444408895-6-9-2023-07-CC-CNEN-CSMVFQ-20230609162419

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444408895
Report Date: 06/09/2023
Date Signed: 06/09/2023 04:24:25 PM

Document Has Been Signed on 06/09/2023 04:24 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:	QUAIL HOLLOW MONTESSORI		FACILITY NUMBER:	444408895
ADMINISTRATOR:	VICKI HIPWELL		FACILITY TYPE:	830
ADDRESS:	187 LAUREL DRIVE		TELEPHONE:	(831) 335-4710
CITY:	FELTON	STATE: CA	ZIP CODE:	95018
CAPACITY:	7	CENSUS: 0	DATE:	06/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:13 AM
MET WITH:	Mindy Gillen & Cheryl McGowen		TIME COMPLETED:	04:35 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), Cortney Nelson, met with Licensee, Mindy Gillen, for an unannounced Required- 1 Year Inspection. LPA was granted access to the facility by staff member, Natalie, and toured both indoors and outdoors during the inspection. Upon arrival, there were no infants present. Mindy states that no infants needed care today and the infant staff are off. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 7:30AM-5:30PM. The facility completes sign-in/out using the App "Procare" and LPA advised that all digital sign-in/out still require parents to sign with full legal signature. Mindy states that due to connectivity issues, she has discontinued parent signature and LPA advised considering paper signature for parents with use of Procare. The last fire/disaster drill was conducted on 10/2021, which is not compliant with the six-month requirement for facilities. LPA observed a fully charged 3A40BC fire extinguisher (last serviced: 6/2023), functioning smoke detector and carbon monoxide detector. There is a child in care who requires medication at this time and LPA observed it is stored inaccessible to children. There are no weapons or firearms on the premises. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 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 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

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

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: QUAIL HOLLOW MONTESSORI	FACILITY NUMBER: 444408895
	VISIT DATE: 06/09/2023

NARRATIVE

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Indoor areas of the facility were inspected by the LPA and observed to be clean, orderly, and safe for day care infants. The Dove classroom for infants is physically separate from other childcare center components. LPA observed sufficient age-appropriate materials, toys, and play equipment in the facility. Toys are safe and do not have sharp edges or small parts that may pose a choking hazard. Infant changing table was observed to be padded, within arms reach of a sink, in good repair and safe condition. No infants in care are currently using a crib to nap and LPA advised that infants using cots should still be limited in use of blankets/pillows per Infant Safe Sleep Regulations. The floors are clean and free of tripping hazards and waste containers have tight fitting lids.

The outdoor area was inspected and observed to be fenced in and physically separated from space utilized by other child care center components. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials (fake grass) to absorb falls. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy and building overhang.

Five infant files were reviewed and all required documents were present.

Two staff files were reviewed and all required documents were present. There is at least one staff member present with current CPR/First-Aid that expires 4/2024. LPA reminded that Mandated Reporter and First-Aid/CPR training should be renewed every two years.

Exit interview conducted and report was reviewed with staff member, Cheryl McGowen.

As a result of today’s inspection, deficiencies were cited, see LIC809-D.

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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/09/2023 04:24 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: QUAIL HOLLOW MONTESSORI	FACILITY NUMBER: 444408895
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101174(d)

Disaster and Mass Casualty Plan

(d) Disaster drills shall be conducted at least every six months. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in as the last disaster drill was conducted 10/29/2021, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/16/2023
	Plan of Correction
1 2 3 4	The facility will conduct a disaster drill by 6/16/2023 and submit proof to the Department.

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as water lead testing has not been conducted at the facility, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/23/2023
	Plan of Correction
1 2 3 4	The facility will schedule water lead testing and submit required paperwork (facility sketch, LIC9275, LIC9276) upon completion. Proof of scheduled water lead testing to be submitted to the Department by 6/23/2023.

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 Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/09/2023 04:24 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: QUAIL HOLLOW MONTESSORI	FACILITY NUMBER: 444408895
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day 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 following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in for two out of two infant staff members, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/21/2023
	Plan of Correction
1 2 3 4	The Licensee will submit proof of Mandated Reporter training for Child Care Providers (AB1207) for two staff members by 6/21/2023. (www.mandatedreporterca.com)

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

LIC809 (FAS) - (06/04)

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