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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408888
Report Date: 10/12/2023
Date Signed: 10/12/2023 01:18:31 PM


Document Has Been Signed on 10/12/2023 01:18 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:MONTESSORI IMPRESSIONS ACADEMYFACILITY NUMBER:
073408888
ADMINISTRATOR:KAUR, JATINDER P.FACILITY TYPE:
850
ADDRESS:20 ORINDA FIELDS LANETELEPHONE:
(925) 286-5164
CITY:ORINDASTATE: CAZIP CODE:
94563
CAPACITY:29CENSUS: 24DATE:
10/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Jatinder KaurTIME COMPLETED:
01:30 PM
NARRATIVE
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On 10/12/2023 at 9:15 AM Licensing Program Analyst (LPA), A. Curry conducted an unannounced required inspection. LPA met with designated facility Director, Jatinder Kaur. This is a preschool age program licensed for 29 children which operates Monday – Friday from 7:30 AM – 5:30 PM in studio 4 of the Art & Garden Center at Wilder Fields. Per the Director there are 24 children enrolled.

LPA A. Curry began facility tour with Director. All areas identified on the facility sketch were inspected. LPA observed 24 children with 3 staff. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times.

LPA observed the facility to be clean, safe, sanitary and in good repair. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. All toilets and hand washing facilities are in safe and sanitary operating conditions. Director was advised that a fully qualified staff must accompany children to the restroom located outside of the classroom. The director is also aware that Teacher's Aids cannot be alone with children. All materials and surfaces accessible to children are toxic free. At this time, an area in the classroom is used as an isolation area. Parents are contacted immediately when children are determined to be ill and staff are ensuring that children with obvious symptoms of illness are not being accepted.

Snack menus were reviewed. The facility provides snack only. All food storage areas are clean, free of litter, rubbish, and rodents/vermin. There is drinking water available in all indoor classrooms and individual water bottles are taken outdoors. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. The director indicated the facility has one or more functioning carbon monoxide detectors that meet statutory requirements, which is maintained by the City Of Orinda. The director indicated the carbon monoxide detector was last tested in June 2023. The licensee takes measures to keep the facility free of flies, other insects and rodents.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley CurryTELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2023
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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: MONTESSORI IMPRESSIONS ACADEMY
FACILITY NUMBER: 073408888
VISIT DATE: 10/12/2023
NARRATIVE
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Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Areas around and/or under climbing equipment have cushioning material to absorb a fall. The LPA observed the playground and restrooms being shared with the general public (See 809D). The director, Jatinder Kaur, was advised during the Prelicensing visit in 2020, that the facility must have exclusive use of the playground. The director was also advised today that the playground must not be used by the children in care when the public is there and the restrooms must be placed off-limit to the public. LPA did not observe any bodies of water during this visit. Director states there are no weapons or firearms on the premises.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Staff Records were reviewed to ensure that a health screening report and immunization records are on file. 1 staff did not have required immunization record in file (See 809D). Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed.



AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com

Lead testing is not required. LPA verified the construction of the building was completed on 06/02/2019.

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 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/.

Licensee 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.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley CurryTELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023
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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: MONTESSORI IMPRESSIONS ACADEMY
FACILITY NUMBER: 073408888
VISIT DATE: 10/12/2023
NARRATIVE
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Licensee 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.

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.


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


Exit interview conducted, appeal rights were given, and report was reviewed with the director, Jatinder Kaur.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley CurryTELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023
LIC809 (FAS) - (06/04)
Page: 3 of 8
Document Has Been Signed on 10/12/2023 01:18 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612


FACILITY NAME: MONTESSORI IMPRESSIONS ACADEMY
FACILITY NUMBER: 073408888

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above by ensuring all staff have the required immunization records in file, which poses/posed a potential health, safety or personal rights risk to persons in care. 1 staff did not have proof of immunity for Measles in file.
POC Due Date: 11/10/2023
Plan of Correction
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By 11/10/2023 email LPA proof of immunity for Measles for staff. LIC 859 was provided during today's visit.
Type B
Section Cited
CCR
101161(a)
Limitations on Capacity and Ambulatory Status
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview , the licensee did not comply with the section cited above by ensuring the playground and restrooms utilized by the child care facility are not being shared with the public, which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed the children in care and the public share the playground at the same time. LPA also observed the public using the restroom that should only be utlized by the day care children.
POC Due Date: 10/24/2023
Plan of Correction
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By 10/24/23 submit a written plan on how the facility will ensure the playground and restrooms are not being shared with the public. If the facility needs a waiver request to share the playground, please submit request in writing as soon as possible.
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: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley CurryTELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2023
LIC809 (FAS) - (06/04)
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