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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566214333
Report Date: 09/11/2019
Date Signed: 09/11/2019 10:42:11 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:MONTESSORI ONEFACILITY NUMBER:
566214333
ADMINISTRATOR:AMAL PELAWATTAFACILITY TYPE:
850
ADDRESS:620 TRIUNFO CANYON ROADTELEPHONE:
(805) 777-8833
CITY:WESTLAKE VILLAGESTATE: CAZIP CODE:
91361
CAPACITY:91CENSUS: 67DATE:
09/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Amal PelawattaTIME COMPLETED:
10:55 AM
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Licensing Program Analyst (LPA) Frank Pedroza made an unannounced inspection for the purpose of conducting an Annual/Random Inspection. LPA met with facility Director Amal Pelawatta and explained the purpose of the inspection. LPA and Director together toured the facility inside and out. The facility currently had 67 children in care at the time of the inspection. The center operates from 7:30 AM to 6:00 PM, Monday thru Friday.

Licensing required notices were posted prominently on the wall at the entrance of the facility. The preschool uses three classrooms for care. There are two restrooms available for children to use. Each restroom has four toilets and two sinks. LPA did not observe any toxins/hazardous items accessible to children. The classrooms have age appropriate toys and furniture available for children. LPA observed and reviewed the posted snack menu. The center provides a morning and afternoon snack. Children bring their lunch from home. The outdoor playground has age appropriate toys and equipment. The playground has an ample amount of shade available. The outdoor playground has a storage unit secured preventing children from having access. The center has water available for children inside and out. Administrator advised the center does not have firearms or ammunition at the facility. Continued on 809-C.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019
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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: MONTESSORI ONE
FACILITY NUMBER: 566214333
VISIT DATE: 09/11/2019
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Center uses written sign-in/sign-out sheets located at the entrance of the building. A sampling of children and staff records were reviewed. Teachers have required qualifications. Teachers present have current First Aid/CPR certificates that expire on 03/20/20. Teachers present have current AB 1207 Mandated Reporter Training certificates that expire on 10/15/20. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. Director was provided with and discussed a guide for Safe Sleep and effects of Lead Exposure brochures.

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 Child Care Centers Sections 101173 and 101226.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

No deficiencies were cited during today's visit.



THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019
LIC809 (FAS) - (06/04)
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