<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414335
Report Date: 05/18/2022
Date Signed: 05/18/2022 02:28:26 PM


Document Has Been Signed on 05/18/2022 02:28 PM - It Cannot Be Edited

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:ABC LEARNING MONTESSORI, LLCFACILITY NUMBER:
434414335
ADMINISTRATOR:SANDRA YVETTE CALDERONFACILITY TYPE:
850
ADDRESS:15345 CALLE ENRIQUETELEPHONE:
(408) 465-2015
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:50CENSUS: 36DATE:
05/18/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Sandra "Yvette" Calderon and Diana ManixTIME COMPLETED:
02:30 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) Samantha Yip conducted an unannounced Case Management- Incident inspection. LPA met with Director Sandra "Yvette" Calderon and Licensee Diana Manix and explained the reason for the inspection. The purpose of this inspection is to review an incident that was self reported on 05/10/2022. The incident occurred on 05/10/2022 involving C-1, where C-1 sustained a broken bone and dislocated their elbow.

During today's inspection, LPA interviewed staff, children, and parents. LPA inspected the playground area. LPA observed that the playground is age appropriate and is for children ages 2 year old to 5 years old. There is resilient material around the play structure. Based on interviews, C-1 was going down the ladder, slipped, and fell forward. There was one staff with 9 children at the time of the incident. The staff was standing by the gate. Director called 9-11 following the incident. Facility does have video feed; however, video footage deletes after the seventh day. LPA was unable to review video footage during today's inspection. Based on the information obtained, LPA determined that more information is needed. LPA advised Director and Licensee that a follow-up inspection will be conducted.

Present during today's inspection were 8 staff and 36 children. S-1, S-2, and S-3 have cleared fingerprints and are associated to ABC Learning Montessori #434407563, but not to this current facility number. Licensee has access to the facility roster for #434407563. Licensee Kana Manix transferred S-1, S-2, and S-3's fingerprints to this facility number during today's inspection. Licensee and Director were reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or

-----------------------continues on 809 dated 05/18/2022 page 2----------------------------------
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2022
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: ABC LEARNING MONTESSORI, LLC
FACILITY NUMBER: 434414335
VISIT DATE: 05/18/2022
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
26
27
28
29
30
31
32
--------------------------continuation of 809 dated 05/18/2022 page 1----------------------------

exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

As a result of this inspection, a Type B and a civil penalty of $300 was assess for caregiver background check. Exit interview conducted and report was reviewed with the licensee Diana Manix and Director Yvette Calderon. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/18/2022 02:28 PM - It Cannot Be Edited

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: ABC LEARNING MONTESSORI, LLC
FACILITY NUMBER: 434414335

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
05/19/2022
Section Cited

1
2
3
4
5
6
7
Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 101170(f) or
This requirement is not met as evident by:
8
9
10
11
12
13
14
Based on record reviews, S-1, S-2, and S-3 have cleared fingerprints and are associated to ABC Learning Montessori #434407563, which Licensees are also the Licensees of that facility. Licensees have assess to facility roster for both facility numbers. Staff's fingerprints were not transferred to this facility number, which posed a potential health and safety risk to the children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
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: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3