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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415095
Report Date: 09/18/2019
Date Signed: 09/18/2019 03:35:28 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:ONE WORLD MONTESSORI SCHOOL, INC. LEIGHFACILITY NUMBER:
434415095
ADMINISTRATOR:KAREN BAMBERGFACILITY TYPE:
850
ADDRESS:4343 LEIGH AVENUETELEPHONE:
(408) 615-1254
CITY:SAN JOSESTATE: CAZIP CODE:
95124
CAPACITY:67CENSUS: 39DATE:
09/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Pascale MarionTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA), Stephanie Rangel, met with Pascale Marion, Office Manager, for an unannounced annual/random inspection. LPA notes that the Facility is licensed for 67 preschool children in P1, Multi Use Room, Nap Room, and for occasional use in the Live Big Hall, Wright Hall and Sanctuary. The days and hours that the facility operates are Monday - Friday from 7:30am to 6:00pm. 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), Menus, and Activity Schedule.

A review of staff records on September 17, 2019 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Pascale 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.

LPA reviewed ten children's and three staff files during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All teacher files reviewed contain the required transcripts/verification of experience. At least one staff present has current CPR and First Aid certifications on file that expire 6/25/21. Pascale 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 inspection. Office Manager understands the conditions, limitations, and capacity specifications of the Facility license. and understands that children shall be visually supervised at all times and never left unattended.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 09/18/2019):)
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C RangelTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2019
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 2
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: ONE WORLD MONTESSORI SCHOOL, INC. LEIGH
FACILITY NUMBER: 434415095
VISIT DATE: 09/18/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 08/09/2018):

LPA observed that the preschool rooms are clean and safe for all children and staff. Office Manager states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Drinking water is readily available for the children in the classroom via water dispensers and personal water cups. LPA observed solid waste containers with tight-fitting lids throughout the facility. Staff bathrooms are clean, sanitary, and operable. The separate staff stall can be used by an isolated child if needed. Office Manager states that there are no weapons or firearms on the premises.

IMS Plan is on file.

The food preparation and 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 at 45 degrees F or less. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children. 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. LPA observed that the outdoor equipment is age appropriate and in good condition. There is sufficient resilient material in the outdoor playground area. LPA did not observe any bodies of water.

Effect of Lead Exposure handout dated 1/20/19 given during today’s inspection. Licensee understands that per Assembly Bill (AB 2370), written information regarding lead exposure needs to be given out to enrolling and re-enrolling parents or guardians. LPA discussed the requirement to complete the California School Immunization Record (PM 286) for children's files.

No deficiencies issued during today's inspection.

Licensing Forms, Title 22 Regulations and information can be obtained through the internet at www.ccld.ca.gov. A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C RangelTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2