434410834-8-12-2021-52-CC-MESA-C5TQ44-20210812114943

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410834
Report Date: 08/12/2021
Date Signed: 08/12/2021 11:49:49 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	CRESCENT MONTESSORI SCHOOL		FACILITY NUMBER:	434410834
ADMINISTRATOR:	JEA SEVILLA		FACILITY TYPE:	850
ADDRESS:	1651 N. MILPITAS BLVD		TELEPHONE:	(408) 263-8170
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	108	CENSUS:	DATE:	08/12/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jea Seviila		TIME COMPLETED:	12:00 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	On Thursday, August 12, 2021 at 9 AM, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required 1 Year Visit. LPA met with the Director Jea Sevilla and explained the nature of the site visit. Present on this visit were 11 Staff and 49 preschool children. Facility operates from Monday to Friday 7am to 6pm. LPA toured the facility to conduct a Health and Safety Inspection. The facility has 4 preschool classroom name as Cassatt, Monet, Van Gogh and O'Keefe. LPA observed the required posted materials, including the Facility License, Waivers (Electronic Sign In and out and Play yard), Emergency Disaster Plan, (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. Fire Department Permit expires on 12/31/2021. A review of staff records on indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. LPA reviewed children and staff files during today's visit. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). The staff files reviewed contains the required transcripts/verification of experience, also new immunization requirement (pertussis, measles, and flu vaccines) for all staff, volunteers that work directly with the children was present. Director has current CPR and First Aid certifications on file. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). LPA observed that the teacher/child ratio was in compliance during today's visit. Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understands that children shall be visually supervised at all times. SEE 809 C....

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CRESCENT MONTESSORI SCHOOL	FACILITY NUMBER: 434410834
	VISIT DATE: 08/12/2021

NARRATIVE

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Continuation.....
LPA obtained copies of the Staff and Children Sign In and Out for the day, Staff and Children's Rosters.
LPA observed that all rooms are clean and safe for all children and staff. LPA observed solid waste containers with tight-fitting lids throughout the facility. Children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Designated isolation room is the Director's office. Director states that there are no weapons or firearms on the premises.

The food preparation and storage areas are clean. All food and beverages that require refrigeration are stored in covered containers. Cleaning supplies are stored away from children. The children bring their own lunch and the school also have a catering service. Medications at the facility are stored in the each classroom.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. Drinking water is readily available for the children inside the facility and in the outdoor playground.
LPA observed that the outdoor equipment is age appropriate and in good condition. There is sufficient resilient materials in the outdoor playground area. LPA did not observe any bodies of water. LPA observed a garden on right side yard that is occasionally used by children.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

LPA Estoesta discussed of Lead Poisoning Facts Flyer and California Child Safetyto the director. For more information, please follow the linkhttps://cdss.ca.gov/inforesources/child-care-licensing/water-testing-information
No deficiencies cited today.
A NOTICE OF SITE VISIT WAS GIVEN TO THE DIRECTOR DURING THE VISIT TODAY. THE DIRECTOR WAS INFORMED THAT THE NOTICE MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

LIC809 (FAS) - (06/04)

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