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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371117
Report Date: 02/25/2025
Date Signed: 02/25/2025 12:58:23 PM

Document Has Been Signed on 02/25/2025 12:58 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:MONTESSORI INTERNATIONAL ACADEMYFACILITY NUMBER:
304371117
ADMINISTRATOR/
DIRECTOR:		SUMIKAWA, SUMIYOFACILITY TYPE:
840
ADDRESS:1211 E. DYER RD #110TELEPHONE:
(714) 444-2733
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY: 60TOTAL ENROLLED CHILDREN: 125CENSUS: 25DATE:
02/25/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Assistant Director-Megumi, FrancoTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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On 2/25/2025 at 9:10AM, Licensing Program Analysts (LPAs) Karen Navar and Susan Deschampe conducted an on site inspection for the purpose of an annual inspection. LPAs and Facility Representative Megumi, Franco toured the facility inside and outside and the floor and yard plan were verified. Census was taken in the individual classroom. The overall census observed was 25 school age children with 4 staff during work time.

During the inspection it was determined the facility is operating within its licensed capacity and within compliance with staffing ratios. Facility hours are 8:00a.m.- 6p.m., Monday through Friday. 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. Poisons/Hazardous Items are not kept on the premises.

Morning snacks and lunch is provided.Food is properly stored. Menus are posted and emailed where they could be reviewed by parents. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. There is drinking water available to children indoors through the water jugs, teachers refill cups or sports bottles with the child’s name on it as needed.

The children's bathrooms are clean and sanitary. Facility Representative stated that children do not nap and are offered a quiet time through different activities like books and yoga.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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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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: MONTESSORI INTERNATIONAL ACADEMY
FACILITY NUMBER: 304371117
VISIT DATE: 02/25/2025
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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 sand. Drinking water in the outdoor activity space is provided by cups or sports bottles with the child’s name on them and refilled as needed. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water or weapons present at the facility. The facility grounds were safe, sanitary and in good repair.

The facility has conducted an emergency drill within the past six months. 1/31/2025. The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirements. The California Child Passenger Safety Law was posted by the entrance of the facility.

4 out of 4 staff files were reviewed for staff present during the facility inspection on this date. 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 day care center if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis and measles for staff were reviewed and within compliance.

At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires 8/2026. 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.

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. Parent/Guardians uses an app called 1Coresolution for signing in and out. The procedure was reviewed for compliance. The person who signs the child in and out uses their full legal signature and records the time of the day.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
LIC809 (FAS) - (06/04)
Page: 2 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: MONTESSORI INTERNATIONAL ACADEMY
FACILITY NUMBER: 304371117
VISIT DATE: 02/25/2025
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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 childcare 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). LPAs verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.

This facility provides Incidental Medical Services and Facility Representative stated there are no children enrolled at this time who take medication at this time. LPAs 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.htmTransfer Request (LIC9182).

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

The facility representative was informed that Licensing Quarterly Updates are available at www.ccld.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.ccld.ca.gov . Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
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: MONTESSORI INTERNATIONAL ACADEMY
FACILITY NUMBER: 304371117
VISIT DATE: 02/25/2025
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LPAs discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs also informed director 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.

· Always place infants on their backs for sleeping
· Use only a tight-fitting sheet on the crib or play yard mattress.
· Do not hang any items from the crib or above the crib.
· Keep all items, including blankets, out of the crib or play yard.
· Pacifiers may be used if they do not have items attached to them.
· Infants shall not be swaddled or have any items covering them while sleeping.

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

The director understands 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 the initial presence in a licensed childcare facility. Violation of this requirement will result in a citation of a deficiency and civil penalties of one hundred dollars ($100) per violation per day for a maximum of five (5) days. Subsequent violations within a twelve (12) month period will result in a civil penalty of one hundred dollars ($100) per violation per day for a maximum of thirty (30) days in accordance with Section 1596.871 of the Health and Safety Code.

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

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
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: MONTESSORI INTERNATIONAL ACADEMY
FACILITY NUMBER: 304371117
VISIT DATE: 02/25/2025
NARRATIVE
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An Inspection and exit interview were completed with facility represnative. The report was reviewed and discussed.

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.

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: Thuy Ho
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
LIC809 (FAS) - (06/04)
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