300606148-1-28-2025-06-CC-VTRH-DDCRGF-20250128120039

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300606148
Report Date: 01/28/2025
Date Signed: 01/28/2025 12:00:52 PM

Document Has Been Signed on 01/28/2025 12:00 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	INT'L CHRISTIAN MONTESSORI ACADEMY OF ORANGE		FACILITY NUMBER:	300606148
ADMINISTRATOR/ DIRECTOR:	EMBRADOR, ALLISON		FACILITY TYPE:	850
ADDRESS:	1539 MAYFAIR		TELEPHONE:	(714) 997-8242
CITY:	ORANGE	STATE: CA	ZIP CODE:	92867
CAPACITY: 13	TOTAL ENROLLED CHILDREN: 13	CENSUS: 2	DATE:	01/28/2025
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:50 AM
MET WITH:	Embrador, Allison (Director)		TIME VISIT/ INSPECTION COMPLETED:	12:15 PM

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On 1/28/2025, Licensing Program Analyst (LPA) Trinh conducted an unannounced Required – Annual inspection assisted. LPA and the facility representative Valdez, Yolanda toured the facility inside and outside, and the floor and yard plan (LIC 999) were verified. Around 10:00 am Director arrived. Census was taken in individual classrooms. The overall census observed was two (2) preschool children supervised by one (1) teacher. During the inspection, it was determined the facility is operating within its licensed capacity and within compliance of staff-to-child ratios. Facility hours are 7:30 a.m.- 4:30 p.m., Monday through Friday.

CRIMINAL RECORD CLEARANCE: A review of the Facility Personnel Report Summary on this date, 01/28/25, indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. 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.

INDOOR INSPECTION: The LPA inspected the indoor areas and areas accessible to children at the time of the visit. The facility was equipped with working carbon monoxide and smoke detectors, working telephone service, and at least one fire extinguisher that meets statutory and State Fire Marshall standards. A record review shows that the last drill was documented on 10/28/2024. The director stated that there are no firearms and/or other dangerous weapons in the facility; none were observed during the inspection. Detergents, cleaning compounds, medicines, and other items that could pose a danger if readily available were inaccessible to clients in care. No poisons or other items that could pose a danger to children were observed during the inspection. The facility provides age-appropriate toys, play equipment, and materials for the children served.

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SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

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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Document Has Been Signed on 01/28/2025 12:00 PM - It Cannot Be Edited

Created By: Vivian Trinh On 01/28/2025 at 10:51 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: INT'L CHRISTIAN MONTESSORI ACADEMY OF ORANGE	FACILITY NUMBER: 300606148
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/28/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, The licensee did not comply with the section cited above. At 9:00 am, during staff file review and interview, 1 out 2 staff members did not have their mandated reporter training certificate expired 6/6/2024, which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/14/2025
	Plan of Correction
1 2 3 4	Director states will submit the updated/current Mandated Reporter training certificate for Staff #2 (S2) to LPA by the due date.

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above. At 9:00 am during the staff review and interview, 2 out of 2 staff members Pediatric first aid was expried on 1/12/2024, which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/14/2025
	Plan of Correction
1 2 3 4	Director states will submit the updated Pediatric First Aid certificate for 2 staff members to LPA by the due date.

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:

Nguyen K Tran

LICENSING EVALUATOR NAME:

Vivian Trinh

LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: INT'L CHRISTIAN MONTESSORI ACADEMY OF ORANGE	FACILITY NUMBER: 300606148
	VISIT DATE: 01/28/2025

NARRATIVE

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ON-SITE FOOD PREPARATION: This facility Parents will bring their own food to their own children. Drinking water is available to children indoors children bring their own water bottles from home with the child’s name on them, and also by water bottles and filtered water. The LPA observed that the facility’s floors, equipment, furniture, and children’s bathrooms were clean, in good repair, and free of sharp edges. The facility meets all posting requirements.

OUTDOOR INSPECTION: The outdoor activity space was inspected for compliance. The playground is enclosed by a fence at least four feet in height and is in good repair. The surface of the outdoor activity space is maintained and free of hazards. The cushioning material around outdoor play equipment and other similar equipment appeared to be enough to absorb falls. Drinking water in the outdoor activity space is provided by water bottles. The outdoor equipment and toys are in good repair and free of sharp edges. There are no bodies of water present at the facility. The inspected outdoor facility grounds are safe, sanitary and in good repair.

PERSONNEL RECORDS: Staff files were reviewed for staff present during the facility inspection on this date, 2 out of 2 staff files were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a child day care center if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for staff members were reviewed and within compliance. Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training and to renew the training every two years. At 10:00 am, during staff file review and interview, Staff 2 (S2) staff member did not have their mandated reporter training certificate expired 6/6/2024. At least one staff member present has current EMSA-approved Pediatric CPR/First Aid certifications expired on 1/12/2024.

CHILDREN’S RECORDS: Children's records were reviewed for compliance present during the facility inspection on this date, 2 out of 2 children files were reviewed Each child has a separate, complete, and current record. Sign in/out procedure was reviewed for compliance. Transportation is NOT or offered to children.

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SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: INT'L CHRISTIAN MONTESSORI ACADEMY OF ORANGE	FACILITY NUMBER: 300606148
	VISIT DATE: 01/28/2025

NARRATIVE

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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-carecenters/.

The Director was informed that Licensing Quarterly Updates are available at www.cdss.ca.gov Director may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.cdss.ca.gov

LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The facility representative was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative.

LEAD TESTING: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. Facility is exempt from lead testing requirement due to not using any water outlet for drinking and cooking.

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SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: INT'L CHRISTIAN MONTESSORI ACADEMY OF ORANGE	FACILITY NUMBER: 300606148
	VISIT DATE: 01/28/2025

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Based on LPA record review, the facility was not in compliance and is being cited in accordance to the Health and Safety Code; for the following violations; CCR 101216 (f) Personnel Requirement, and HSC 1596.8662(b)(1) Administration of Day Care Licensing on the attached LIC 809D.

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.

Appeal Rights and deficiencies were discussed. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and the report was reviewed with the director.

End of the Report.

SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Vivian Trinh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC809 (FAS) - (06/04)

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