed child care center without the licensee or staff's knowledge and was unsupervised for up to 1 hour.

Licensee stated child #1 was sitting at a table in the classroom which was behind a pillar and and when all the children lined up to go into the other classroom. Child #1 was left alone in the classroom and left the building, went out the entrance gate, through the breeze way, then walked down Constellation Road and crossed Burton Mesa street alone to a local barber/beauty shop at 3865 Constellation Road, Lompoc. Licensee stated a customer at the shop recognized child #1 and contacted the parent of child #1.

Licensee stated between 8:00 AM - 9:00 AM is when a the preschoolers went into the school age classroom to observe the school age children's Christmas rehearsal. Licensee stated around 8:30 AM, he heard the glass door close and went to check, but did not see anyone and assumed it was an adult.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
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
VISIT DATE: 01/16/2020
NARRATIVE
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Licensee stated witness #1 came to the center and asked if, we were missing a child which was described to him. Licensee stated the preschoolers had returned to their classroom and he checked the children and observed child #1 was missing. Licensee stated, he asked the individual #1 what direction child #1 had gone. Licensee immediately began searching in the area. Licensee stated he also spoke with individual #2 and #3 who were out walking if they had observed child #1 who directed toward the local barber/beauty shop. Licensee stated when he arrived at the beauty shop the sheriff was already there and discussed the incident with him. Licensee stated the parent of child #1 arrived at the beauty shop and discussed the incident with him. Licensee stated parent and child #1 returned to the center. Licensee reviewed the incident further with parent of child #1. Child #1 remained at the center the remainder of the day and continues to attend the program.

Licensee stated the ratio was two staff supervising 15 preschoolers when the incident occurred.

The following Type A deficiencies are cited on the following pages in regards to Supervision, Revocation or Suspension, and Type B Reporting Requirements.
An immediate civil penalty assessed of $500.00.

Licensee has been provided a copy of LIC 9224 Acknowledgement of Receipt of Licensing Reports.

Licensee shall post these reports for 30 days and provide copies of these licensing reports to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Appeal Rights were reviewed.

Failure to post the "Notice of Site Visit" for 30 days may result in a $100.00 Civil Penalty.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
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
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: 01/16/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/16/2020
Section Cited

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Responsibility for Providing Care and Supervision: The licensee shall provide care and supervision as necessary to meet the children's needs.
No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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This requirement was not met as evidenced by interviews and record review which revealed child #1 was unsupervised in the classroom and was able to wander from the licensed child care center to 3865 Constellation Rd, Lompoc without the licensee's or staff's knowledge. Child #1 was without supervision for up 1 hour. This Poses an immediate Health, Safety, or Personal Rights risk to children in care
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Type A
01/16/2020
Section Cited

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Revocation or Suspension: The Department has the authority to suspend or revoke a license on any of the grounds specified in Health and Safety Code Section 1596.885. Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state.
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This requirement was not met as evidenced by interviews and record review which revealed Licensee failed to contact the local Sheriff's Department or local law enforcement when he became aware child #1 was missing from the day care center.
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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: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: 01/16/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/17/2020
Section Cited

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Reporting Requirements: Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. Events reported shall include the
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following: Any unusual incident or child absence that threatens the physical or emotional health or safety of any child.
This is evidenced by licensee's failure to notify the Department of child #1 wandering away by telephone or fax within the next working day. This Poses a potential risk to the 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: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2020
LIC809 (FAS) - (06/04)
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