304370799-8-1-2023-06-CC-AFCN-CUAPJD-20230801112123

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370799
Report Date: 08/01/2023
Date Signed: 08/01/2023 11:21:29 AM

Document Has Been Signed on 08/01/2023 11:21 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	MONTESSORI INTERNATIONAL ACADEMY		FACILITY NUMBER:	304370799
ADMINISTRATOR:	MAKI KOBAYASHI		FACILITY TYPE:	850
ADDRESS:	2717 SOUTH HALLADAY STREET		TELEPHONE:	(714) 444-2733
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92705
CAPACITY:	114	CENSUS: 15	DATE:	08/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:25 AM
MET WITH:	Assistant Director Megumi Kuboshima		TIME COMPLETED:	11:40 AM

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 08/01/2023, Licensing Program Analyst (LPA), Anna Chan conducted an onsite inspection for the purpose of an Annual Random Visit. LPA met with Assistant Director Megumi Kuboshima. LPA and Assistant Director toured the facility inside and outside and the floor and yard plan were verified. Census was taken. The overall census observed was 15 daycare children and 4 staff and 1 security staff. It is daycare hours (8:00am-9:00am) at the outdoor play yard when LPA arrived at the facility. At around 9:00am, Director Maki Kobayashi arrived at the facility. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 8:00a.m.- 6:00p.m., Monday through Friday. (Early daycare drop off is 8:00am to 9:00am and program starts at 9:00am and ends at 3:30pm, 3:30pm-6:00pm is the extended care hours.) A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Age-appropriate materials such as books, puzzles, indoor plants, blocks, pretend play are provided. Lunch and AM/PM snacks are provided by the facility, home lunch can also be brought by children from home. Food is prepared on site. Food prep areas were clean and sanitary. Food is properly stored. Menus were sent to parents monthly and also posted in the office. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. There is filtered drinking water available to children indoors and sports bottle are also brought by children from home with the child’s name on it. Page 1 of 3

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Anna Francesca Chan	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI INTERNATIONAL ACADEMY	FACILITY NUMBER: 304370799
	VISIT DATE: 08/01/2023

NARRATIVE

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The children's bathrooms are clean and sanitary. Children nap on cots/mats, and bedding is stored individually. Blankets and sheets are brought home every Friday and brought back on child’s first day back in school. The facility has conducted an emergency drill on July 14, 2023. The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility.

The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The surface of the outdoor activity space was well maintained and free of hazards. The cushioning material is grass and appeared to be enough to absorbs falls. There are slides, pretend kitchen, climbing equipment around the playground, filtered drinking water in the outdoor activity space is provided and sports bottles with the child’s name on it. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility. The facility grounds were safe, sanitary and in good repair.

Staff files were reviewed for staff present during the facility inspection on this date, 5 staff files were reviewed. Health screening and immunization as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for the facility were reviewed and within compliance.

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.

Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporter training, and to renew the training every two years. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires 08/2024

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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Anna Francesca Chan	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI INTERNATIONAL ACADEMY	FACILITY NUMBER: 304370799
	VISIT DATE: 08/01/2023

NARRATIVE

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5 Children's records were reviewed, and there was a separate, complete and current record for each child. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed for compliance. One Core app is used to sign in and out children.

LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

Transfer Request (LIC9182). The Director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov and 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.ccld.ca.gov
LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

The areas that were evaluated, NO deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

An Inspection and exit interview were completed with Director Maki Kobayashi. The report was reviewed and discussed. Appeal Rights were discussed. The facility representative 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.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Anna Francesca Chan	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

LIC809 (FAS) - (06/04)

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