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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413201
Report Date: 10/05/2021
Date Signed: 10/05/2021 03:00:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CHILDREN'S WORLD BILINGUAL MONTESSORIFACILITY NUMBER:
434413201
ADMINISTRATOR:YU-CHIEH HSIUNGFACILITY TYPE:
850
ADDRESS:820 KIELY BLVDTELEPHONE:
(408) 247-8600
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY:60CENSUS: DATE:
10/05/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Michelle HsiungTIME COMPLETED:
03:10 PM
NARRATIVE
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(#1) Licensing Program Analysts ( LPA's) Anna Morales and Aman Sharma conducted an unannounced Annual Required inspection. LPAs met with Director, Michelle Hsiung at today's inspection. Facility's License, Notification of Parents’ Rights Poster, Personal Rights (LIC 613A), Emergency Disaster Plan, and Earthquake Preparedness Checklist were observed to be posted. The center's operating hours are Monday through Friday from 8:30am--6:00pm. Age served is 2 years to entry into Pre-K. Last disaster drill was conducted in June of 2021.

The Preschool Program is operating in two classrooms. One is a toddler classroom and the other is a preschool classroom. LPAs toured the facility both indoor and outdoor. LPA's observed that the facility was operating in compliance with teacher to children ratio requirement. LPA 's observed eight teachers and a total of 50 children. Children were napping when LPA's arrived. There were no bodies of water observed. Director stated that the facility does not have weapons on the premises. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. Floors were clean.

Outdoor activity space is enclosed by fencing and is observed to be free of hazards. LPAs observed play equipment were all in good condition. LPA's observed resilient materials under the climbing structures. Drinking water was readily available to children indoor and outdoor. Activities schedule and Menu were posted. Facility provides lunch (via a catering company) and two snacks (morning and afternoon). LPA's observed that food storage areas were clean and free of litter.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 334-2153
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CHILDREN'S WORLD BILINGUAL MONTESSORI
FACILITY NUMBER: 434413201
VISIT DATE: 10/05/2021
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Foods and beverages were kept protected against contamination and spoilage. Trash cans for solid waste had tight-fitting covers on, and were in good repair. Fire extinguisher, smoke and carbon monoxide detectors were observed.

This facility is providing Incidental Medical Services – IMS Plan. Director stated there is an isolation area for sick children to wait for parent pick-up. Director also stated that there are children who are taking medications.

LPAs reviewed sign in and out record, and procedure. LPA's reviewed a random selection of children files. Children records reviewed include Identification and Emergency Contact, Medical Assessment, Immunization.

LPA's reviewed a random selection of Staff records which included Immunization (Measles, Pertussis, and Flu) record and required Training. LPAs reminded Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. There was at least one person with current certification in Pediatric CPR and First Aid present at the facility.

LPAs reminded Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

LPAs also reviewed with Director the violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 334-2153
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CHILDREN'S WORLD BILINGUAL MONTESSORI
FACILITY NUMBER: 434413201
VISIT DATE: 10/05/2021
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LPAs Aman Sharma and Anna Morales discussed the requirements of AB 633 with the Director. The Director understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations with the Director and advised the Director of the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

In the areas that were evaluated, there were no deficiencies cited.

A copy of this report was provided to the facility at the conclusion of the inspection.

NOTICE OF SITE VISIT WAS ISSUED. DIRECTOR WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE CENTER FOR A PERIOD OF 30 DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 334-2153
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3