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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 196216291
Report Date: 07/08/2022
Date Signed: 07/08/2022 11:49:07 AM

Document Has Been Signed on 07/08/2022 11:49 AM - 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:MONTESSORI SCHOOL OF AGOURAFACILITY NUMBER:
196216291
ADMINISTRATOR:BISHAN SENEVIRATNEFACILITY TYPE:
850
ADDRESS:28124 W DRIVER AVETELEPHONE:
(818) 991-8936
CITY:AGOURA HILLSSTATE: CAZIP CODE:
91301
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 19DATE:
07/08/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:21 AM
MET WITH:Terri HoskinsTIME COMPLETED:
12:03 PM
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This is a change in ownership for the previous facility number 197414804 effective 7/8/2022.

On July 8, 2022 at 10:21 AM, Licensing Program Analysts (LPA's) conducted a pre-licensing change of ownership inspection. LPA's met with owner Bishan Seneviratne, previous owner Karen Kunstler, and facility Director Maria "Terri" Hoskins. LPA advised them the purpose of the inspection. LPA's were provided a tour of the facility inside and out. The center hours are Monday – Friday 8:00 am – 5:00 pm. There were 19 children in care at the time of the inspection.

LPA's observed required licensing notices posted prominently on the wall at the entrance of the facility. The facility will be using three (3) classrooms. LPA's observed enough restrooms for children in care. LPA's did not observe hazardous/toxin items accessible to children in care. LPA observed age appropriate toys and furnishings readily available to children. Children bring their snacks and lunch from home. The facility will provide a sleeping mat during quiet hours should children want to sleep. LPA observed age appropriate structures and play equipment readily accessible to children in the outdoor recreation area. The facility has ample amount of shade. The facility has water available for children inside and out. Children use their own water bottles brought from home.

Director was made aware that it is the facility's responsibility to know the current regulations for a CCC which can be accessed on-line at www.cdss.ca.gov.

The center meets Title 22 Division 12 requirements.

License will be effective today, July 8, 2022 for 60 children.

Continued on 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE: DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2022
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: MONTESSORI SCHOOL OF AGOURA
FACILITY NUMBER: 196216291
VISIT DATE: 07/08/2022
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THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817.

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 discussed the safe sleep regulations with Administrator and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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

Exit interview and report was conducted with Owner Bishan Seneviratne, previous owner Karen Kunstler, and facility Director Terri Hoskins.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
LIC809 (FAS) - (06/04)
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