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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415853
Report Date: 06/07/2019
Date Signed: 06/07/2019 03:54:15 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:ALOHA MONTESSORIFACILITY NUMBER:
434415853
ADMINISTRATOR:MARGARET EYERMANFACILITY TYPE:
850
ADDRESS:995 APRICOT AVENUETELEPHONE:
(408) 858-9886
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY:28CENSUS: 0DATE:
06/07/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Margaret EyermanTIME COMPLETED:
04:05 PM
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Licensing Program Analyst (LPA), Stephanie Rangel conducted an announced prelicensing inspection to the Facility today. LPA met with Margaret Eyerman, owner and husband Roy Watson and explained the nature of today's inspection to them. Operating hours will be 6:30am to 6:30pm. LPA toured and measured the indoor and outdoor areas of the Facility during today's inspection.

INDOOR MEASUREMENTS ARE AS FOLLOWS:
Math: 12.083 x 11.417 = 137.952
Language: 14.333 x 19.417= 278.304
Sensorial Practical Life: 15 x 11.833 = 177.495
Sun Room: 19.5 x 8.667 = 169.001 minus encumbered 2.01 = 166.991
Reading: 10.167 x 9.417 + 1.375 x 4.458= 101.872
Art Room: 12.250 x 11.333 = 138.829

TOTAL INDOOR SPACE: 137.952 + 278.304 + 177.495 + 166.991 + 101.872 + 138.829 = 1001.846 divided by 35 = 28 preschool children.

There are 3 (45) working faucets. There is one additional faucet under repair, and 3 (45) toilets available to the preschool children. There is hot and cold water available in the children's sinks. Staff have separate bathrooms, that can be utilized by sick children if necessary. Sick children will be isolated in the reading room and isolation equipment is provided. The preschool rooms have appropriate lighting & ventilation. First aid supplies are stored in a high cabinet in the kitchen and in a classroom, inaccessible to children. There is at least one staff on site with the full 16 hours of Health and Safety Training. Medications will be stored in an appropriate boxes inaccessible to children in either the refrigerator, or in the kitchen.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 06/7/2019):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C RangelTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2019
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: ALOHA MONTESSORI
FACILITY NUMBER: 434415853
VISIT DATE: 06/07/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 06/07/2019):
School will provide morning and afternoon snacks and lunch will be brought for the children's homes. The kitchen is equipped with hot and cold running filtered water, refrigerator, stove and dishwasher. Cleaning supplies will also be stored in kitchen, inaccessible to children.

There are 6 tables, 10 chairs, and 20 cots, and 27 cubbies. There is adequate equipment, supplies and toys for the children in each room. Filtered drinking water will be provided indoors via water pitches and reusable cups. There is a working telephone at the site. The phone number is (408) 353-7049.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

PRESCHOOL OUTDOOR MEASUREMENTS ARE AS FOLLOWS:


30 x 51.500 + 18.667 x 15.583 + 11 x 9 + 13.833 x 6.093 + 40.167 x 12.333 + 32 x 59 = 4,402.551
TOTAL OUTDOOR SPACE: 4,402.551 sq. ft. divided by 75 =58 preschool children.

LPA observed that the preschool playground area is surrounded by appropriate fencing. Playground equipment is age appropriate. Artificial grass and tan bark is used as resilient material. Shade is provided by trees and building overhang. Filtered drinking water will be provided by a water pitcher, and reusable water cups. There is adequate equipment, supplies, and toys for children outdoors. LPA did not observe any bodies of water during today's inspection. Transportation will not be provided by the Facility.

A fire clearance was received from the Santa Clara Co. Fire Department prior to today's inspection.

Updated facility sketch was received during today's inspection. Updated fire clearance, and list of furniture/play equipment needs to be received. LPA conducted an exit interview with owner prior to the conclusion of today's inspection and advised her that a license for 28 preschool children, even though the outdoor facility space measures for 58 preschool children, will be approved upon management's review and approval.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C RangelTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2019
LIC809 (FAS) - (06/04)
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