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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444404974
Report Date: 10/16/2019
Date Signed: 10/16/2019 12:44:29 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:SANTA CRUZ MONTESSORI SCHOOL (TODDLER CAMPUS)FACILITY NUMBER:
444404974
ADMINISTRATOR:ANDREA KARJACKFACILITY TYPE:
850
ADDRESS:2446 CABRILLO COLLEGE DRIVETELEPHONE:
(831) 465-7681
CITY:SOQUELSTATE: CAZIP CODE:
95073
CAPACITY:24CENSUS: 17DATE:
10/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kim Saxton TIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Zaid Hakim conducted an Unannounced Annual / Random Inspection at the facility today. Upon arrival, LPA observed seventeen (17) preschool age children and at least seven (7) staff engaging in daily activities and met with Ms. Kim Saxton, Director. LPA toured the facility inside and out and observed required postings including but not limited to; the License to Operate, Emergency Disaster Plan (LIC 610) and Notification of Parents Rights (PUB 393). Days and hours of operation are Monday through Friday 8:00am to 04:00pm. The facility is licensed to serve a maximum of twenty four (24) children ages eighteen months (18) months to entry to three years and six months (3.5) old with a toddler option for up to eighteen children. Two children may be non-ambulatory. During the inspection, LPA observed children to be supervised and attended to and the facility to be within ratio requirements.

LPA observed that the facility is operating within the terms of the license and is in compliance with the approved fire clearance capacity. The facility was toured inside and out and was observed to be clean, safe, sanitary, and in good repair. Disinfectants, cleaning solutions, and all other items that are dangerous to children were observed to be securely stored and inaccessible. Restrooms are located in the classroom and were observed to be clean and functional. Due to the classroom layouts staff have direct supervision of the restrooms in the classroom. Indoor and outdoor activity spaces were observed as properly equipped with age appropriate toys and supplies that are in safe condition. Storage containers for waste have tight fitting covers and floors and carpeting are free from hazard and obstruction. LPA observed that the facility has posted menus throughout the facility that are consistent with food supplies. The facility provides snacks and meals that are prepared daily on site and parents are informed of what foods may be served at any given time prior to being served. Children may bring lunches from home and facility staff may assist with warming food in the microwave and storing lunches in the refrigerator when needed. The Director stated that all staff are aware of food allergies or dietary restrictions, which are outlined in children's files. LPA discussed staff protocols upon serving food such as; visual observation of all foods and maintaining appropriate temperatures prior to serving. LPA and the Director discussed children's personal rights and napping / rest time at the facility. Children may be allowed to engage in a stationary activity or quiet rest time instead of napping should they prefer it. The Director understands that cots for napping should be arranged with sufficient space for a walkway in between. The facility stores linens and items for napping in individual cubbies so linens do not touch and linens are sent home to be washed weekly.

The Director has been referred to the department website for Licensing resource and updates: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 10/16/2019):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
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 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: SANTA CRUZ MONTESSORI SCHOOL (TODDLER CAMPUS)
FACILITY NUMBER: 444404974
VISIT DATE: 10/16/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 10/16/2019):

A review of staff records today indicate that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also discussed and reviewed immunization including Measles, Pertussis, and Influenza. LPA also reminded Licensee 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 violation within a 12 month period.

LPA reminded the Director of the immunization requirement regarding Senate Bill 792 (pertussis, measles, and flu vaccines) for ALL STAFF THAT WORK DIRECTLY WITH CHILDREN and the required "Mandated Reporter" training that all staff will be required to complete starting January 1, 2018 per AB 1207. LPA observed that all stall files reviewed maintained training certificates and LPA and the Director also discussed applicable updates to this training regarding length and material and the renewal period of every 2 years. LPA provided additional written information on Mandated Reporter Training, Active Shooter Information, Effects of Lead Exposure, and Safe Sleep for Infants.

The Director has been referred to the department website for Licensing resources and updates: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

A Notice of Site Visit has been issued and must remain posted for 30 consecutive days.

No Deficiencies have been cited during today's inspection.
Exit interview conducted with Ms. Kim Saxton, Director.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
LIC809 (FAS) - (06/04)
Page: 3 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: SANTA CRUZ MONTESSORI SCHOOL (TODDLER CAMPUS)
FACILITY NUMBER: 444404974
VISIT DATE: 10/16/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 10/16/2019):

No weapons are stored on site and no bodies of water are on the premises. There are older age groups that also operate on the premises and the Director understands that children outside of the program may not be left unattended or provide care or supervision. LPA observed fire extinguishers, smoke detectors, carbon monoxide detectors, and complete first aid kits throughout the facility. Emergency disaster drills are performed as required, last of which was done in 10/2019. The last fire safety inspection conducted by the local fire authority was conducted in 10/2019 in which detectors, alarm systems, and fire extinguishers were serviced. LPA reminded the Director that all fire safety items and equipment should be maintained at least every 12 months including, fire extinguishers and all detectors. LPA reviewed a random sample of children's records and observed that there is a separate, complete, and current record for each child enrolled in the center. LPA observed that each child record reviewed maintained a valid health screening report, required immunization records, and emergency contact information.

The facility maintains a written sign in and out system, that is updated throughout the day, containing full signatures from responsible parties. The facility maintains an updated roster of children enrolled in the program that is updated regularly. A random sample of administration and staff records were reviewed and all teachers and staff maintain valid background clearances. LPA reminded the Director that all staff that provide direct care and supervision to children shall have complete files on site or immediately accessible at all times, including immunization records. LPA reviewed a random sample of teacher files and observed at least two staff on site maintains valid CPR / First aid certification which expires in 01/2020 and 01/2021. The Director stated that she is aware that there must be at least one staff with current CPR/ First Aid training at all times. LPA toured the outdoor play area, which was observed to be safe and equipped with age appropriate toys and equipment. There is secure perimeter fencing around the outdoor play areas and play structures and equipment appeared to be in safe condition. Privacy is provided to children via non-transparent perimeter fencing. LPA observed that there is sufficient absorbent materials under structures, drinking water available for children via drinking fountains, and sufficient covering for shade provided by the building overhang, canopies, and trees. LPA and the Director discussed transition protocol, including direct supervision of children at all times. LPA and the Director discussed children staying hydrated in hot weather, weather conditions such as extreme heat and air quality, the facility outdoor supervision and staff rotation plan for supervision and safety outside, and being aware of weather conditions that affect program operation such as air quality.

The facility does assist with medications and LPA observed storage of medication ton be inaccessible to children and accessible to staff should it be needed and stored with all required documentation. The facility does not provide transportation to children. The program does not include off site field trips, excluding outings when parents of children are present. LPA and the Director discussed emergency disaster drills and preparedness, emergency lock-down procedures, children's personal rights including no corporal punishment, positive forms of discipline, and staffing qualifications / educational units in the core subject areas: Child Development (3 units), Family Child Community (3 units), and Program + Curriculum (6 units).

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3 - REPORT DATED 10/16/2019):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3