191201656-6-7-2022-30-CC-DLOE-CF6QN6-20220607121838

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191201656
Report Date: 06/07/2022
Date Signed: 06/07/2022 12:18:43 PM

Document Has Been Signed on 06/07/2022 12:18 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	CASA MONTESSORI, INC		FACILITY NUMBER:	191201656
ADMINISTRATOR:	CONSUELO VALERA		FACILITY TYPE:	850
ADDRESS:	17633 LASSEN STREET		TELEPHONE:	(818) 886-7922
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY: 72	TOTAL ENROLLED CHILDREN: 47	CENSUS: 38	DATE:	06/07/2022
TYPE OF VISIT:	Case Management - COVID-19	UNANNOUNCED	TIME BEGAN:	08:10 AM
MET WITH:	Consuelo Valera, Director		TIME COMPLETED:	10:00 AM

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On 6/07/2022 at 8:10 am, Licensing Program Analyst (LPA) Deborah Lowe conducted an unannounced Case Management – Incident inspection for the purpose of following up on an Unusual Incident Reports (UIR) submitted on 6/01/2022 for COVID-19. LPA Lowe met with Director, Consuelo Valera, who toured LPA through the inside and outside of the facility.

LPA observed 38 children in care with 4 staff and 1 volunteer. Staff present were observed to have their criminal record clearances. At 8:44 am LPA Lowe found through Guardian review and interview, today was the volunteers first day and background clearance did not show in Guardian under facility roster.

LPA Lowe researched volunteer in Guardian and found the volunteer to have a background clearance. LPA Lowe worked with facility to associate volunteer to facility during visit. LPA Lowe provided information about the Guardian System including showing Director and Office Administrator on the computer where to sign up and view tutorials. LPA Lowe provided consultation on the importance of using Guardian and the following regulation.

LPA Lowe advised per CCR Criminal Record Clearance 101170 (e)(1)(2) 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: (1) Obtain a California clearance or a criminal record exemption as required by the Department or (2) Request a transfer of a criminal record clearance as specified in Section 101170(f).

Facility representative 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.

According to the UIR, on 06/01/2022 - 1 child was reported as testing positive for COVID-19 on 5/24/2022. LPA Lowe completed a COVID-19 follow up with Director. Observation of classrooms shows some children

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CASA MONTESSORI, INC	FACILITY NUMBER: 191201656
	VISIT DATE: 06/07/2022

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and staff are wearing masks, children are sitting 2 to a table, and hand washing signs in the bathrooms.

LPA observed parents dropping children off at the door with a teacher standing at the classroom door greeting the parent and the children. Parents did not go into the classrooms. Sign in/out sheets were observed just outside of each classroom door with parents using full signatures.

Facility has a supply of supplies to assist in the cleaning and sanitation of the classrooms. Facility has gloves, hand sanitizer, masks, and disinfecting spray dispensers. LPA observed the children washing hands upon arrival and between activities. COVID-19 signs are no longer posted in facility but notice of visitor policy was observed posted at the entrance of the facility along with a hand sanitizer system.

Director stated facility provides COVID-19 testing every Wednesday and no new cases of COVID-19 have been reported.

LPA Lowe discussed with Director current COVID-19 resources and guidance.

No deficiencies are cited, per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

An exit interview was conducted and a copy of this report (LIC 809) and Notice of Site Visit were provided to Director, Consuelo Valera

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022

LIC809 (FAS) - (06/04)

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