198016696-3-16-2022-33-CC-TRAO-CCERC6-20220311115350

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016696
Report Date: 03/11/2022
Date Signed: 03/16/2022 08:50:33 AM

Document Has Been Signed on 03/16/2022 08:50 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	AMERICAN MONTESSORI PRESCHOOL		FACILITY NUMBER:	198016696
ADMINISTRATOR:	NOELINE SHANMUGAN		FACILITY TYPE:	830
ADDRESS:	4817 EAGLE ROCK BLVD.		TELEPHONE:	(323) 257-3709
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90041
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS:	DATE:	03/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:53 AM
MET WITH:	Vlasta Blaha, Staff		TIME COMPLETED:	12:00 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 3/11/2022 at 8:53AM, Licensing Program Analyst (LPA) Thelma Razo arrived at the facility to conduct an unannounced Required – 1 year inspection. LPA met with staff Helen Mangahis and stated the purpose of the visit. A COVID-19 risk assessment was made prior to entry to the facility. At 9:10AM, staff Vlasta Blaha arrived. LPA provided Ms. Blaha with a copy of the LIC 125 Entrance Checklist to facilitate the inspection. This is an infant program which consists of one classroom. Facility hours of operation is from Monday to Friday, 7:00AM to 5:00PM. This facility has a preschool component (LIC #198020038). LPA was guided to a facility tour by Ms. Blaha at 9:24AM. All areas identified on the Facility Sketch were inspected. The infant program is located next to the center's preschool program. Two classrooms were observed with 2 staff and 8 infants. The facility was operating within the license capacity and limitations. The following was observed during the tour of the facility: Furniture and equipment were inspected for age appropriateness and good repair. The facility has enough napping equipment, feeding chairs, and changing tables. Infants in this program are from the age of 6 weeks to 24 months. Infants sleep on the cribs and toddlers on the cots. No infants were observed to be swaddled. Telephone service, heating, lighting and ventilation were evaluated. Infants have their own cubby to store their belongings. Bedding is provided by the parents and is washed at the end of the week, or as needed. Per Ms. Blaha, the isolation area is located in her office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in the classroom. First Aid supplies were observed. Disinfectants, cleaning solutions, and other items that are dangerous to infants, were inaccessible to infants. All floors were observed to be clean and safe. All materials accessible to infants were observed to be toxic free. Per Ms. Blaha, there are no firearms stored on the premises. There are no pools or bodies of water at the facility. Page 1 of 3

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AMERICAN MONTESSORI PRESCHOOL	FACILITY NUMBER: 198016696
	VISIT DATE: 03/11/2022

NARRATIVE

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Ms. Blaha stated that there were no poisons stored at the facility. Carbon monoxide detector was tested and was operational. All food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin.

All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Infants are on formula and soft foods. Snack menu was observed to be posted. Food in refrigerator was labeled. Sink counter tops were clean and free of clutter or standing food. Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request.

The outdoor playground was observed to be physically separate from the preschool component. Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. The outdoor surface is cushioned with material that absorbs a fall. There is adequate shade in the play yard. LPA advised that no children shall be left without the supervision of a teacher at any time.

Children’s Records were reviewed. Infant Needs and Service plans were reviewed and observed to be in each file and renewed at least quarterly or as needed. Facility have a sleeping log in which infants are physically checked on by staff every 15 minutes. Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in.

LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present have proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present have proof of TB negative test, measles, pertussis, and influenza. All staff have been given on-the-job training sanitation principles, housekeeping, including universal health precautions. All staff present have obtained a criminal record clearance or criminal record exemption as a condition of employment. All staff present were trained in CPR and Pediatric First Aid during this inspection.

According to the staff, there are currently no infants on medication.

Page 2 of 3

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AMERICAN MONTESSORI PRESCHOOL	FACILITY NUMBER: 198016696
	VISIT DATE: 03/11/2022

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

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/tion-process.

There were no deficiencies cited during today’s inspection.

A Notice of Site visit was posted and must remain for 30 days.

Exit interview conducted and report was reviewed with facility representative Vlasta Blaha.

Page 3 of 3

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022

LIC809 (FAS) - (06/04)

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