010208784-5-21-2024-02-CC-JMCN-D5GTB7-20240521143440

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010208784
Report Date: 05/21/2024
Date Signed: 05/21/2024 02:34:53 PM

Document Has Been Signed on 05/21/2024 02:34 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	MOUNTAIN BOULEVARD MONTESSORI SCHOOL		FACILITY NUMBER:	010208784
ADMINISTRATOR:	WANKEN, DENNIS		FACILITY TYPE:	850
ADDRESS:	4432 MOUNTAIN BOULEVARD		TELEPHONE:	(510) 482-2850
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94619
CAPACITY:	45	CENSUS: 36	DATE:	05/21/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Eleni Wanken		TIME COMPLETED:	02:45 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 May 21, 2024 at 10:20am Licensing Program Analyst (LPA) Janai McClain and Licensing Program Manager (LPM) Mayla Mendoza met with Director Eleni Wanken to conduct an unannounced annual inspection. There were 36 preschool age children and seven fingerprint cleared staff. The teacher/child ratio was being met today. The center was toured for a health and safety inspection. The facility operates from 7:30am – 5:00pm Monday through Friday. Classrooms: The preschool operates out of three classrooms. All sinks and toilets are observed to be clean and in proper working order. The facility has age appropriate materials in all classrooms that are observed to be clean and in good condition. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. The children bring water bottles from home and refill them throughout the day from the water jugs and water fountains. There is a working combined Carbon Monoxide and smoke detector, a fully charged fire extinguisher and a working telephone. Outdoor: The outdoor play area is clean with ample age appropriate materials for the children. The yard is fully fenced in and has plenty of shade for the children. LPA did not observe any harmful or unattended bodies of water in or around the facility. Isolation area: computer room Food Service: Two snacks are provided to the children and lunch is brought from home. LPA observed the snack menus posted. The kitchen was observed be clean, well maintained, free from defects and hazards. Records: The fire/disaster drill log was complete with the last drill logged May 2, 2024. A physical census of the children was taken and cross referenced with the electronic sign-in and out log. All staff have obtained **************************** Page 1 of 3 *******************************

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Janai McClain	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024

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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: MOUNTAIN BOULEVARD MONTESSORI SCHOOL	FACILITY NUMBER: 010208784
	VISIT DATE: 05/21/2024

NARRATIVE

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a criminal record clearance. LPA reviewed six children files, all children files were complete. LPA reviewed eight staff files and found the files to be complete. The parent board was inspected and had required postings attached to the board.

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone or fax. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing

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SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Janai McClain	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024

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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: MOUNTAIN BOULEVARD MONTESSORI SCHOOL	FACILITY NUMBER: 010208784
	VISIT DATE: 05/21/2024

NARRATIVE

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was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. CCC COMPLETED LEAD TESTING AND NO LEAD EXCEEDANCE DETECTED. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

This facility does not provide Incidental Medical Services – IMS. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

There were no deficiencies cited during today's visit.

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

Exit interview conducted.

Report was reviewed with Director Eleni Wanken.

************************************** End of Report ***********************************

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Janai McClain	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024

LIC809 (FAS) - (06/04)

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