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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283007857
Report Date: 03/09/2023
Date Signed: 03/09/2023 01:12:55 PM

Document Has Been Signed on 03/09/2023 01:12 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:NAPA MONTESSORI CHILDREN'S HOUSE, INC.FACILITY NUMBER:
283007857
ADMINISTRATOR:PERERA, CHANDINIFACILITY TYPE:
850
ADDRESS:29 WINESTONE COURTTELEPHONE:
(707) 266-1596
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY: 14TOTAL ENROLLED CHILDREN: 17CENSUS: 14DATE:
03/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:43 AM
MET WITH:Chandini Perera, Licensee and DirectorTIME COMPLETED:
01:04 PM
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An annual required inspection was made to the facility by Licensing Program Analyst (LPA), Y. Yang. The facility file was reviewed prior to this inspection. A review of the personnel report on 03/09/23 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The licensee/center director 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.

The LPA met with the facility's licensee/center director, Chandini Perera today. The facility’s operating hours are 08:30am-02:30pm, Monday to Friday and extended care 02:30pm to 04:30pm on Tuesday to Thursday. This facility has a waiver on file with the Department. The conditions of the waiver were being met during today's inspection visit. The facility was toured inside and outside and the floor and yard plan submitted by the licensee were verified. The toys, floors, desks and other equipment and surfaces were clean, free of toxins, safe and in good condition. The facility was free of flies, insects and rodents. There is drinking water available to children both indoors in the classroom and outdoors on the playground. The children’s bathrooms were in sanitary condition. Food prep areas are clean. Food is properly stored and free of contamination. No menu was posted; children bring all meals and snacks from home. Garbage cans containing solid waste were in good repair and had tight fitting lids. The facility's yard is fully fenced and free of hazards. There are no climbing structures in the play yard that require fall cushioning. There were no bodies of water observed. The director stated no weapons or poisons are stored on site. During today's inspection, staffing ratios were being met and there were 14 children being supervised by two staff members. The facility was operating within the licensed capacity. At least one staff member present during the visit possessed current CPR and First Aid certifications. The sign in/out sheet was reviewed and was in compliance with regulations. Ten children’s records were reviewed and contained identification forms with authorized representative information, as well as medical assessment forms. Two staff files were reviewed and contained the required documents as specified on the inspection checklist. Continued on LIC 809-C
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/09/2023
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: NAPA MONTESSORI CHILDREN'S HOUSE, INC.
FACILITY NUMBER: 283007857
VISIT DATE: 03/09/2023
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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.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee/center director, Chandini Perera. There were no Title 22 deficiencies cited during today's inspection.

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

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023
LIC809 (FAS) - (06/04)
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