434414879-9-25-2019-07-CC-SRED-BGCV6L-20190925160945

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414879
Report Date: 09/25/2019
Date Signed: 09/25/2019 04:09:51 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:	CABRILLO MONTESSORI SCHOOL INC		FACILITY NUMBER:	434414879
ADMINISTRATOR:	MILINH VILLANUEVA		FACILITY TYPE:	850
ADDRESS:	2495 CABRILLO AVENUE		TELEPHONE:	(408) 418-3568
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95051
CAPACITY:	89	CENSUS: 71	DATE:	09/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Milinh Villanueva		TIME COMPLETED:	04:15 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), Shannel Reed, met with Director, Milinh Villanueva, for an unannounced annual/ random inspection in the Preschool Program. LPA observed 71 napping children with one (1) Aide and six (6) teachers (1 Aide and 1 teacher were on a lunch break). LPA observed the required posted materials, including the Facility License, 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), Snack Menus, and Activity Schedule. LPA toured the indoor and outdoor areas of the Facility during today's inspection. LPA observed that the classrooms are clean and safe for all children and staff. The Director states that the program has a third party company of janitors that clean the facility Monday through Friday in the evenings and one day on the weekends. Drinking water is readily available for the children inside and outside via water pitchers and disposable cups. LPA observed solid waste containers with tight-fitting lids in the classrooms and outside. The children’s bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children. And a lobby bathroom which an isolated child can use if needed. The Director states that there are no weapons or firearms on the premises. The facility provides Am and PM snacks for the children. Lunch is brought from home or can be ordered by a third party food service, School Catering Company. Food storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers in the in classroom refrigerators. Cleaning supplies are inaccessible to the children. Any medications at the Facility are stored in backpacks that are locked and hung in each classroom and are inaccessible to children in care. The facility conducts fire and emergency disaster drills every three months. The last fire drill was conducted on 09/20/19 and the last Earthquake (emergency) drill was conducted on 08/02/19. REPORT CONTINUED ON THE FOLLOWING PAGE (REPORT DATED 09/25/2019):

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CABRILLO MONTESSORI SCHOOL INC	FACILITY NUMBER: 434414879
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/25/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/08/2019 Section Cited	1 2 3 4 5 6 7	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.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: LPA observed that five (5) staff have completed an incorrect Mandated Reporter training and do have the correct required training (AB1207) certificate on file.The Director understand this is a potential risk to the children in care and a deficiency to the Health and Safety regulations.	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: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CABRILLO MONTESSORI SCHOOL INC	FACILITY NUMBER: 434414879
	VISIT DATE: 09/25/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (REPORT DATED 09/25/2019):
LPA reviewed nine (9) staff files during today's inspection. A review of staff records indicates that all individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded the 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. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month period. All teacher files reviewed contain the required transcripts/verification of experience. LPA observed that five of the teachers have completed an incorrect training (School Personnel) and do not have the required Mandated Reporter Training (AB1207) on file. LPA observed required Immunization’s against Measle, Pertussis and Influenza (or Decline Statement) on file. At least one staff member onsite at all times has a current CPR and First Aid certification on file. The Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times and present during off-site activities (field trips). The Director understands the conditions, limitations, and capacity specifications of the Facility license. The Director understands that children shall be visually supervised at all times.
LPA reviewed eight (8) children’s files and observed all of the required documentation and immunizations. LPA observed all furniture and equipment in each classroom is in good condition and safe for the children. The playground areas utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. There is resilient material on the outdoor playground areas, however additional resilient material under the high climbing structure is recommended. LPA did not observe any bodies of water.
LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised the Director of their responsibility to stay current in regard to new regulations. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list childcareadvocatesprogram@dss.ca.gov. The Mandated Reporter Training (AB1207) can be completed at the website listed. http://www.mandatedreporterca.com. LPA discussed Assembly Bill (AB) 2370 and gave Lead Safety information.
LPA obtained a Facility roster and an updated facility sketch. LPA conducted an exit review with the Director.
Title 22 Deficiencies were cited during today’s inspection.

NOTICE OF SITE VISIT WAS GIVEN AND MUST BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

LIC809 (FAS) - (06/04)

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