566215596-8-16-2022-17-CC-MMAW-CHD2WR-20220816174557

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215596
Report Date: 08/16/2022
Date Signed: 08/16/2022 05:46:04 PM

Document Has Been Signed on 08/16/2022 05:46 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	CAMARILLO PROGRESSIVE MONTESSORI PRESCHOOL		FACILITY NUMBER:	566215596
ADMINISTRATOR:	BRANDY KRISTEN PICARD		FACILITY TYPE:	850
ADDRESS:	4646 ADOLFO		TELEPHONE:	(805) 484-1464
CITY:	CAMARILLO	STATE: CA	ZIP CODE:	93012
CAPACITY:	60	CENSUS: 37	DATE:	08/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	David Picard		TIME COMPLETED:	06:00 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	On 8/16/2022 at 1:30 PM, Licensing Program Analysts (LPA) MIchael Mathew conducted an unannounced Annual/Random inspection. LPA conducted the Covid-19 screening questions prior to entering the facility. LPA met with director David Picard and advised him the purpose of the inspection. LPA was provided a tour of the facility inside and out. There were 37 children in care and 4 staff at the time of the inspection. LPA observed required licensing documents mounted on the walls throughout the facility. LPA observed the center menu schedule which the facility provides morning and afternoon snack. Fire drill was last conducted on 6/9/22. The center has four (4) classrooms available. At the time of inspection, 3 classrooms were in use. LPA observed enough restrooms available for children in care. LPA did not observe any hazards/toxins items accessible to children in care. There are no guns/weapons or ammunition at the facility. LPA observed no bodies of water. Each of the classrooms have age-appropriate toys and furniture readily accessible for children. Facility provides children sleeping cots during nap time. LPA observed Carbon monoxide detector present at the facility, director was not able to test since children were sleeping at the time of inspection. The outdoor playground has ample amount of space for children to play. LPA observed the playground has age-appropriate toys and structures available for children to use. LPA observed rubber padding as well as rubber tan bark to help protect the children when they fall. The playground has ample amount of shade available. Facility provides water, and the children have water bottles with there names on it for use. LPA observed S1 who is not associated with the facility caring for children. S1 has been working at the facility as of 3/4/2022. Director state that director believes that S1 transfer request from old facility to current facility was completed and director received a clearance number. LPA reviewed Guardian and observed that S1 is not associated with the current facility.. A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. Currently the facility has children that require Incidental Medical services (IMS). LPA observed medications locked and stored out of reach from children. LPA observed staff files to be complete and current. LPA observed all staff to have a current mandated reporter training completed. LPA also observed two staff members with a current CPR/ first aid training. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. LPA spoke with director about new Covid-19 guidelines. Facility is currently following Covid-19 guidelines. . Continued on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CAMARILLO PROGRESSIVE MONTESSORI PRESCHOOL	FACILITY NUMBER: 566215596
	VISIT DATE: 08/16/2022

NARRATIVE

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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 follow 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

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.

PIN 22-06-CCP: Lead Testing in Child Care Centers – Frequently Asked Questions and Information on Lead Toxicity Prevention and Water Testing Information was discussed to director David Picard

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA Mathew informed director David Picard that this report dated 8/16//2022 document One Type A citation and should be posted for 30 consecutive days. LPA Mathew informed the director to provide a copy of this licensing report dated 8/16/2022 that documents a Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification

"One type A deficiency was cited in todays visit."

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights were given, and report was reviewed with the director David Picard

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/16/2022 05:46 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CAMARILLO PROGRESSIVE MONTESSORI PRESCHOOL	FACILITY NUMBER: 566215596
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101170(e)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care. LPA observed S1 who is not associated with the facility caring for children. S1 has been working at the facility as of 3/4/2022. Director states that director believes that S1 transfer request from old facility to current facility was completed and director received a clearance number. LPA reviewed Guardian and observed that S1 is not associated with the current facility,
	POC Due Date: 08/26/2022
	Plan of Correction
1 2 3 4	Director agreed that S1 will not be not be at the facility until S1 is cleared and associated with the facility Director will submit a written plan how to prevent a similar occurrence in the future. Written plan must be submitted by end of day 8/26/2022

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: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

LIC809 (FAS) - (06/04)

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