013421338-3-21-2024-52-CC-LDBX-D3KQR4-20240321122319

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421338
Report Date: 03/21/2024
Date Signed: 03/21/2024 12:23:26 PM

Document Has Been Signed on 03/21/2024 12:23 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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	PLEASANTON BILINGUAL MONTESSORI SCHOOL		FACILITY NUMBER:	013421338
ADMINISTRATOR:	LI GUAN		FACILITY TYPE:	830
ADDRESS:	5724 W. LAS POSITAS BLVD		TELEPHONE:	(925) 460-9920
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94588
CAPACITY:	21	CENSUS: 6	DATE:	03/21/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Li Guan		TIME COMPLETED:	12:30 PM

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On 03/21/2024 at approximately 09:30 AM, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux conducted an Unannounced Annual Required Inspection. LPA met with Facility Representative, Li Guan. Also present at the time of the inspection were five (5) additional staff (includes administrative staff) and six (6) infants children in care. LPA provided facility representative the Entrance Checklist (LIC 125). The facility was toured to conduct a Health and Safety inspection. The facility currently operates 8:00 am-6:00 pm, Monday - Friday in one (1) classrooms. This facility has an preschool component #013421337.

Classroom: There is one (1) infant classroom that was inspected for age-appropriate furnishings, equipment, and adequate storage for children’s belongings. LPA observed the cleanliness of floors and surfaces, the presence of a fully functional carbon monoxide detector located in the hallway (tested and working), pull down fire alarms, and at least four (4) fully charged 3A40BC fire extinguisher that is accessible throughout the facility. The center is equipped with a fully stocked first-aid kit and available in the classrooms. Per facility representative infant age starts at 15 months.

Food Service Areas: All center provided food items are properly labeled & stored separately from cleaning supplies. Food prep area is clean, adequately equipped, & free from hazardous materials. Snack menu is posted one week in advance, available for review, & dated. Solid waste bins are equipped with tight fitting lid. Facility representative is reminded to serve foods from at least two food groups according to Title 22 regulations "Food Services".

Bathrooms: Staff bathrooms are separate from the children's bathrooms. Toilets and faucets are in safe and sanitary operating condition. The children are able to reach the sinks, toilets, and supplies. Diaper changing table is within arms reach of the sink.

Outdoor Play Area: The playground outside is fully fenced and all equipment and surfaces are free from hazards, there is a canopy and trees to provide shade for the children. There are no bodies of water, or free-standing water accessible to children. There are age appropriate toys and materials for the children. Facility representative confirmed there are no pools are bodies of water at the facility.

809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PLEASANTON BILINGUAL MONTESSORI SCHOOL	FACILITY NUMBER: 013421338
	VISIT DATE: 03/21/2024

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Records: At 10:50 AM LPA requested and reviewed children and staff files. All individuals subject to criminal record review have a clearance and have been associated to the facility. LPA reviewed two (2) children’s files and three (3) staff files. LPA evaluated transcripts and signed the Evaluation of Teacher Qualifications (LIC 9095) form for two (2) staff members. LPA reviewed the facility roster and personnel report and copies were obtained. At least one opening/closing staff member has a current Pediatric CPR/First-Aid Certification. Mandated Reporter certificates were reviewed. Director’s CPR/First-Aid Certificate is current and expires on 12/7/25. Director was reminded of their responsibility to renew CPR/First Aid and Mandated Reporter certificates every two years. The center is in compliance with sign in and out procedure. Emergency Drills are recorded and performed at least every six months last one was 03/08/24. Per facility representative, there are no firearms on the premises.

CCLD Inspection Process: 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.

Criminal Record Clearance: 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.

Lead Testing: 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. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PLEASANTON BILINGUAL MONTESSORI SCHOOL	FACILITY NUMBER: 013421338
	VISIT DATE: 03/21/2024

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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 (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/.

MyChildCarePlan.org: 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.

Unusual Incident/Student Injury Report: Effective August 1, 2003 California Law requires Child Care Licensees 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 to the regional office by phone and the written report, LIC 624, within 7 business days.

No deficiencies found during today's inspection.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights Provided. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the facility representative, Li Guan.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

LIC809 (FAS) - (06/04)

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